Abstract
BackgroundDeveloping countries, such as India, are experiencing rapid urbanization, which may have a major impact on the environment: including worsening air and water quality, noise and the problems of waste disposal. We used health data from an ongoing cohort study based in southern India to examine the relationship between the urban environment and homeostasis model assessment of insulin resistance (HOMA-IR).MethodsWe utilized three metrics of urbanization: distance from urban center; population density in the India Census; and satellite-based land cover. Restricted to participants without diabetes (N = 6350); we built logistic regression models adjusted for traditional risk factors to test the association between urban environment and HOMA-IR.ResultsIn adjusted models, residing within 0–20 km of the urban center was associated with an odds ratio for HOMA-IR of 1.79 (95% CI 1.39, 2.29) for females and 2.30 (95% CI 1.64, 3.22) for males compared to residing in the furthest 61–80 km distance group. Similar statistically significant results were identified using the other metrics.ConclusionsWe identified associations between urban environment and HOMA-IR in a cohort of adults. These associations were robust using various metrics of urbanization and adjustment for individual predictors. Our results are of public health concern due to the global movement of large numbers of people from rural to urban areas and the already large burden of diabetes.
Highlights
Developing countries, such as India, are experiencing rapid urbanization, which may have a major impact on the environment: including worsening air and water quality, noise and the problems of waste disposal
homeostasis model assessment of insulin resistance (HOMA-IR) levels in both females and males were significantly higher in sub-populations with low and moderate physical activity compared to high physical activity
HOMA-IR levels were higher for residents of urban areas compared to non-urban
Summary
Developing countries, such as India, are experiencing rapid urbanization, which may have a major impact on the environment: including worsening air and water quality, noise and the problems of waste disposal. We used health data from an ongoing cohort study based in southern India to examine the relationship between the urban environment and homeostasis model assessment of insulin resistance (HOMA-IR). 54% of the world’s population lives in urban areas, a proportion that is expected to increase to 66% by 2050 [1]. To China, the world’s second largest urban population resides in India with approximately 410 million people and this number is projected to double by 2050 [1]. India had over 69.2 million people living with diabetes in 2015, and this number is expected to grow to 123.5 million by 2040 [2, 3].
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