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Yu S, Zhang M, Zhu J, Yang X, Bigambo FM, Snijders AM, Wang X, Hu W, Lv W, Xia Y. The effect of ambient ozone exposure on three types of diabetes: a meta-analysis. Environ Health 2023; 22:32. [PMID: 36998068 PMCID: PMC10061724 DOI: 10.1186/s12940-023-00981-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Ozone as an air pollutant is gradually becoming a threat to people's health. However, the effect of ozone exposure on risk of developing diabetes, a fast-growing global metabolic disease, remains controversial. OBJECTIVE To evaluate the impact of ambient ozone exposure on the incidence rate of type 1, type 2 and gestational diabetes mellitus. METHOD We systematically searched PubMed, Web of Science, and Cochrane Library databases before July 9, 2022, to determine relevant literature. Data were extracted after quality evaluation according to the Newcastle Ottawa Scale (NOS) and the agency for healthcare research and quality (AHRQ) standards, and a meta-analysis was used to evaluate the correlation between ozone exposure and type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D), and gestational diabetes mellitus (GDM). The heterogeneity test, sensitivity analysis, and publication bias were performed using Stata 16.0. RESULTS Our search identified 667 studies from three databases, 19 of which were included in our analysis after removing duplicate and ineligible studies. Among the remaining studies, three were on T1D, five were on T2D, and eleven were on GDM. The result showed that ozone exposure was positively correlated with T2D [effect size (ES) = 1.06, 95% CI: 1.02, 1.11] and GDM [pooled odds ratio (OR) = 1.01, 95% CI: 1.00, 1.03]. Subgroup analysis demonstrated that ozone exposure in the first trimester of pregnancy might raise the risk of GDM. However, no significant association was observed between ozone exposure and T1D. CONCLUSION Long-term exposure to ozone may increase the risk of T2D, and daily ozone exposure during pregnancy was a hazard factor for developing GDM. Decreasing ambient ozone pollution may reduce the burden of both diseases.
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Affiliation(s)
- Sirui Yu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingzhi Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiamin Zhu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Francis Manyori Bigambo
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Antoine M Snijders
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
| | - Wei Lv
- Healthcare Management Program, School of Business, Nanjing University, 22 Hankou Rd, Nanjing, 210093, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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