Association between ultraviolet exposure and type 2 diabetes: Insights from the China Health and Retirement Longitudinal Study (CHARLS).

Abstract

Objective: To investigate the association between long-term exposure to ambient ultraviolet radiation (UVR) and the risk of developing type 2 diabetes (T2D).

Research design and methods: This study analyzed data from 14,825 participants enrolled in the 2015 China Health and Retirement Longitudinal Study (CHARLS). Ground-based daily average UVR monitoring data, collected from January 1, 2005, to December 31, 2014, across 724 stations in China, were matched to 125 cities corresponding to participants' residences. UVR exposure levels were calculated separately for annual, spring, summer, autumn, and winter. All analyses were stratified by sex. Initially, a generalized linear mixed-effects model (GLMM) was employed to assess the association between city-level UVR exposure and individual-level risk of T2D. Further stratified analyses were performed based on age, body mass index (BMI), and urban versus rural residence.

Results: Higher UVR exposure was associated with a lower risk of T2D in women (OR_annual: 0.250, 95 % CI: 0.081-0.773; OR_spring: 0.437, 95 % CI: 0.194-0.984; OR_autumn: 0.305, 95 % CI: 0.098-0.944; OR_winter: 0.227, 95 % CI: 0.079-0.655). Stratified analyses revealed that annual UVR exposure had a strong protective effect in T2D among women aged under 60 years (OR: 0.163, 95 % CI: 0.034-0.792), normal and underweight women and men (OR_women: 0.080, 95 % CI: 0.017-0.383; OR_men: 0.180, 95 % CI: 0.038-0.850) and rural women (OR: 0.207, 95 % CI: 0.065-0.661).

Conclusions: Exposure to UVR appears to confer a protective effect against T2D, with this association being especially evident in women. The protective influence is more marked among individuals younger than 60 years, those with normal weight or underweight, and those residing in rural areas.