Air pollution and lifestyle changes are triggering Asthma and other health complications among diabetics. This is a three part series highlighting the causes of Asthma and its impact on people.

Air pollution can potentially speed up health complications amongst diabetic patients, shows a first–of–its kind study done by Chest Research Foundation (CRF) and KEM Hospital, Pune ringing alarm bells on the health time bomb the people are sitting on.

The World Health Organization estimated that 8,65,000 premature deaths occur every year due to the adverse health effects of ambient air pollution and that China and India are the most affected countries.

"Inhaled particles and gaseous air pollutants cause the release of reactive oxygen species from cells in the lung and circulating immune cells, which in turn trigger the release of inflammatory mediators into the systemic circulation to affect other body organs," Director of CRF Dr Sundeep Salvi told Sakal Times.

Such an increase in systemic inflammation has been shown to increase cardiovascular disease (CVD) risk.

Extremes of age, obesity, and underlying respiratory, cardiovascular, and metabolic disorders (diabetes) seem to increase vulnerability and susceptibility to the harmful effects of air pollution, and the systemic inflammatory response may further worsen the disease state.

C–reactive protein (CRP) is a nonspecific marker of systemic inflammation that predicts type–2 diabetes and CVD events.

But there is only a little information from Asia. This study reports that type 2 diabetic patients residing in Pune, show high concentrations of CRP concentrations that correlate positively and significantly with ambient levels of Sulfur dioxide (SO2) and Nitrogen Oxide (NOx). SO2 showed a stronger association compared with NOx.

"In summary, we found that exposure to traffic–related air pollutants is associated with a rapid increase in systemic inflammation (ie CRP) in diabetic patients,” Salvi said

"A total of 1,392 type–2 diabetic patients in Pune were studied. We demonstrated, for the first time, a possible contribution of ambient air pollution to systemic inflammation in Indian type 2 diabetic patients" Dr Salvi said.

The study titled 'Systemic Inflammation (C–Reactive Protein) in Type 2 Diabetic Patients Is Associated With Ambient Air Pollution in Pune City, India' has been published in the journal Diabetes Care.

It has been authored by Iranian PhD scholar Morteza A Khafaie, Dr Salvi, Dr Chittaranjan S Yajnik from KEM Hospital Pune and others.

"This is the first time that air pollution has shown a significant impact on diabetic patients. Apart from diet and regular exercise, diabetic patients will now to have to take care if air pollution exposures as well," Dr Yajnik added.

THE LINK...

• CRP is an established risk factor for coronary heart disease and type 2 diabetes
• It is produced exclusively in liver during systemic inflammation
• Inflammation occurs after exposure to traffic–related air pollutants
• Enhanced susceptibility of diabetic patients to pollutants due to heightened inflammation
• Findings may have implications for enhanced risk of CVD in urban diabetic patients

Source
Sakal Times
10 Sep 2013, Pune