Diabetes
is a chronic metabolic disease that affects 8.3% of people worldwide.1
The three types of diabetes are type I (also called juvenile diabetes), type
II, and gestational diabetes.2 Type II diabetes accounts for
approximately 90% of all diabetes cases worldwide and develops gradually following
long periods of insulin resistance, which is considered an independent
predictor of diabetes.1 Obesity, specific gene variations, poor
nutrition, and lack of exercise have all been identified as risk factors for
type II diabetes.1 In the past five years, air pollution has also
been proposed to be an additional risk factor for type II diabetes. This has
motivated several research groups to investigate this topic.
In
their recent publication in Diabetes,
Wolf et al. detail their study of the relationship between long-term exposure
to air pollution and biomarkers related to air pollution.1 They
collected data from a group of 2,944 participants that contained non-diabetic,
pre-diabetic, and diabetic individuals. They analyzed HOMA-IR (homeostatic
model assessment for insulin resistance), glucose, insulin, HBA1c (haemoglobin
A1c, identifies average plasma glucose), leptin, and hs-CRP (high-sensitivity
C-reactive protein) in relation to long-term exposures to particulate matter ≤ 10 μm
in diameter (PM10), between 2.5-10 μm (PMcoarse), and ≤ 2.5 μm (PM2.5) as well as nitrogen oxides. They discovered
that exposure to NO2 showed significant positive association with
HOMA-IR, glucose, insulin, and leptin levels for participants from all
subgroups. Furthermore, PM10, PMcoarse, PM2.5
absorbance and NOx showed positive associations with HOMA-IR and
insulin levels. These results led the authors to conclude that there is a
positive relationship between traffic-related air pollution and biomarkers
related to insulin resistance. As one would expect from a scientific
publication, Wolf et al. as conservative with the wording of their conclusions
and are careful not to overstate the meaning of their findings.
John Raphael of Nature
World News summarized the findings of the report by Wolf et al. in his
article, “Warning! Air Pollution Could Lead to Diabetes.”3 The title
of Raphael’s report suggests that he is much less conservative than Wolf et al.
when associating air pollution with diabetes prevalence. However, Raphael is
fairly careful in the body of his article to accurately communicate the results
of the study without inflating the conclusions made by Wolf et al. Furthermore,
Raphael provides a reasonable amount of relevant information about the study
without overwhelming the reader with technical jargon. Despite this, I do think
Raphael could have been more careful in the first statement of his report,
where he claims that, “exposure to air pollution could lead to diabetes.” Wolf
et al. linked long-term exposure to air pollutants with increased insulin levels, which can lead to diabetes. This caveat is important, and
I think Raphael should have been more careful about how he began his article.
Despite this, I found Raphael’s report to be a great bridge between the science
that was reported on and a more general audience.
In conclusion, I thought Raphael skillfully communicated
the most important results from Wolf et al.’s extensive study on the
relationship between long-term air pollution exposure and insulin levels. While
the title of Raphael’s article made it seems as though he might overstate the
conclusions made by Wolf et al, I thought he did a fairly good job of
translating the scientific article into a digestible and informative report. As
such, I would give his article a score of 9/10.
1.
Wolf et al. “Association between long-term
exposure to air pollution and biomarkers related to insulin resistance,
subclinical inflammation and adipokines.” Diabetes
2016 http://dx.doi.org/10.2337/db15-1567.
2.
Wild et al. “Global prevalence of diabetes.” Diabetes Care 2004, 27, 1047.
3.
John Raphael “Warning! Air pollution could
lead to diabetes.” Nature World News. http://www.natureworldnews.com/articles/28506/20160912/warning-air-pollution-could-lead-to-diabetes.htm
I agree with your analysis of the Nature World News article. Raphael's statements and associations were less conservative than Wolf's, but he did do a good job of translating Wolf's findings in the body of the article.
ReplyDeleteThe correlation between traffic-related air pollution and biomarkers related to insulin resistance peaked my interest. I did a little Googling, and according to the International Diabetes Federation, "India is the country with the most people with diabetes, with a current figure of 50.8 million, followed by China with 43.2 million. Behind them the United States (26.8 million)...", with four out of five people with diabetes living in low and middle class communities (http://www.idf.org/latest-diabetes-figures-paint-grim-global-picture). Keeping this in mind, data gathered from the World Health Organization of the Top 15 most polluted cities on Earth has 7 of them in India, and 3 of them in China. An interesting and unsettling thought.
Nice post, Liz! I also thought that Raphael did a good job of presenting the Diabetes paper findings to the general public in a manner that was engaging and easy to understand. The title of his article is gripping, yet upon drawing the reader's attention, he nicely conveys the results of the study in an objective and relatively cautious way. I also appreciate Raphael's efforts to provide a concise narrative of the experimental methods Wolf et al. used for data collection/analysis. It was also nice that Raphael specified the air pollutant (nitrogen dioxide) that was examined in the study.
