Abstract
Aim We aimed to assess and compare secular trends in type 2 diabetes mortality attributable to particulate matter pollution in China and U.S. Methods We performed an age-period-cohort (APC) analysis to estimate the independent effects of age, period, and cohort on mortality of type 2 diabetes attributable to particulate matter pollution. We collected age-standardized and age-specific mortality rates (1990-2017) from the Global Burden of Disease 2017 Study for China and the U.S. Results During the period 1990-2017, the age-standardized mortality rates of type 2 diabetes attributable to particulate matter pollution in China showed a general increasing trend, while that in U.S. showed an increase before 2002 and subsequently a decrease. The age effect increased markedly in China compared with the U.S. The period effect showed a substantially increase in China while that in the U.S. increased during 1990-2007 and tended to be stable during 2007-2017. The cohort effect peaked in birth cohort born in 1902–1906 in both China and U.S. and declined consistently in the cohort born in 1992-1996. Conclusions The age-standardized mortality rates of type 2 diabetes attributable to particulate matter pollution, the age, and period effect in China have been increasing in both sexes from 1990 to 2017. The overall mortality in the U.S. began to decrease since 2003, and the period effect showed a tendency to stabilize. Consequently, it is necessary to educate the nation with the correct knowledge and adopting policies on pollutant emission and techniques to reduce air pollution in China.
Highlights
Diabetes is one of the largest epidemics the world faces in the 21st century [1,2,3]
A significant increase in the age-standardized mortality rates attributable to particulate matter pollution has been observed in China during the same period, which possibly indicates that the inadequate implementation of public health control policies, limited medical resources, and clinical treatment may have driven the increasing trend observed in the Chinese population
We evaluated the general trends in type 2 diabetes mortality attributable to particulate matter pollution in China and U.S during the periods 1990-2017
Summary
Diabetes is one of the largest epidemics the world faces in the 21st century [1,2,3]. Air pollution has an increased association with risk of type 2 diabetes [8, 9], and particulate matter air pollution is prevalent in China. A previous study reported that exposure to particulate matter pollution has been suggested as a contributing factor to type 2 diabetes incidence and progression [11,12,13]. Analysis of type 2 diabetes attributable to particulate matter pollution would provide a better understanding of the epidemiology of diabetes, identify endemic areas, and further contribute to the global and national discussions on the hazardous effect of air pollution on diabetes. In this study, we aimed to further estimate the trend of type 2 diabetes mortality attributable to particulate matter pollution to throw light on policy making regarding diabetes
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