Air pollution exposure may increase cardiovascular disease risk among diabetes patients: Study

A new study published in the journal of BMC Diabetology and Metabolic Syndrome revealed that air pollution exposure is linked to a higher risk of cardiovascular disease (CVD) in middle-aged and older persons with diabetes, and the inflammatory lipid ratio (ILR) exacerbates this risk.

In addition to affecting glucose metabolism, diabetes causes a number of metabolic dysfunctions that raise the risk of cardiovascular disease. According to studies, people with diabetes are far more likely than people without the disease to get myocardial infarction and stroke. The patients with diabetes who are middle-aged or older are more vulnerable to the negative effects of air pollution.

Globally, air pollution is widely acknowledged as a serious danger to public health, particularly in regions experiencing rapid urbanization, where its detrimental effects on human health are most noticeable. Studies that systematically examine the precise impact of air pollution on the risk of CVD in middle-aged and older diabetes patients are scarce, nevertheless. 

Thus, to understand the interplay and to offer a scientific foundation for targeted health interventions for diabetic patients, the current study sought to examine the relationship between air pollution exposure and CVD risk in this population as well as the function of ILR as a modifier.

This study tracked 5,430 persons over 4 years using data from the China Health and Retirement Longitudinal Study (CHARLS). Air pollution exposure to PM1, PM2.5, PM10, and O3 was evaluated using high-resolution data, and baseline CVD and diabetes status were established. To account for inflammatory and lipid metabolic states, the inflammatory lipid ratio (ILR) was computed. The impact of air pollution and ILR on the risk of CVD associated with diabetes was examined using a generalized linear model (GLM).

In the healthy population, the prevalence of CVD was 8.5%, but in the diabetic group, it was 13.8%. Exposure to air pollution was substantially linked to a higher risk of CVD in those with diabetes.

In the diabetic group, the risk of CVD increased by 21%, 19%, 28%, and 19% for every interquartile range (IQR) rise in the concentrations of pollutants O3, PM1, PM10, and PM2.5. A nonlinear link between ILR levels and CVD risk was found, and higher ILR values were positively correlated with CVD incidence. This suggests that higher ILR values worsen the effects of air pollution on people with diabetes.

Overall, the results highlight the need for improved clinical and environmental treatments in the diabetic community to lower exposure to air pollutants and manage systemic inflammation in order to lower the risk of CVD in this susceptible population.

Source:

Yan, C., Chen, G., Jing, Y., Ruan, Q., & Liu, P. (2025). Association between air pollution and cardiovascular disease risk in middle-aged and elderly individuals with diabetes: inflammatory lipid ratio accelerate this progression. Diabetology & Metabolic Syndrome, 17(1). https://doi.org/10.1186/s13098-025-01638-3