The Association Between Air Pollution Exposure and Glucose and Lipids Levels

J Clin Endocrinol Metab. 2016 Jun;101(6):2460-7. doi: 10.1210/jc.2016-1378. Epub 2016 May 24.


Context: 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.

Objective: 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.

Design: Population-based retrospective cohort study of a 10-year period.

Setting: Members of the largest health care provider in Southern Israel.

Participants: 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.

Main outcome: Log-transformed glucose, HbA1c, and lipid values were explored by mixed models, with adjustment for personal and seasonal confounders.

Results: 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.

Conclusions: Intermediate-term, but not short term, exposure to PM is associated with alterations in glucose, HbA1c, and lipids, especially among people with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Air Pollutants / adverse effects
  • Air Pollution / adverse effects*
  • Blood Glucose / analysis*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Israel
  • Lipoproteins, HDL / blood*
  • Lipoproteins, LDL / blood*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Triglycerides / blood*
  • Young Adult


  • Air Pollutants
  • Blood Glucose
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Triglycerides