title: The Association Between Air Pollution Exposure and Glucose and Lipids Levels.
abstract: Evidence from recent decades supports a causal association between air pollution (particulate matter <10 μm in diameter [PM10] and PM <2.5 μm in diameter [PM2.5]) and oxidative stress, possibly involving impaired metabolism of glucose and lipids.
  
  
  
  Using a satellite based model to assess PM exposure at 1-km spatial resolution, we examined the associations between PM and glucose, hemoglobin A1c (HbA1c), and lipids.
  
  
  
  Population-based retrospective cohort study of a 10-year period.
  
  
  
  Members of the largest health care provider in Southern Israel.
  
  
  
  We included all serum glucose, HbA1c, and lipids tests of subjects with known cardiovascular diseases and risk factors. Subjects' glycemic status was defined as normal or diabetes.
  
  
  
  Log-transformed glucose, HbA1c, and lipid values were explored by mixed models, with adjustment for personal and seasonal confounders.
  
  
  
  We assessed 73 117 subjects with over 600 000 samples. Three-month average concentration of PM10, but not 1- to 7-d exposure, was associated with increases of serum glucose, HbA1c, low-density lipoprotein and triglycerides, and decrease of high-density lipoprotein. The strongest associations were observed among subjects with diabetes (percent increase [95% confidence interval], for interquartile range increase of PM10 and PM2.5): 3.58% (1.03%; 6.20%) and 2.93% (0.35%; 5.59%) increase in HbA1c and 2.37% (2.11%; 2.63%) and 1.54% (1.26%; 1.83%) increase in low-density lipoprotein. Antidiabetic medications (other than insulin) attenuated the air pollution effect on serum glucose.
  
  
  
  Intermediate-term, but not short term, exposure to PM is associated with alterations in glucose, HbA1c, and lipids, especially among people with diabetes.
authors.affiliation: Department of Medicine (M.Y.S., I.F.L., V.N.), Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Clinical Research Center (M.Y.S., V.N.), Soroka University Medical Center, Beer Sheva, Israel 84101; Department of Geography and Environmental Development (I.K.), Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Asuta Medical Center (I.F.L.), Beer Sheva, Israel 8489507; and Environmental Epidemiology Program (J.S.), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115.
authors.forename: Maayan
authors.initials: M
authors.lastname: Yitshak Sade
authors.affiliation: Department of Medicine (M.Y.S., I.F.L., V.N.), Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Clinical Research Center (M.Y.S., V.N.), Soroka University Medical Center, Beer Sheva, Israel 84101; Department of Geography and Environmental Development (I.K.), Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Asuta Medical Center (I.F.L.), Beer Sheva, Israel 8489507; and Environmental Epidemiology Program (J.S.), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115.
authors.forename: Itai
authors.initials: I
authors.lastname: Kloog
authors.affiliation: Department of Medicine (M.Y.S., I.F.L., V.N.), Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Clinical Research Center (M.Y.S., V.N.), Soroka University Medical Center, Beer Sheva, Israel 84101; Department of Geography and Environmental Development (I.K.), Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Asuta Medical Center (I.F.L.), Beer Sheva, Israel 8489507; and Environmental Epidemiology Program (J.S.), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115.
authors.forename: Idit F
authors.initials: IF
authors.lastname: Liberty
authors.affiliation: Department of Medicine (M.Y.S., I.F.L., V.N.), Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Clinical Research Center (M.Y.S., V.N.), Soroka University Medical Center, Beer Sheva, Israel 84101; Department of Geography and Environmental Development (I.K.), Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Asuta Medical Center (I.F.L.), Beer Sheva, Israel 8489507; and Environmental Epidemiology Program (J.S.), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115.
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.affiliation: Department of Medicine (M.Y.S., I.F.L., V.N.), Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Clinical Research Center (M.Y.S., V.N.), Soroka University Medical Center, Beer Sheva, Israel 84101; Department of Geography and Environmental Development (I.K.), Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer Sheva, Israel 84105; Asuta Medical Center (I.F.L.), Beer Sheva, Israel 8489507; and Environmental Epidemiology Program (J.S.), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115.
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects; D000397:Air Pollution / Q000009:adverse effects*; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007557:Israel; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D001786:Blood Glucose; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides