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Thiering, E. ; Markevych, I. ; Brüske, I. ; Fuertes, E. ; Kratzsch, J.* ; Sugiri, D.* ; Hoffmann, B.* ; von Berg, A.* ; Bauer, C.P.* ; Koletzko, S.* ; Berdel, D.* ; Heinrich, J.

Associations of residential long-term air pollution exposures and satellite-derived greenness with insulin resistance in German adolescents.

Environ. Health Perspect. 124, 1291-1298 (2016)

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BACKGROUND: Epidemiological studies have identified associations between air pollution and green space access with type 2 diabetes in adults. However it remains unclear to what extent associations with greenness are attributable to air pollution exposure. OBJECTIVES: We aimed to investigate associations between long-term exposure to air pollution and satellite-derived greenness with insulin resistance in adolescents. METHODS: 837 participants of two German birth cohorts (LISAplus and GINIplus) were included in the analysis. Generalized additive models were used to determine the association of individual satellite-derived greenness defined by the Normalized Difference Vegetation Index (NDVI), long-term air pollution exposure estimated by land-use regression (LUR) models with insulin resistance (HOMA-IR) in 15 year-old adolescents. Models were adjusted for study area, cohort, socioeconomic, and individual characteristics such as BMI, physical activity, and smoking. RESULTS: 2-SD increases in nitrogen dioxide (NO2, 8.9 μg/m(3)) and particulate matter smaller than 10μm in diameter (PM10, 6.7 μg/m(3)) were significantly associated with 11.4% (95% CI: 4.4, 18.9) and 11.4% (95% CI: 0.4, 23.7) higher HOMA-IR. A 2-SD increase in NDVI in a 1000m buffer (0.2 units) was significantly associated with a lower HOMA-IR (-7.4% (95% CI: -13.3, -1.1)). Associations tended to be stronger in adolescents who spent more time outside and those with a lower socioeconomic status. In combined models including both air pollution and greenness, only NO2 remained significantly associated with HOMA-IR, while effect estimates for all other exposures attenuated after adjustment for NO2. CONCLUSIONS: NO2, often considered as a marker of traffic, was independently associated with insulin resistance. The observed association between higher greenness exposure and lower HOMA-IR in adolescents might thus be mainly due to the lower co-exposure to traffic-related air pollution.

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