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| Item Type: | Article |
|---|---|
| Title: | Sex-specific individual and joint associations of multiple environmental exposures with diabetes and obesity in the population-based German National Cohort (NAKO) |
| Creators: |
Niedermayer, Fiona  ORCID: https://orcid.org/0000-0002-6798-2630, Hoffmann, Barbara ORCID: https://orcid.org/0000-0002-8435-5575, Zhang, Boya, Chen, Jie, Hart, Jaime E. ORCID: https://orcid.org/0000-0002-0826-1163, Laden, Francine ORCID: https://orcid.org/0000-0002-2813-2174, Bolte, Gabriele ORCID: https://orcid.org/0000-0002-0269-5059, Lakes, Tobia, Schikowski, Tamara ORCID: https://orcid.org/0000-0002-4559-9374, Greiser, Karin Halina, Staab, Jeroen, Nikolaou, Nikolaos ORCID: https://orcid.org/0000-0003-0346-3142, Dallavalle, Marco, Schulze, Matthias B., Lieb, Wolfgang ORCID: https://orcid.org/0000-0003-2544-4460, Övermöhle, Cara, Tönnies, Thaddäus, Katzke, Verena ORCID: https://orcid.org/0000-0002-6509-6555, Becher, Heiko ORCID: https://orcid.org/0000-0002-8808-6667, Fischer, Beate, Leitzmann, Michael, Berger, Klaus, Mayvaneh, Fatemeh, Keil, Thomas ORCID: https://orcid.org/0000-0002-9108-3360, Krist, Lilian ORCID: https://orcid.org/0000-0002-6089-5163, Klett-Tammen, Carolina J. ORCID: https://orcid.org/0000-0001-9685-5369, Heise, Jana-Kristin ORCID: https://orcid.org/0000-0001-7194-8673, Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X, Moreno Velásquez, Ilais ORCID: https://orcid.org/0000-0001-6058-8983, Schmidt, Börge, Nagrani, Rajini, Rach, Stefan, Brenner, Hermann, Holleczek, Bernd, Harth, Volker, Obi, Nadia ORCID: https://orcid.org/0000-0002-0903-9142, Köttgen, Anna, Mikolajczyk, Rafael ORCID: https://orcid.org/0000-0003-1271-7204, Meinke-Franze, Claudia, Hoffmann, Wolfgang ORCID: https://orcid.org/0000-0002-6359-8797, Schneider, Alexandra ORCID: https://orcid.org/0000-0002-1084-2442, Wolf, Kathrin ORCID: https://orcid.org/0000-0002-4343-201X and Peters, Annette
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| Abstract: | Recent studies have suggested a potential association of particulate matter (PM) and noise with diabetes and obesity, but studies examining other environmental exposures and their sex-specific and joint associations remain limited. Therefore, we investigated sex-specific individual and joint associations of annual exposure to multiple environmental factors with diabetes and obesity-related measures using cross-sectional data from the population-based multi-center German National Cohort (NAKO). Outcomes included self-reported diabetes mellitus, body mass index (BMI), obesity (BMI ≥30 kg/m(2)), and waist circumference. Annual mean residential exposures included air pollutants, air temperature, day-evening-night road traffic noise (L(den)) and surrounding greenness (normalized difference vegetation index (NDVI)). We used sex-stratified linear and logistic regression models to assess individual associations and quantile g-computation to assess joint associations. Among 174,955 adult participants (50.4% women), 5.6% reported a diabetes diagnosis and 20.9% were obese. An interquartile range increase in PM(2.5) and L(den) was consistently associated with diabetes and obesity-related measures (e.g., PM(2.5)-diabetes for men: odds ratio (OR) [95% confidence interval] = 1.12 [1.02; 1.22]; L(den)-BMI for women: 0.22 kg/m(2) [0.16; 0.27]). Greenness showed non-linear (inverted U-shaped) with all outcomes. An interquartile range increase in multiple exposures simultaneously was associated with higher odds of diabetes, obesity and higher obesity-related measures (e.g., mixture (PM(2.5),L(den), lack of NDVI)-diabetes: OR = 1.20 [1.09; 1.33] for men; mixture (PM(2.5),L(den), lack of NDVI)-BMI: 0.33 kg/m(2) [0.21; 0.44] for women). While longitudinal studies need to confirm these findings, the study highlights that reducing multiple adverse environmental exposures could be potential targets for the prevention of diabetes and obesity. |
| Keywords: | Metabolic Disease, Environmental Epidemiology, Urbanization, Exposure Mixture |
| Source: | Environmental Research |
| ISSN: | 0013-9351 |
| Publisher: | Elsevier / Academic Press |
| Volume: | 297 |
| Page Range: | 124096 |
| Date: | 15 May 2026 |
| Official Publication: | https://doi.org/10.1016/j.envres.2026.124096 |
| PubMed: | View item in PubMed |
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