title: Systemic inflammation (C-reactive protein) in type 2 diabetic patients is associated with ambient air pollution in Pune City, India.
abstract: OBJECTIVE
  To study the association between ambient air pollutants and serum C-reactive protein (CRP) concentration in 1,392 type 2 diabetic patients in Pune, India.
  
  
  METHODS
  A cross-sectional study was conducted that linked daily time series of ambient air pollution data (obtained from central monitoring sites) and plasma CRP concentration in type 2 diabetic patients from the Wellcome Trust Genetic (WellGen) Study, recruited between March 2005 and May 2007. Air pollution effects on CRP concentration were investigated with delays (lags) of 0-7 days and multiday averaging spans of 7, 14, and 30 days before blood collection adjusted for age, sex, BMI, hemoglobin, fasting plasma glucose, treatment with agents with anti-inflammatory action, season, air temperature, and relative humidity.
  
  
  RESULTS
  Median CRP concentration was 3.49 mg/L. For 1 SD increase in SO(2) and oxides of nitrogen (NO(x)) concentrations in ambient air, a day before blood collection (lag(1)), we observed a significant increase in CRP (9.34 and 7.77%, respectively). The effect was higher with lag(2) (12.42% for SO(2) and 11.60% for NO(x)) and wore off progressively thereafter. We also found a significant association with multiday averaging times of up to 30 and 7 days for SO(2) and NO(x), respectively. No significant associations were found between particulate matter with an aerodynamic profile ≤10 µm (PM(10)) and CRP concentration except in summer. The association was significantly higher among patients with a shorter duration of diabetes, and in those not on statin and thiazolidinedione treatment.
  
  
  CONCLUSIONS
  We demonstrate, for the first time, a possible contribution of ambient air pollution to systemic inflammation in Indian type 2 diabetic patients. This may have implications for vascular complications of diabetes.
authors.affiliation: Department of Health, Jondi-Shapour University of Medical Sciences, Ahvaz, Iran.
authors.forename: Morteza A
authors.initials: MA
authors.lastname: Khafaie
authors.forename: Sundeep S
authors.initials: SS
authors.lastname: Salvi
authors.forename: Ajay
authors.initials: A
authors.lastname: Ojha
authors.forename: Behzad
authors.initials: B
authors.lastname: Khafaie
authors.forename: Sharad S
authors.initials: SS
authors.lastname: Gore
authors.forename: Chittaranjan S
authors.initials: CS
authors.lastname: Yajnik
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007249:Inflammation / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged
chemical_list: D002097:C-Reactive Protein