Journal Article

DKFZ-2026-00462

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Sex-specific individual and joint associations of multiple environmental exposures with diabetes and obesity in the population-based German National Cohort (NAKO).

Niedermayer, F. ; Hoffmann, B. ; Zhang, B. ; Chen, J. ; Hart, J. E. ; Laden, F. ; Bolte, G. ; Lakes, T. ; Schikowski, T. ; Greiser, K. H.DKFZ* ; Staab, J. ; Nikolaou, N. ; Dallavalle, M. ; Schulze, M. B. ; Lieb, W. ; Övermöhle, C. ; Tönnies, T. ; Katzke, V.DKFZ* ; Becher, H. ; Fischer, B. ; Leitzmann, M. ; Berger, K. ; Mayvaneh, F. ; Keil, T. ; Krist, L. ; Klett-Tammen, C. J. ; Heise, J.-K. ; Pischon, T. ; Velásquez, I. M. ; Schmidt, B. ; Nagrani, R. ; Rach, S. ; Brenner, H.DKFZ* ; Holleczek, B. ; Harth, V. ; Obi, N. ; Köttgen, A. ; Mikolajczyk, R. ; Meinke-Franze, C. ; Hoffmann, W. ; Schneider, A. ; Wolf, K. ; Peters, A.

2026
Elsevier San Diego, Calif.

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/m2), and waist circumference. Annual mean residential exposures included air pollutants, air temperature, day-evening-night road traffic noise (Lden) 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 PM2.5 and Lden was consistently associated with diabetes and obesity-related measures (e.g., PM2.5-diabetes for men: odds ratio (OR) [95% confidence interval] = 1.12 [1.02; 1.22]; Lden-BMI for women: 0.22 kg/m2 [0.16; 0.27]). Greenness showed non-linear (inverted U-shaped) with all outcomes. A one-quartile increase in multiple exposures simultaneously was associated with higher odds of diabetes, obesity and higher obesity-related measures (e.g., mixture (PM2.5,Lden, lack of NDVI)-diabetes: OR =1.14 [1.07; 1.21] for men; mixture (PM2.5,Lden, lack of NDVI)-BMI: 0.28 kg/m2 [0.21; 0.36] 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.

Keyword(s): environmental epidemiology ; exposure mixture ; metabolic disease ; urbanization

Note: 2026 May 15;297:124096

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Contributing Institute(s):

1. Epidemiologie von Krebs (C020)
2. C070 Klinische Epidemiologie der Krebsfrüherkennung (C070)
3. Koordinierungsstelle der Cancer Prevention GS (M320)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026

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Database coverage:
; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Agriculture, Biology and Environmental Sciences ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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