The association between short-term ozone exposure and fasting blood glucose levels in non-diabetic adults was more obvious in rural residents: the evidence from a typical “urban–rural dual structure” province in southwestern China

Ambient ozone (O₃) is associated with diabetes (DM), but the data on the association between O₃ and fasting blood glucose (FBG) in non-diabetic adults is relatively rare, especially the evidence of urban–rural difference in such association is still lacking. Our research aimed to investigate the potential effects of short-term O₃ exposure on FBG levels. We carried out a cross-sectional analysis of a representative sample of 5329 adults from the Guizhou Population Health Cohort Study and the association between O₃ and FBG levels was determined. In rural populations, subgroup analyses were performed by gender, age, nationality, and so on. We observed that short-term exposure to ambient O₃ was positively associated with FBG levels. The strongest association was observed at lag 015 days, with per 10 μg/m³ increase of O₃ concentration leading to a significant increase of 0.050 mmol/L (95%CIs: 0.037, 0.063) in FBG. More importantly, the association between O₃ and FBG levels was stronger in rural populations with lower income levels. Further stratified analyses showed that participants who were older than 60 years, males, smokers, Han, non-drinkers, warm season, dietary score ≥ 3, exercise time < 150 min/week, sleep duration < 7 h/day, and BMI < 18.5 kg/m² were potentially more susceptible to the effects of O₃ in rural populations. In general, our study not only provided the evidence that O₃ exposure can be associated with increased FBG levels, but also shed new light on the further understanding of the adverse effects of O₃ on DM. Furthermore, rural populations may be more vulnerable to the effects of O₃. Our findings indicate that the issue of air pollution in rural areas is equally noteworthy.