Nitrogen dioxide exposure attenuates or even reverses the association between physical activity and fasting plasma glucose levels in non-diabetic elderly Chinese adults

暴露于二氧化氮会减弱甚至逆转中国非糖尿病老年人体力活动与空腹血浆葡萄糖水平之间的关系

Authors：Chen Zhang, Qingsi Wu, Xuqiu Cheng, Ziwei Tian, Junzhe Li, Qiang Liu, Yan Zhang, Xianwei Guo, Guimei Chen, Huaibiao Li, Changliu Liang, Bing Hu, Dongmei Zhang, Chunmei Liang, Jie Sheng, Fangbiao Tao, Jun Wang, Yuyou Yao, Linsheng Yang

Source：BMC Public Health

DOI: 10.1186/s12889-025-22050-6

Abstract

Background: The combined effects of physical activity (PA) and nitrogen dioxide (NO₂) on fasting plasma glucose (FPG) levels have rarely been studied. This study aimed to examine whether long-term exposure to NO₂ attenuates the association between PA and FPG levels in non-diabetic older adults.

Methods: A total of 2600 non-diabetic elderly Chinese adults were included in this cross-sectional study. PA data were collected using the International Physical Activity Questionnaire (IPAQ). The Space-Time Extra-Trees model was utilized to estimate the annual concentration of NO₂. General linear regression models were used to assess independent and interaction associations of long-term exposure to NO₂ and PA with FPG levels. An interaction plot was employed to enhance the visual representation of the interaction.

Results: A 0.32 µg/m³ increase in the 3-year average NO₂, corresponding to one interquartile range (IQR), was positively associated with FPG levels (β = 0.099 mmol/L, 95% CI: 0.069-0.130). PA exhibited a negative, albeit non-significant, association with FPG levels (β = -0.027 mmol/L, 95% CI: -0.069, 0.015). A statistically significant interaction between PA and NO₂ on FPG levels was observed (P for interaction= 0.016). The interaction plots revealed that the beneficial effects of PA on FPG levels were attenuated or even reversed as NO₂ concentrations increased, with a threshold for reversal at 33.02 µg/m³.

Conclusions: Long-term exposure to NO₂ attenuates or reverses the beneficial effects of PA on FPG levels in non-diabetic older adults. Therefore, further action is imperative to reduce air pollution and thereby enhance the benefits of PA on FPG levels.

Keywords: Fasting plasma glucose; Nitrogen dioxide; Non-diabetic older adults; Physical activity.

摘要：

背景：很少有人研究过体育锻炼（PA）和二氧化氮（NO₂）对空腹血浆葡萄糖（FPG）水平的综合影响。本研究旨在探讨长期暴露于二氧化氮是否会减弱非糖尿病老年人的体力活动与 FPG 水平之间的联系。

研究方法：这项横断面研究共纳入了 2600 名非糖尿病中国老年人。采用国际体力活动调查表（IPAQ）收集体力活动数据。利用时空外树模型估算二氧化氮的年浓度。一般线性回归模型用于评估长期暴露于二氧化氮和体育锻炼与 FPG 水平之间的独立关联和交互关联。采用交互图来增强交互作用的视觉效果。

结果：3 年平均NO₂增加 0.32 µg/m3（相当于一个四分位数间距 (IQR)）与 FPG 水平呈正相关（β = 0.099 mmol/L，95% CI：0.069-0.130）。PA 与 FPG 水平呈负相关，尽管不显著（β = -0.027 mmol/L，95% CI：-0.069，0.015）。PA 和NO₂对 FPG 水平的交互作用具有统计学意义（P for interaction = 0.016）。交互图显示，随着二氧化氮浓度的增加，PA 对 FPG 水平的有益影响减弱甚至逆转，逆转的临界值为 33.02 µg/m3。

结论：长期暴露于二氧化氮会削弱或逆转 PA 对非糖尿病老年人 FPG 水平的有益影响。因此，必须采取进一步行动减少空气污染，从而增强 PA 对 FPG 水平的益处。

关键词： 空腹血浆葡萄糖，二氧化氮，非糖尿病老年人，体力活动