Elderly and middle aged populations with diabetes are at a higher risk of developing cardiovascular diseases due to long-term air pollution exposure, a Chinese study has found.
Researchers from a hospital affiliated with the Northwest University in Shanxi Province used data from the China Health and Retirement Longitudinal Study (CHARLS) to track the effects of air pollution exposure in older diabetics. The CHARLS is a nationally representative survey of adults aged 45 years and older.
The study followed the progress of 5,430 eligible participants over four years using 2011 as a base line, dividing them into four groups: participants with no diabetes and no new cardiovascular disease at baseline and during follow-up; participants with no diabetes but with new cardiovascular disease at baseline and during follow-up; participants with diabetes but no new cardiovascular disease at baseline and during follow-up; and participants with diabetes and new cardiovascular disease at baseline and during follow-up.
New cardiovascular disease occurrence was determined via self-reports by participants, while diabetes was diagnosed per American Diabetes Association criteria. Cardiovascular disease included incidence of myocardial infarction, coronary artery disease, angina pectoris, congestive heart failure, stroke, and other heart diseases.
The prevalence of cardiovascular disease was found to be 13.8% among participants with a history of diabetes, compared to 8.5% of those without. For each interquartile range increase in pollutant concentration, cardiovascular disease risk increased by 19 to 28%, with PM10 showing the strongest association. Other pollutants included in the study were PM1, PM2.5, and ozone.
The researchers used Inflammatory Lipid Ratio, a biomarker, to capture vulnerability to cardiovascular disease. Air pollution, when entering the blood stream, can cause widespread inflammatory responses in the body which cause tissue damage. “ILR may exacerbate the inflammatory response and lipid metabolism disorders, which in turn increase the risk of cardiovascular disease in diabetic patients,” says the study, adding, “Given the heightened inflammatory state and lipid metabolic imbalance in diabetic patients under chronic air pollution exposure, tailored therapies may be needed.”
Though the data is from China, the study has implications for India, where high levels of air pollution are chronic during peak winter months. India also has one of world’s highest disease burdens for diabetes, with approximately 90 million adults diagnosed with the disease.
A landmark study from Delhi and Chennai found exposure to PM2.5 pollution to raise blood sugar levels and increase the risk of developing Type 2 diabetes.
Banner image: A blood sample is collected from a diabetic patient a health camp in Kolkata, West Bengal. (AP Photo/Bikas Das, File)