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. 2025 Sep 15;19(8):103298.
doi: 10.1016/j.dsx.2025.103298. Online ahead of print.

Association between long-term fine particulate matter exposure and incident type 2 diabetes in a low-exposure Danish cohort: An AIRCARD analysis

Stephan Peronard Mayntz  1 , Roda Abdulkadir Mohamed  2 , Anna Mejldal  3 , Jens-Jakob Kjer Møller  3 , Jes Sanddal Lindholt  4 , Axel Cosmus Pyndt Diederichsen  5 , Lise Marie Frohn  6 , Jørgen Brandt  6 , Matthias Ketzel  6 , Jibran Khan  6 , Jess Lambrechtsen  2
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Free article

Association between long-term fine particulate matter exposure and incident type 2 diabetes in a low-exposure Danish cohort: An AIRCARD analysis

Stephan Peronard Mayntz et al. Diabetes Metab Syndr. .
Free article

Abstract

Aim: The global burden of type 2 diabetes (T2D) continues to rise, with evidence suggesting that air pollution may contribute to its pathogenesis. This study examines the association between long-term exposure to fine particulate matter (PM2.5) and the risk of developing T2D in a cohort of older Danish men living in a low-exposure setting.

Methods: We conducted a prospective cohort study using 16,665 participants from the Viborg Vascular (VIVA) screening trial, aged 65-74 years without T2D at baseline. Residential PM2.5 was modeled with the DEHM/UBM/AIRGIS system from historical address data; road-traffic noise was estimated with Nord2000. Cox models with age as timescale evaluated time-varying PM2.5 exposure and T2D risk, adjusting for age, BMI, smoking status, socioeconomic factors, and traffic noise exposure.

Results: Over a mean 9.3-year follow-up, 324 participants (1.9 %) developed T2D. Incidence was lower than reported in prevention trials, reflecting differences in population risk and registry-based outcome capture. Participants who developed T2D had slightly higher long-term PM2.5 exposure compared to non-cases (12.12 vs 11.93 μg/m3; p < 0.001). Although absolute differences in exposure were small, they were consistent across the exposure distribution, suggesting a population-level effect even in a low-pollution environment. In adjusted time-varying Cox models, a 1.15 μg/m3 increment in PM2.5 was associated with a 30.6 % higher risk of T2D (HR 1.306, 95 % CI 1.08-1.58; p = 0.006). Associations were independent of body mass index, smoking, socioeconomic status, and traffic noise.

Conclusions: Long-term PM2.5 exposure was associated with T2D incidence in this cohort of older Danish men. Findings are hypothesis-generating, most applicable to low-to-moderate exposure settings, and should be interpreted with caution.

Keywords: Air pollution; Denmark; Traffic noise; Type 2 diabetes.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stephan Peronard Mayntz reports financial support was provided by Region of Southern Denmark. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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