Association of long-term exposure to air pollution, built environment and air temperature with the incidence of prediabetes phenotypes, and prediabetes remission and progression to type 2 diabetes: a longitudinal study in the KORA cohort
Authors' conclusion
The findings indicate potential heterogeneity in environmental exposures and prediabetes phenotypes. Specifically, they are associated with increased incidence of IGT and decreased remission of iIFG.
Study context
- Population
- Participants of the KORA cohort, Southern Germany (2006–2022); glucose tolerance by 1999/2006 WHO criteria
- Participants
- 1,618 participants
- Exposure
- IQR changes in environmental exposures
- Outcome
- Incidence of prediabetes phenotypes (iIFG, iIGT, IFG+IGT), remission to NGT or progression to T2D
Methodological detailspopulation-based cohort (KORA), complementary log-log regression, quantile g-computation for joint associations
- Population-based cohort (KORA)
- Complementary log-log regression
- Quantile g-computation for joint associations
Main finding
As reported in the abstract
Incidence of prediabetes phenotypes; remission; progression to T2D
- Developed prediabetes
- 370/1618
- Developed iIFG
- 124
- Developed iIGT
- 199
- Developed IFG+IGT
- 47
- Prediabetes (without medication) regressed to normal glucose tolerance (NGT)
- 136/367
- Prediabetes progressed to T2D
- 133/420
- IFG+IGT risk per IQR increase in PM2.5: HR
- 1.89 (1.07, 3.31) (95% CI)
- IFG+IGT risk with a decrease in normalised difference vegetation index (NDVI): HR
- 1.59 (1.03, 2.46) (95% CI)
- Remission of iIFG with lower NDVI: HR
- 0.52 (0.28, 0.96) (95% CI)
- Remission of iIFG with higher light at night (LAN): HR
- 0.22 (0.08, 0.62) (95% CI)
Observational data: associations, not effects.
Original publication
Association of long-term exposure to air pollution, built environment and air temperature with the incidence of prediabetes phenotypes, and prediabetes remission and progression to type 2 diabetes: a longitudinal study in the KORA cohort. Diabetologia. Published 25 July 2026. doi:10.
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