Older and middle-aged adults living with diabetes face a significantly higher risk of developing cardiovascular diseases when exposed to air pollution over long periods, according to new research from China.
The study analysed data from a large, nationally representative survey of adults aged 45 and above, tracking more than 5,400 participants over a four-year period starting in 2011. Researchers examined how sustained exposure to various air pollutants influenced the onset of heart-related illnesses, particularly among people with diabetes.
Participants were grouped based on whether they had diabetes and whether they developed cardiovascular disease during the study period. Cardiovascular conditions assessed included heart attack, coronary artery disease, angina, heart failure, stroke, and other heart-related disorders. Diabetes was identified using standard clinical diagnostic criteria, while new cases of cardiovascular disease were determined through participant reports.
Findings showed that 13.8% of individuals with diabetes developed cardiovascular disease, compared to 8.5% among those without diabetes. The analysis revealed that for every interquartile range increase in air pollutant levels, the risk of cardiovascular disease rose by 19% to 28%. Among the pollutants studied, coarse particulate matter (PM10) demonstrated the strongest link, followed by PM1, PM2.5, and ozone.
To better understand vulnerability, researchers used a biomarker known as the Inflammatory Lipid Ratio (ILR). The study noted that air pollutants entering the bloodstream can trigger widespread inflammation, leading to tissue damage. In people with diabetes, who already tend to have heightened inflammation and disrupted lipid metabolism, this effect may be amplified, further increasing cardiovascular risk. The findings suggest that customised preventive and therapeutic strategies may be necessary for diabetic patients living in polluted environments.
Although the research was conducted using data from China, the results are highly relevant to countries such as India, where air pollution remains severe, especially during winter months. India also carries one of the world’s largest diabetes burdens, with an estimated 90 million adults affected. Previous research in major Indian cities has shown that exposure to fine particulate matter can elevate blood sugar levels and raise the risk of developing Type 2 diabetes, underscoring the broader public health implications of air pollution.
