Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis

Rajini Nagrani; Maike Wolters; Christoph Buck; Danielle Vienneau; Kees deHoogh; Stefaan De Henauw; Lauren Lissner; Dénes Molnár; Luis Moreno; Marika Dello Russo; Valeria Pala; Wolfgang Ahrens; Vanessa Didelez; Claudia Börnhorst

doi:10.1016/j.envres.2025.122920

Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis

Rajini Nagrani^*
, Maike Wolters
, Christoph Buck
, Danielle Vienneau
, Kees deHoogh
, Stefaan De Henauw
, Lauren Lissner
, Dénes Molnár
, Luis Moreno
, Marika Dello Russo
, Valeria Pala
, Wolfgang Ahrens
, Vanessa Didelez
, Claudia Börnhorst

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Observational studies have suggested that air pollution is associated with impaired glucose metabolism; yet randomized controlled trials to confirm the causality of this association are ethically and practically unfeasible. We emulated a hypothetical trial to evaluate the effects of sustained reductions in ambient air pollutants on homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose (FG) in children and adolescents. Combining target trial emulation with g-computation, we estimated the effects of sustained hypothetical reductions of air pollutants on HOMA-IR and FG compared to no intervention (natural course). Our sample comprised 1417 children aged 2–9 years at baseline (2007/2008) participating in the pan-European IDEFICS/I.Family cohort. Ambient annual average levels of particulate matter

Original language	English
Article number	122920
Journal	Environmental Research
Volume	292
DOIs	https://doi.org/10.1016/j.envres.2025.122920
Publication status	Published - 1 Mar 2026
Externally published	Yes

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Nagrani, R., Wolters, M., Buck, C., Vienneau, D., deHoogh, K., De Henauw, S., Lissner, L., Molnár, D., Moreno, L., Dello Russo, M., Pala, V., Ahrens, W., Didelez, V., & Börnhorst, C. (2026). Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis. Environmental Research, 292, Article 122920. https://doi.org/10.1016/j.envres.2025.122920

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title = "Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis",

abstract = "Observational studies have suggested that air pollution is associated with impaired glucose metabolism; yet randomized controlled trials to confirm the causality of this association are ethically and practically unfeasible. We emulated a hypothetical trial to evaluate the effects of sustained reductions in ambient air pollutants on homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose (FG) in children and adolescents. Combining target trial emulation with g-computation, we estimated the effects of sustained hypothetical reductions of air pollutants on HOMA-IR and FG compared to no intervention (natural course). Our sample comprised 1417 children aged 2–9 years at baseline (2007/2008) participating in the pan-European IDEFICS/I.Family cohort. Ambient annual average levels of particulate matter",

author = "Rajini Nagrani and Maike Wolters and Christoph Buck and Danielle Vienneau and Kees deHoogh and \{De Henauw\}, Stefaan and Lauren Lissner and D{\'e}nes Moln{\'a}r and Luis Moreno and \{Dello Russo\}, Marika and Valeria Pala and Wolfgang Ahrens and Vanessa Didelez and Claudia B{\"o}rnhorst",

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doi = "10.1016/j.envres.2025.122920",

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Nagrani, R, Wolters, M, Buck, C, Vienneau, D, deHoogh, K, De Henauw, S, Lissner, L, Molnár, D, Moreno, L, Dello Russo, M, Pala, V, Ahrens, W, Didelez, V & Börnhorst, C 2026, 'Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis', Environmental Research, vol. 292, 122920. https://doi.org/10.1016/j.envres.2025.122920

TY - JOUR

T1 - Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis

AU - Nagrani, Rajini

AU - Wolters, Maike

AU - Buck, Christoph

AU - Vienneau, Danielle

AU - deHoogh, Kees

AU - De Henauw, Stefaan

AU - Lissner, Lauren

AU - Molnár, Dénes

AU - Moreno, Luis

AU - Dello Russo, Marika

AU - Pala, Valeria

AU - Ahrens, Wolfgang

AU - Didelez, Vanessa

AU - Börnhorst, Claudia

PY - 2026/3/1

Y1 - 2026/3/1

N2 - Observational studies have suggested that air pollution is associated with impaired glucose metabolism; yet randomized controlled trials to confirm the causality of this association are ethically and practically unfeasible. We emulated a hypothetical trial to evaluate the effects of sustained reductions in ambient air pollutants on homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose (FG) in children and adolescents. Combining target trial emulation with g-computation, we estimated the effects of sustained hypothetical reductions of air pollutants on HOMA-IR and FG compared to no intervention (natural course). Our sample comprised 1417 children aged 2–9 years at baseline (2007/2008) participating in the pan-European IDEFICS/I.Family cohort. Ambient annual average levels of particulate matter

AB - Observational studies have suggested that air pollution is associated with impaired glucose metabolism; yet randomized controlled trials to confirm the causality of this association are ethically and practically unfeasible. We emulated a hypothetical trial to evaluate the effects of sustained reductions in ambient air pollutants on homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose (FG) in children and adolescents. Combining target trial emulation with g-computation, we estimated the effects of sustained hypothetical reductions of air pollutants on HOMA-IR and FG compared to no intervention (natural course). Our sample comprised 1417 children aged 2–9 years at baseline (2007/2008) participating in the pan-European IDEFICS/I.Family cohort. Ambient annual average levels of particulate matter

U2 - 10.1016/j.envres.2025.122920

DO - 10.1016/j.envres.2025.122920

M3 - Article

SN - 0013-9351

VL - 292

JO - Environmental Research

JF - Environmental Research

M1 - 122920

ER -

Effect of long-term air pollution reduction on insulin resistance and fasting glucose in children: A causal analysis

Abstract

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