Long-term exposure to PM₂.₅ and fasting plasma glucose in non-diabetic adolescents in Yogyakarta, Indonesia

Abstract

Background: Indonesia is facing serious air pollution. However, very few studies have been conducted to examine the health risks of air pollution in Indonesia, particularly for adolescents. Objective: To assess the association between long-term exposure to ambient particles with a diameter of <2.5 mm (PM2.5) and fasting plasma glucose (FPG) in adolescents. Methods: A cross-sectional study was conducted in 482 adolescents aged 14e18 years in Yogyakarta, Indonesia in 2016. We finally included 469 (97.30%) participants who had no missing data for data analysis. We collected individual data on socio-demographics, behavioral habits, and health information through standardized questionnaires. Satellite-based PM2.5 concentrations from 2013 to 2016 were assigned based on participants’ residential addresses. The association between PM2.5 and FPG was examined using a generalized linear regression model while FPG was modeled as a continuous variable. An ordered logistic regression model was used to assess the relationship between PM2.5 and FPG categories. Results: Every 1 mg/m3 increase in PM2.5 was associated with a 0.34 mg/dL [95 confidence interval (95% CI): 0.08 mg/dL, 0.59 mg/dL] increase in FPG levels. Comparing with the low FPG level (under 86 mg/dL), every 1 mg/m3 increase in PM2.5 was associated with a 10.20% (95% CI: 1.60%, 19.80%) increase in the odds of impaired fasting glucose (IFG) (100e125 mg/dL). Stratified analyses indicated greater effects on participants with hypertension [odds ratio (OR) ¼ 1.30, 95% CI: 1.09, 1.57] and those had higher physical activities (OR ¼ 1.36, 95% CI: 1.09, 1.57). Adolescents’ sex, obesity status and different cutoff points of FPG did not modify the association between the exposure to PM2.5 and FPG levels. Conclusion: Long-term exposure to PM2.5 was associated with increased FPG levels in Indonesian nondiabetic adolescents.