TY - JOUR
T1 - Exposure to particulate matter (PM2.5) and prevalence of diabetes mellitus in Indonesia
AU - Suryadhi, Made Ayu Hitapretiwi
AU - Suryadhi, Putu Ayu Rhamani
AU - Abudureyimu, Kawuli
AU - Ruma, I. Made Winarsa
AU - Calliope, Akintije Simba
AU - Wirawan, Dewa Nyoman
AU - Yorifuji, Takashi
N1 - Funding Information:
This research was supported by grant No. 17K09085 to investigator Takashi Yorifuji from JSPS KAKENHI, Japan . The sponsor was not involved in the study design, the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the paper for publication.
Funding Information:
The authors acknowledge the National Institute of Health Research and Development, Indonesia (NIHRD), The Indonesia Ministry of Health and Saori Irie for their valuable support. This research was supported by grant No. 17K09085 to investigator Takashi Yorifuji from JSPS KAKENHI, Japan. The sponsor was not involved in the study design, the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the paper for publication.
Publisher Copyright:
© 2020 The Authors
PY - 2020/7
Y1 - 2020/7
N2 - Background: Recently emerging evidence suggests an association between particulate matter less than 2.5 µm in diameter (PM2.5) exposure and diabetes risk. However, evidence from Asia is limited. Here, we evaluated the association between PM2.5 exposure and the prevalence of diabetes mellitus in one of the most populated countries in Asia, Indonesia. Methods: We used the 2013 Indonesia Basic Health Research, which surveyed households in 487 regencies/municipalities in all 33 provinces in Indonesia (n = 647,947). We assigned individual exposure to PM2.5 using QGIS software. Multilevel logistic regression with a random intercept based on village and cubic spline analysis were used to assess the association between PM2.5 exposure and the prevalence of diabetes mellitus. We also assessed the lower exposure at which PM2.5 has potential adverse effects. Results: We included 647,947 subjects with a mean age of 41.9 years in our study. Exposure to PM2.5 levels was associated with a 10-unit increase in PM2.5 (fully adjusted odds ratio: 1.09; 95% confidence interval: 1.05–1.14). The findings were consistent for quartile increases in PM2.5 levels and the cubic spline function. Even when we restricted to those exposed to PM2.5 concentrations of less than 10.0 µg/m3 in accordance with the recommended guidelines for annual exposure to PM2.5 made by the World Health Organization, the association remained elevated, especially among subjects living in the urban areas. Hence, we were unable to establish a safe threshold for PM2.5 and the risk of diabetes. Conclusions: Our findings suggest a positive association between PM2.5 exposure and prevalence of diabetes mellitus, which is possibly below the current recommended guidelines. Further studies are needed to ascertain the causal association of this finding.
AB - Background: Recently emerging evidence suggests an association between particulate matter less than 2.5 µm in diameter (PM2.5) exposure and diabetes risk. However, evidence from Asia is limited. Here, we evaluated the association between PM2.5 exposure and the prevalence of diabetes mellitus in one of the most populated countries in Asia, Indonesia. Methods: We used the 2013 Indonesia Basic Health Research, which surveyed households in 487 regencies/municipalities in all 33 provinces in Indonesia (n = 647,947). We assigned individual exposure to PM2.5 using QGIS software. Multilevel logistic regression with a random intercept based on village and cubic spline analysis were used to assess the association between PM2.5 exposure and the prevalence of diabetes mellitus. We also assessed the lower exposure at which PM2.5 has potential adverse effects. Results: We included 647,947 subjects with a mean age of 41.9 years in our study. Exposure to PM2.5 levels was associated with a 10-unit increase in PM2.5 (fully adjusted odds ratio: 1.09; 95% confidence interval: 1.05–1.14). The findings were consistent for quartile increases in PM2.5 levels and the cubic spline function. Even when we restricted to those exposed to PM2.5 concentrations of less than 10.0 µg/m3 in accordance with the recommended guidelines for annual exposure to PM2.5 made by the World Health Organization, the association remained elevated, especially among subjects living in the urban areas. Hence, we were unable to establish a safe threshold for PM2.5 and the risk of diabetes. Conclusions: Our findings suggest a positive association between PM2.5 exposure and prevalence of diabetes mellitus, which is possibly below the current recommended guidelines. Further studies are needed to ascertain the causal association of this finding.
KW - Air pollution
KW - Diabetes mellitus
KW - Environmental epidemiology
KW - Environmental health
KW - Indonesia
KW - Particulate matter
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U2 - 10.1016/j.envint.2020.105603
DO - 10.1016/j.envint.2020.105603
M3 - Article
C2 - 32344253
AN - SCOPUS:85083740566
VL - 140
JO - Environmental International
JF - Environmental International
SN - 0160-4120
M1 - 105603
ER -
