title: Long-term exposure to traffic-related air pollution and type 2 diabetes prevalence in a cross-sectional screening-study in the Netherlands.
abstract: BACKGROUND
  Air pollution may promote type 2 diabetes by increasing adipose inflammation and insulin resistance. This study examined the relation between long-term exposure to traffic-related air pollution and type 2 diabetes prevalence among 50- to 75-year-old subjects living in Westfriesland, the Netherlands.
  
  
  METHODS
  Participants were recruited in a cross-sectional diabetes screening-study conducted between 1998 and 2000. Exposure to traffic-related air pollution was characterized at the participants' home-address. Indicators of exposure were land use regression modeled nitrogen dioxide (NO2) concentration, distance to the nearest main road, traffic flow at the nearest main road and traffic in a 250 m circular buffer. Crude and age-, gender- and neighborhood income adjusted associations were examined by logistic regression.
  
  
  RESULTS
  8,018 participants were included, of whom 619 (8%) subjects had type 2 diabetes. Smoothed plots of exposure versus type 2 diabetes supported some association with traffic in a 250 m buffer (the highest three quartiles compared to the lowest also showed increased prevalence, though non-significant and not increasing with increasing quartile), but not with the other exposure metrics. Modeled NO2-concentration, distance to the nearest main road and traffic flow at the nearest main road were not associated with diabetes. Exposure-response relations seemed somewhat more pronounced for women than for men (non-significant).
  
  
  CONCLUSIONS
  We did not find consistent associations between type 2 diabetes prevalence and exposure to traffic-related air pollution, though there were some indications for a relation with traffic in a 250 m buffer.
authors: Department of Environmental Health, Public Health Service Amsterdam, Amsterdam, the Netherlands. mdijkema@ggd.amsterdam.nl
authors: Marieke B A
authors: MB
authors: Dijkema
authors: Sanne F
authors: SF
authors: Mallant
authors: Ulrike
authors: U
authors: Gehring
authors: Katja
authors: K
authors: van den Hurk
authors: Marjan
authors: M
authors: Alssema
authors: Rob T
authors: RT
authors: van Strien
authors: Paul H
authors: PH
authors: Fischer
authors: Giel
authors: G
authors: Nijpels
authors: Coen D A
authors: CD
authors: Stehouwer
authors: Gerard
authors: G
authors: Hoek
authors: Jacqueline M
authors: JM
authors: Dekker
authors: Bert
authors: B
authors: Brunekreef
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009585:Nitrogen Dioxide / Q000032:analysis / Q000633:toxicity*; D015995:Prevalence; D012111:Residence Characteristics; D012424:Rural Population; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D001335:Vehicle Emissions / Q000032:analysis / Q000633:toxicity*
chemical_list: D000393:Air Pollutants; D001335:Vehicle Emissions; D009585:Nitrogen Dioxide