Abstract
BACKGROUND: Exposure to fine particulate matter (PM(2.5)) and its constituents (SO(4)(2-), NO(3)(-), NH(4)(+), OM, BC) is strongly linked to the incidence of diabetes. This study aimed to assess the health benefits of improved air quality on the incidence risk of type 2 diabetes mellitus (T2DM). METHODS: Data from 19,884 participants in the Jinchang Cohort were analyzed. The concentration levels of PM(2.5) and its constituents were obtained from the China Air Pollution Tracking (TAP) dataset. The effects of reduced pollutant concentrations on the risk of T2DM and glucose and lipid indicators were assessed via Cox proportional hazards models and generalized linear models (GLMs). Exposure‒response relationships were plotted, with subgroup analyses by sex and age. The combined effects of multiple pollutants were also evaluated. RESULTS: A decrease in the concentration of mixed pollutants was significantly associated with a reduced risk of T2DM (HR = 0.57, 95% CI: 0.52,0.62), as well as significantly lower levels of fasting plasma glucose variation (ΔFPG; β = -0.62, 95% CI: -0.79, -0.45), total cholesterol variation (ΔTC; β = -0.62, 95% CI: -0.98, -0.26), triglyceride variation (ΔTG; β = -5.08, 95% CI: -6.76, -3.40), and low-density lipoprotein cholesterol variation (ΔLDL-C; β = -3.99, 95% CI: -4.42, -3.55). In comparison, similar inverse associations were also observed in single-pollutant models. The effects appeared to be slightly stronger among females and older adults than among males and younger individuals. CONCLUSION: Reductions in the concentrations of PM(2.5) and its constituents were significantly associated with a lower risk of T2DM and improvements in glucose and lipid metabolism, particularly for decreases in mixed pollutant concentrations. Subgroup analyses suggested that women and older adults may be the primary beneficiaries of improved air qualities.