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Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2·5 air pollution, 1990–2019: an analysis of data from the Global Burden of Disease Study 2019

Publicado en:Lancet Planet Health. 6 (7): e586-e600 - 2022-01-01 6(7), DOI: 10.1016/S2542-5196(22)00122-X

Autores: Burkart K; Causey K; Cohen AJ; Wozniak SS; Salvi DD; Abbafati C; Adekanmbi V; Adsuar JC; Ahmadi K; Alahdab F; Al-Aly Z; Alipour V; Alvis-Guzman N; Amegah AK; Andrei CL; Andrei T; Ansari F; Arabloo J; Aremu O; Aripov T; Babaee E; Banach M; Barnett A; Bärnighausen TW; Bedi N; Behzadifar M; Béjot Y; Bennett DA; Bensenor IM; Bernstein RS; Bhattacharyya K; Bijani A; Biondi A; Bohlouli S; Breitner S; Brenner H; Butt ZA; Cámera LA; Cantu-Brito C; Carvalho F; Cerin E; Chattu VK; Chauhan BG; Choi J-YJ; Chu D-T; Dai X; Dandona L; Dandona R; Daryani A; Davletov K; De Courten B; Demeke FM; Denova-Gutiérrez E; Dharmaratne SD; Dhimal M; Diaz D; Djalalinia S; Duncan BB; El Sayed Zaki M; Eskandarieh S; Fareed M; Farzadfar F; Fattahi N; Fazlzadeh M; Fernandes E; Filip I; Fischer F; Foigt NA; Freitas M; Ghashghaee A; Gill PS; Ginawi IA; Gopalani SV; Guo Y; Gupta RD; Habtewold TD; Hamadeh RR; Hamidi S; Hankey GJ; Hasanpoor E; Hassen HY; Hay SI; Heibati B; Hole MK; Hossain N; Househ M; Irvani SSN; Jaafari J; Jakovljevic M; Jha RP; Jonas JB; Jozwiak JJ; Kasaeian A; Kaydi N; Khader YS; Khafaie MA; Khan EA; Khan J; Khan MN; Khatab K; Khater AM; Kim YJ; Kimokoti RW; Kisa A; Kivimäki M; Knibbs LD; Kosen S; Koul PA; Koyanagi A; Defo BK; Kugbey N; Lauriola P; Lee PH; Leili M; Lewycka S; Li S; Lim L-L; Linn S; Liu Y; Lorkowski S; Mahasha PW; Mahotra NB; Majeed A; Maleki A; Malekzadeh R; Mamun AA; Manafi N; Martini S; Meharie BG; Menezes RG; Mestrovic T; Miazgowski B; Miazgowski T; Miller TR; Mini GK; Mirica A; Mirrakhimov EM; Mohajer B; Mohammed S; Mohan V; Mokdad AH; Monasta L; Moraga P; Morrison SD; Mueller UO; Mukhopadhyay S; Mustafa G; Muthupandian S; Naik G; Nangia V; Ndwandwe DE; Negoi RI; Ningrum DNA; Noubiap JJ; Ogbo FA; Olagunju AT; Onwujekwe OE; Ortiz A; Owolabi MO; Mahesh PA; Panda-Jonas S; Park E-K; Kan FP; Pirsaheb M; Postma MJ; Pourjafar H; Radfar A; Rafiei A; Rahim F; Rahimi-Movaghar V; Rahman MA; Rai RK; Ranabhat CL; Raoofi S; Rawal L; Renzaho AMN; Rezapour A; Ribeiro D; Roever L; Ronfani L; Sabour S; Saddik B; Sadeghi E; Moghaddam SS; Sahebkar A; Sahraian MA; Salimzadeh H; Salvi SS; Samy AM; Sanabria J; Sarmiento-Suárez R; Sathish T; Schmidt MI; Schutte AE; Sepanlou SG; Shaikh MA; Sharafi K; Sheikh A; Shigematsu M; Shiri R; Shirkoohi R; Shuval K; Soyiri IN; Tabarés-Seisdedos R; Tefera YM; Tehrani-Banihashemi A; Temsah M-H; Thankappan KR; Topor-Madry R; Car LT; Ullah I; Vacante M; Valdez PR; Vasankari TJ; Violante FS; Waheed Y; Wolfe CDA; Yamada T; Yonemoto N; Yu C; Zaman SB; Zhang Y; Zodpey S; Lim SS; Stanaway JD; Brauer M

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Background: Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods: We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings: In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation: Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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