title: Effect of long-term exposure to air pollution on type 2 diabetes mellitus risk: a systemic review and meta-analysis of cohort studies.
abstract: OBJECTIVE
  To assess the effect of long-term exposure to air pollution on type 2 diabetes risk, a meta-analysis of prospective cohort studies was performed.
  
  
  METHODS
  Literature search was conducted with Pubmed, Embase, and Web of Science for prospective cohort studies investigating the association of type 2 diabetes risk with increments in particulate matter (PM, diameter<2.5 μm (PM2.5) or <10 μm (PM10)) or nitrogen dioxide (NO2). We used a random-effects model to calculate the overall relative risk (RR) with 95% CI.
  
  
  RESULTS
  Of 808 identified articles, ten cohort studies were finally included, which involved a total of 2 37,1 907 participants and 21,095 incident cases of type 2 diabetes. Elevated risk of type 2 diabetes was significantly associated with long-term exposures to high levels of PM2.5 (RR=1.28, 95% CI 1.06-1.55, P=0.009, I2=83.5%), PM10 (RR=1.15, 95% CI 1.02-1.30, P=0.022, I2=0%), and NO2 (RR=1.12, 95% CI 1.02-1.23, P=0.015, I2=63.5%). When using standardized risk estimates, the RRs of type 2 diabetes were significant for increments in concentrations of PM2.5 (1.39 per 10 μg/m3 increment, 95% CI 1.14-1.68, P=0.001), PM10 (1.34 per 10 μg/m3 increment, 95% CI 1.22-1.47, P<0.001), and NO2 (1.11 per 10 μg/m3 increment, 95% CI 1.07-1.16, P<0.001). No obvious evidence of publication bias was observed.
  
  
  CONCLUSIONS
  Long-term exposure to high levels of main air pollutants is significantly associated with elevated risk of type 2 diabetes mellitus.
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China nlwang@126.com robin.wangqy@gmail.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China.
authors.forename: Donghua
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China.
authors.forename: Zhaohai
authors.initials: Z
authors.lastname: Jing
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China.
authors.forename: Shengli
authors.initials: S
authors.lastname: Yan
authors.affiliation: Department of EndocrinologyThe Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, ChinaEssencemed ClinicWeifang 261000, ChinaDepartment of RheumatologyFirst Affiliated Hospital of Nanjing Medical University, Nanjing 210029, ChinaDepartment of Urinary SurgerySouthwest Hospital Affiliated to Third Military Medical University, Chongqing 400038, China nlwang@126.com robin.wangqy@gmail.com.
authors.forename: Yangang
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D052638:Particulate Matter / Q000633:toxicity; D012307:Risk Factors; D013997:Time Factors
chemical_list: D052638:Particulate Matter