Association Between Short-Term Exposure to Air Pollution and Dyslipidemias Among Type 2 Diabetic Patients in Northwest China: A Population-Based Study

Int J Environ Res Public Health. 2018 Mar 30;15(4):631. doi: 10.3390/ijerph15040631.


Air pollution exposure may play an adverse role in diabetes. However, little data are available directly evaluating the effects of air pollution exposure in blood lipids of which dysfunction has been linked to diabetes or its complications. We aimed to evaluate the association between air pollution and lipids level among type 2 diabetic patients in Northwest China. We performed a population-based study of 3912 type 2 diabetes patients in an ongoing cohort study in China. Both spline and multiple linear regressions analysis were used to examine the association between short-term exposure to PM10, SO₂, NO₂ and total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). By spline analyses, we observed that the relationship between SO₂ and HDL-C and LDL-C was shown to be non-linear (p_non-lin-association = 0.0162 and 0.000). An inverted U-shaped non-linear relationship between NO₂ and LDL-C was found (p_non-lin-association < 0.0001). A J-shaped non-linear relationship between PM10 and TC, HDL-C (p_non-lin-association = 0.0173, 0.0367) was also revealed. In linear regression analyses, a 10 μg/m³ increment in SO₂ was associated with 1.31% (95% CI: 0.40-2.12%), 3.52% (95% CI: 1.07-6.03%) and 7.53% (95% CI: 5.98-9.09%) increase in TC, TG and LDL-C, respectively. A 10 μg/m³ increment in PM10 was associated with 0.45% (95% CI: 0.08-0.82%), 0.29% (95% CI: 0.10-0.49%) and 0.83% (95% CI: 0.21-1.45%) increase in TC, HDL-C and LDL-C, respectively. For NO₂, an increment of 10 μg/m³ was statistically associated with -3.55% (95% CI: -6.40-0.61%) and 39.01% (95% CI: 31.43-47.03%) increase in HDL-C and LDL-C. The adverse effects of air pollutants on lipid levels were greater in female and elder people. Further, we found SO₂ and NO₂ played a more evident role in lipid levels in warm season, while PM10 appeared stronger in cold season. The findings suggest that exposure to air pollution has adverse effects on lipid levels among type 2 diabetes patients, and vulnerable people may pay more attention on severe air pollution days.

Keywords: air pollution; decreased high-density lipoprotein cholesterol; diabetes; low-density lipoprotein cholesterol; total cholesterol; triglycerides.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • China
  • Diabetes Mellitus, Type 2 / complications*
  • Dyslipidemias / diagnosis
  • Dyslipidemias / etiology*
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Regression Analysis
  • Risk Factors
  • Seasons


  • Air Pollutants