The association between short-term ozone exposure and fasting blood glucose levels in non-diabetic adults was more obvious in rural residents: the evidence from a typical "urban-rural dual structure" province in southwestern China

Ambient ozone (O3) is associated with diabetes (DM), but the data on the association between O3 and fasting blood glucose (FBG) in non-diabetic adults is relatively rare, especially the evidence of urban-rural difference in such association is still lacking. Our research aimed to investigate the potential effects of short-term O3 exposure on FBG levels. We carried out a cross-sectional analysis of a representative sample of 5329 adults from the Guizhou Population Health Cohort Study and the association between O3 and FBG levels was determined. In rural populations, subgroup analyses were performed by gender, age, nationality, and so on. We observed that short-term exposure to ambient O3 was positively associated with FBG levels. The strongest association was observed at lag 015 days, with per 10 mu g/m3 increase of O3 concentration leading to a significant increase of 0.050 mmol/L (95%CIs: 0.037, 0.063) in FBG. More importantly, the association between O3 and FBG levels was stronger in rural populations with lower income levels. Further stratified analyses showed that participants who were older than 60 years, males, smokers, Han, non-drinkers, warm season, dietary score >= 3, exercise time < 150 min/week, sleep duration < 7 h/day, and BMI < 18.5 kg/m2 were potentially more susceptible to the effects of O3 in rural populations. In general, our study not only provided the evidence that O3 exposure can be associated with increased FBG levels, but also shed new light on the further understanding of the adverse effects of O3 on DM. Furthermore, rural populations may be more vulnerable to the effects of O3. Our findings indicate that the issue of air pollution in rural areas is equally noteworthy.