Article Text
Abstract
Objective Rising global temperatures might contribute to the current worldwide diabetes epidemic, as higher ambient temperature can negatively impact glucose metabolism via a reduction in brown adipose tissue activity. Therefore, we examined the association between outdoor temperature and diabetes incidence in the USA as well as the prevalence of glucose intolerance worldwide.
Research design and methods Using meta-regression, we determined the association between mean annual temperature and diabetes incidence during 1996–2009 for each US state separately. Subsequently, results were pooled in a meta-analysis. On a global scale, we performed a meta-regression analysis to assess the association between mean annual temperature and the prevalence of glucose intolerance.
Results We demonstrated that, on average, per 1°C increase in temperature, age-adjusted diabetes incidence increased with 0.314 (95% CI 0.194 to 0.434) per 1000. Similarly, the worldwide prevalence of glucose intolerance increased by 0.170% (95% CI 0.107% to 0.234%) per 1°C rise in temperature. These associations persisted after adjustment for obesity.
Conclusions Our findings indicate that the diabetes incidence rate in the USA and prevalence of glucose intolerance worldwide increase with higher outdoor temperature.
- Type 2 Diabetes
- Epidemiology
- Environment
- Brown Adipose Tissue
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Footnotes
LLB, NAA, HP and PCNR contributed equally.
In memoriam (17 January 2016) Dr Anton J de Craen, Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
Contributors LLB and NAA were involved in study concept and design, acquisition of data, analysis and interpretation of data, statistical analysis, and drafting of the manuscript. MRT was involved in study concept and design, analysis and interpretation of data, and critical revision of the manuscript. CAB was involved in MATLAB programming, analysis and interpretation of data, and critical revision of the manuscript. AJdC was involved in study concept and design, analysis and interpretation of data, and statistical analysis. HP and PCNR were involved in study concept and design, analysis and interpretation of data, critical revision of the manuscript, and study supervision.
Funding LLB is supported by an excellence grant from the Board of Directors of the Leiden University Medical Center. NAA is supported by a VENI grant (#91615080) from the Netherlands Organization of Scientific Research. PCNR is an established investigator of the Dutch Heart Foundation (2009T038).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.