The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.

The burden of type 2 diabetes is rapidly increasing in low- and middle-income countries (LMICs), but determinants are not well-characterized. Household air pollution (HAP) from indoor biofuel use for cooking has been associated with non-communicable diseases and could be contributing to the increasi...

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Main Authors: Happyness Kunzi, Mussa K Nsanya, Belinda Kweka, Evangelista Malindisa, Ng Wamba Sitta Ngissa, Bazil Baltazar Kavishe, Kidola Jeremiah, Mette Frahm Olsen, Rikke Krogh-Madsen, Suzanne Filteau, Henrik Friis, Daniel Faurholt-Jepsen, George PrayGod
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0003816
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author Happyness Kunzi
Mussa K Nsanya
Belinda Kweka
Evangelista Malindisa
Ng Wamba Sitta Ngissa
Bazil Baltazar Kavishe
Kidola Jeremiah
Mette Frahm Olsen
Rikke Krogh-Madsen
Suzanne Filteau
Henrik Friis
Daniel Faurholt-Jepsen
George PrayGod
author_facet Happyness Kunzi
Mussa K Nsanya
Belinda Kweka
Evangelista Malindisa
Ng Wamba Sitta Ngissa
Bazil Baltazar Kavishe
Kidola Jeremiah
Mette Frahm Olsen
Rikke Krogh-Madsen
Suzanne Filteau
Henrik Friis
Daniel Faurholt-Jepsen
George PrayGod
author_sort Happyness Kunzi
collection DOAJ
description The burden of type 2 diabetes is rapidly increasing in low- and middle-income countries (LMICs), but determinants are not well-characterized. Household air pollution (HAP) from indoor biofuel use for cooking has been associated with non-communicable diseases and could be contributing to the increasing burden of diabetes in LMICs, though data are limited. We assessed the association between indoor biofuel use for cooking and glucose metabolism in HIV-infected and HIV-uninfected Tanzanian adults. This cross-sectional analysis included Tanzanian adults with and without HIV, from whom we collected sociodemographic and non-communicable disease risk factor data. The main predictor variable was indoor biofuel use for cooking, established using self-reported cooking location (indoor or outdoor) and fuel type (electricity/gas or biomass fuel), and categorized as minimal or no exposure, moderate exposure, and high exposure. Blood glucose and insulin were measured during oral glucose tolerance tests, allowing computation of outcome variables including markers of β-cell dysfunction (homeostatic model assessment-β, insulinogenic index, oral disposition index), insulin resistance (HOMA-IR and Matsuda index), and pre-diabetes and diabetes status. Logistic regression was used to assess associations, adjusting for age, sex, physical activity, smoking, socioeconomic status, HIV status, and body mass index. Among 1,871 participants (mean age 40.6 ± 11.9 years; 59.8% female), those with moderate and high exposure to HAP had approximately two-fold higher odds of a lower insulinogenic index (adjusted odds ratio [aOR] = 2.13, 95% CI: 1.27-3.57 and aOR = 2.31, 95% CI: 1.39-3.83, respectively) compared to those with minimal or no exposure. HAP was not associated with other markers of β-cell function, insulin resistance, pre-diabetes, or diabetes. In conclusion, HAP is associated with increased risk of β-cell dysfunction among individuals using biofuel for indoor cooking. Longitudinal studies using objective HAP measurements are needed to confirm these findings.
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spelling doaj-art-3e01e0547cdd4b9b9d3f5df523689cd02025-08-20T01:55:30ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0155e000381610.1371/journal.pgph.0003816The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.Happyness KunziMussa K NsanyaBelinda KwekaEvangelista MalindisaNg Wamba Sitta NgissaBazil Baltazar KavisheKidola JeremiahMette Frahm OlsenRikke Krogh-MadsenSuzanne FilteauHenrik FriisDaniel Faurholt-JepsenGeorge PrayGodThe burden of type 2 diabetes is rapidly increasing in low- and middle-income countries (LMICs), but determinants are not well-characterized. Household air pollution (HAP) from indoor biofuel use for cooking has been associated with non-communicable diseases and could be contributing to the increasing burden of diabetes in LMICs, though data are limited. We assessed the association between indoor biofuel use for cooking and glucose metabolism in HIV-infected and HIV-uninfected Tanzanian adults. This cross-sectional analysis included Tanzanian adults with and without HIV, from whom we collected sociodemographic and non-communicable disease risk factor data. The main predictor variable was indoor biofuel use for cooking, established using self-reported cooking location (indoor or outdoor) and fuel type (electricity/gas or biomass fuel), and categorized as minimal or no exposure, moderate exposure, and high exposure. Blood glucose and insulin were measured during oral glucose tolerance tests, allowing computation of outcome variables including markers of β-cell dysfunction (homeostatic model assessment-β, insulinogenic index, oral disposition index), insulin resistance (HOMA-IR and Matsuda index), and pre-diabetes and diabetes status. Logistic regression was used to assess associations, adjusting for age, sex, physical activity, smoking, socioeconomic status, HIV status, and body mass index. Among 1,871 participants (mean age 40.6 ± 11.9 years; 59.8% female), those with moderate and high exposure to HAP had approximately two-fold higher odds of a lower insulinogenic index (adjusted odds ratio [aOR] = 2.13, 95% CI: 1.27-3.57 and aOR = 2.31, 95% CI: 1.39-3.83, respectively) compared to those with minimal or no exposure. HAP was not associated with other markers of β-cell function, insulin resistance, pre-diabetes, or diabetes. In conclusion, HAP is associated with increased risk of β-cell dysfunction among individuals using biofuel for indoor cooking. Longitudinal studies using objective HAP measurements are needed to confirm these findings.https://doi.org/10.1371/journal.pgph.0003816
spellingShingle Happyness Kunzi
Mussa K Nsanya
Belinda Kweka
Evangelista Malindisa
Ng Wamba Sitta Ngissa
Bazil Baltazar Kavishe
Kidola Jeremiah
Mette Frahm Olsen
Rikke Krogh-Madsen
Suzanne Filteau
Henrik Friis
Daniel Faurholt-Jepsen
George PrayGod
The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
PLOS Global Public Health
title The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
title_full The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
title_fullStr The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
title_full_unstemmed The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
title_short The association between indoor biofuel use for cooking and glucose metabolism in adults: A cross-sectional study in Tanzania.
title_sort association between indoor biofuel use for cooking and glucose metabolism in adults a cross sectional study in tanzania
url https://doi.org/10.1371/journal.pgph.0003816
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