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Diabetes may be linked to environment quality

18 Oct 2019
In the first 10 days of May 2017 alone, air pollution reached ‘very high’ and ‘serious’ levels in six out of Hong Kong’s 13 monitoring stations.

Environmental quality and exposure to pollution may play a small part in the development of metabolic diseases, such as diabetes, a new study has found.

Using the Environmental Quality Index (EQI), researchers assessed multifactorial, county-level ambient environmental exposures. The information was then linked to county-level annual age-adjusted, population-based diabetes prevalence estimates. Obesity, leisure time and physical inactivity were included as covariates.

A total of 3,134 counties were represented in the analysis, of which 34.7 percent and 33.7 percent were metropolitan-urbanized and less-urbanized, respectively. On the other hand, 21.3 percent were thinly populated, while the remaining 10.3 percent of the counties were classified as nonmetropolitan urbanized. The mean total diabetes prevalence rate was 13.58±2.44 per 100,000 population.

Controlling for covariates, researchers found that in the overall sample, poor cumulative environmental quality correlated significantly with lower total diabetes prevalence (prevalence difference [PD], –1.36, 96 percent CI, –1.43 to –1.28). The same was true for diagnosed and undiagnosed diabetes.

However, stratifying according to rural-urban status revealed important differences. In less-urbanized (PD, 2.58. 2.46–2.71) and thinly populated (PD, 2.88, 2.74–3.01) counties, poor cumulative environmental quality significantly increased the prevalence of total diabetes. In metropolitan-urbanized areas, on the other hand, the correlation was null (PD, 0.07, –0.03 to 0.17).

Moreover, disaggregation according to EQI domains, and with respect to both domains and rural-urban status, further revealed variations in the interplay between environmental quality and the prevalence of diabetes. This suggests that further studies targeting specific interactions within this complex web are needed.

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Stephen Padilla, 06 Aug 2020
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