Long-term and short-term exposure to outdoor air pollution and its association with glycolipid metabolic disorders

doi:10.4239/wjd.v16.i12.110028

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Diabetes. Dec 15, 2025; 16(12): 110028
Published online Dec 15, 2025. doi: 10.4239/wjd.v16.i12.110028

Long-term and short-term exposure to outdoor air pollution and its association with glycolipid metabolic disorders

Chang Zhou, Gao-Yuan Cui, Yi-Hu Tang, Wu-Yang Zhang, Xue-Lun Zou

Chang Zhou, Department of Oncology, The Third Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China

Gao-Yuan Cui, Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China

Yi-Hu Tang, Department of Emergency, The Third Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China

Wu-Yang Zhang, Clinical Skills Training Center, Central South University, Changsha 410008, Hunan Province, China

Xue-Lun Zou, Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China

Author contributions: Zou XL and Zhou C designed the research and determined the structure of the manuscript. Zou XL, Tang YS, Cui GY, and Zhou C were involved in the implementation of this study. Zou XL, Cui GY, and Zhou C selected the references and contributed to the writing. Zou XL, Tang YS, and Zhou C contributed to the revision and finalization of the manuscript. The manuscript was polished by Zhang WY. All authors contributed to the article and approved the submitted version.

Supported by the Teaching Research and Reform Fund Project of Central South University, No. 2024jy178.

Institutional review board statement: There was no need to get informed consent or ethical approval for this study again because all of the data were taken from published sources, and the informed consent and approval were received.

Informed consent statement: There was no need to get informed consent or ethical approval for this study again because all of the data were taken from published sources, and the informed consent and approval were received.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The original contributions presented in the study are included in the manuscript. Further inquiries can be directed to the corresponding author.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Xue-Lun Zou, PhD, Department of Neurology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha 410008, Hunan Province, China. 1609941099@qq.com

Received: May 28, 2025
Revised: July 25, 2025
Accepted: November 13, 2025
Published online: December 15, 2025
Processing time: 201 Days and 11.8 Hours

Abstract

BACKGROUND

The association between ambient air pollution and glycolipid metabolic disorders (GMDs, including diabetes mellitus and dyslipidemia) is still not well understood, especially when it comes to the different effects of long-term vs short-term exposure and the sources of pollutants (indoor or outdoor).

AIM

To look at how outdoor particulate matter (PM₁, PM_2.5, PM₁₀) and ozone (O₃), as well as indoor pollutants from solid fuels, are related to the risk of developing GMDs in a cohort that represents the national population.

METHODS

We used a longitudinal cohort design to look at how different time periods of air pollution exposure (long-term: 5-year averages; short-term: 1-year averages) affect the incidence of GMDs in middle-aged and elderly adults. Multivariable logistic regression models, which took into account key factors such as age, sex, and smoking status, were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Our study found that exposure to air pollution (1 μg/m³) has different effects on GMDs. Long-term exposure to outdoor pollutants like PM₁, PM_2.5, PM₁₀, and O₃ consistently increased the risk of diabetes (PM₁: OR = 1.106, 95%CI: 1.018-1.205; PM_2.5: OR = 1.038, 95%CI: 1.007-1.071; PM₁₀: OR = 1.023, 95%CI: 1.004-1.043) and dyslipidemia (PM₁: OR = 1.150, 95%CI: 1.064-1.249; PM_2.5: OR = 1.053, 95%CI: 1.023-1.086; PM₁₀: OR = 1.032, 95%CI: 1.014-1.052). Short-term exposure showed even stronger associations, particularly for PM₁ with dyslipidemia (OR = 1.078, 95%CI: 1.044-1.114) and PM₁ with diabetes (OR = 1.047, 95%CI: 1.007-1.089). Notably, certain components of PM_2.5 - chloride (Cl^-), ammonium (NH₄⁺), sulfate (SO₄^2-), and nitrate (NO₃^-) - showed a dose-dependent relationship with both conditions (for example, Cl^-: Diabetes OR = 1.797 per 1 μg/m³, 95%CI: 1.086-2.991; dyslipidemia OR = 2.627, 95%CI: 1.728-4.012). However, neither long-term nor short-term exposure to indoor solid fuel pollutants was significantly associated with diabetes (long-term OR = 1.034, 95%CI: 0.801-1.333; short-term OR = 0.970, 95%CI: 0.774-1.209) or dyslipidemia (short-term OR = 1.159, 95%CI: 0.967-1.386).

CONCLUSION

This national cohort study shows that outdoor air pollution - particularly PM₁, PM_2.5, and their chemical components - is an important environmental factor contributing to GMDs, with long-term exposure showing greater metabolic toxicity than short-term exposure. The lack of association between indoor solid fuel pollutants and GMDs underscores the urgent need for targeted interventions to improve outdoor air quality and reduce metabolic risks at the population level.

Keywords: Air pollution; Glycolipid metabolic disorders; Solid fuel; Cohort study; Diabetes; Dyslipidemia

Core Tip: This national cohort study shows that outdoor air pollution - particularly PM₁, PM_2.5, and their chemical components - is an important environmental factor contributing to glycolipid metabolic disorders, with long-term exposure showing greater metabolic toxicity than short-term exposure. The lack of association between indoor solid fuel pollutants and glycolipid metabolic disorders underscores the urgent need for targeted interventions to improve outdoor air quality and reduce metabolic risks at the population level.