Association of environmental factors and heavy metal exposure with glycemic parameters in rural regions of Tamil Nadu

Air pollution has recently emerged as a novel risk factor for metabolic disorders. Prior research has been largely focused on ambient fine particulate matter PM2.5  a cardio-respiratory and select maternal and child health outcomes among urban populations with limited focus on linkages with diabetes and among rural populations. This study attempts to establish continuous quantitative exposure response relationships between air pollution fine particulate matter and black carbon exposures and glycemic parameters of the rural population by using outdoor and personal exposure monitoring of fine particulate matter and black carbon along with assessments of heavy metals and other pollutants. Further this study is unique to explore the probable mechanism of actions of fine particulate matter and its constituents to glycemic parameters through insulin resistance inflammation oxidative stress and lipid peroxidation. The objective of this study is to estimate the association between air pollutants heavy metals and other inorganic elements and glycemic parameters in the rural adult population of Tamil Nadu in South India. This is a cross-sectional study planned be conducted among 2000 individuals aged 30 to 65 years residing in 10 villages. 200 participants will be selected from each village in two districts of Chengelpet and Kallakurichi of rural Tamil Nadu. Written informed consent will be obtained from all study participants in the local language.An interviewer administered structured questionnaire will be administered to all participants to capture relevant demographic lifestyle personal details medical history information related to household exposure to air pollutants and awareness regarding air pollution. Anthropometric measurements including height weight waist circumference body composition analysis and blood pressure will be measured. A fasting blood sample will be drawn to measure blood sugar HbA1c lipids insulin and other biomarkers. In each participant 24-hour exposure to air pollutants using real-time personal monitors yearlong ambient air data using low-cost devices in one per village and glycemic levels and related biomarkers will be assessed. Every tenth participant that is two hundred participants will undergo additional testing for heavy metals and inorganic elements via personal air quality monitoring and urinary samples. This study will provide critical insights into how air pollutants affect metabolic health in rural India, thereby informing targeted public health interventions and policies.