ReplyDeleteInteresting view，Liz! I appreciate your introduction part very much. You make a quite clear paragraph to introduce the background of diabetes and the relationship between diabetes and air pollution exposure. Actually, I have not thought of long term air pollution will result in the changes of insulin levels before. And this article provides me with a new perspective of daily pollution exposures. Also I do agree with your opinion on Raphael's work. A surprising title may attract more attention to some extend, but he should be more careful in stating some uncertain facts. Thanks for your job!
ReplyDeleteI really enjoyed your post, Liz! It is interesting how these two very different, yet highly concerning health issues are very much intertwined. Both Diabetes (and the related obesity epidemic) and air pollution are concerning health problems that are presented frequently in the media, but never introduced together. It is really important to remember just how many unintended and unfavorable side effects our actions can have. Additionally, I very much agree on your analysis of the Nature World News article. Raphael did a nice job of including a lot of the important findings, so the reader could really take something away from the article, but did not weigh the writing down with excessive data. Sometimes it is hard to find a balance between readability and details, but this article had great information, and flow. Besides the slightly over exaggerated title (which you addressed in your post), the only other issue I had with it was it was the last paragraph. I understand Raphael was trying to link the findings back to U.S. readers, and include information about pollution and its regulation in the U.S., it seemed like an abrupt ending to the article. I would like to know how the pollution in the sites examined in the research compared to some areas in the United States, in terms of air pollutant makeup (e.g. Nitrogen Dioxide) and levels of severity. It would be interesting to see how well these findings translated across countries (somewhat like Kesiree mentioned). Also, as the Wolf et al. publication studied all types of patients (non-diabetic, pre-diabetic, and diabetic individuals), but it would be interesting to see if the preexisting health conditions of populations across countries/populations (Obesity/Diabetes rates, genetic predispositions, etc.) yielded different findings. Overall though, I learned a lot from the Nature World News article, and believe it represented the peer-reviewed article really well!
ReplyDeleteI also agree that it would be interesting to expand the scope of this study to other geographical areas such as the United States and countries that have notoriously high levels of air pollution. Other than time and funding restraints, I imagine a complicating factor to these expanded studies would be the introduction of a new population subgroup as diabetes is known to be more prevalent in certain populations groups. However, I am sure there is a way to take this into consideration when modeling the data and I think the results would be very informative!
DeleteI think it would be very interesting to repeat a study like this in areas with severe air pollution (major industrialized cities). It would be particularly interesting to see how big of a factor air pollution has on diabetes in those cities. Nonetheless, I think this article in Diabetes (which is hot off the press) demonstrates a nice proof of concept for how dangerous air pollution / global climate is on our health and in particular one of the worst diseases affecting such a large population. The study presented in Diabetes is remarkable in that they are able to show a clear positive relationship between air pollution and biomarkers linked to diabetes. We are also made aware that maybe we should be conscious of where we live...it is clearly influential on our health and yet another reminder of how important our global climate is.
ReplyDeleteI agree with you, Liz. Raphael is definitely careful within the article that he writes to state the caveats that Wolf et al. mention in their published piece, as well as stating that they found a "significant association between" air pollution and various biomarkers, when it would have been easy (and possibly tempting) simply to treat the results as evidence of causation rather than correlation. I find it funny that Raphael was so careful in his writeup of the science, though, considering the sensationalist nature of the title. But I think he did well in explaining the methods and helping a reader with an average science background to understand the experiment.
ReplyDeleteAs far as the study itself goes, I'd love to see some more research done on this field. When I looked over the paper, I didn't see anything like a proposed physiological mechanism (though perhaps I missed it), which I think would be critical in understanding the correlation, and in terms of a solution to curbing this effect. Either way, good work!
As we all know the air pollution is also related with respiratory and cardiovascular diseases and it is surprising how more and more diseases can be linked with this type of contamination. I consider that countries in general are not taking seriously the guidelines proposed by World Health Organization that are associated to the concentration levels of pollutants in the air. These are above the established ranges. We know that the world is not as it should and we see that every day pollution increases in an exorbitant way (air, water, soil, food) and therefore humanity is destined to suffer more and more ailments and diseases and this is unlikely to change taking into account global economic interests.
ReplyDeleteI agree with your opinion that the leading nations are not taking air pollution seriously enough. As you observed, air pollution poses several health threats to humans, meaning that it is most certainly affecting other living creatures on the planet. Hopefully, more will be done to address this issue as more research is done on the scope of the harmful affects of air pollution.
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