Department of Cardiology, Fourth Affiliated Hospital of Nantong University, Yancheng, China.
J Epidemiol. 2009;19(6):328-32. doi: 10.2188/jea.je20080074. Epub 2009 Sep 12.
Although the relation between day-to-day temperature change and coronary heart disease (CHD) mortality is well established, it is unknown whether temperature variation within 1 day, ie, diurnal temperature range (DTR), is an independent risk factor for acute CHD death.
We used time-series and case-crossover approaches to assess the relation between DTR and daily CHD mortality between 2001 and 2004 in Shanghai, China. Specifically, we used exposures averaged over periods varying from 1 to 5 days to assess the effects of DTR on CHD mortality. We estimated the percent increase in the number of daily deaths related to CHD that were associated with DTR, after adjustment for daily meteorologic conditions (temperature and relative humidity) and levels of outdoor air pollutants.
Both time-series and case-crossover analyses showed that DTR was significantly associated with the number of daily deaths related to CHD. A 1 degrees C increase in 2-day lagged DTR corresponded to a 2.46% (95% CI, 1.76% to 3.16%) increase in CHD mortality on time-series analysis, a 3.21% (95% CI, 2.23% to 4.19%) increase on unidirectional case-crossover analysis, and a 2.13% (95% CI, 1.04% to 3.22%) increase on bidirectional case-crossover analysis.
Our findings suggest that DTR is an independent risk factor for acute CHD death.
尽管每日气温变化与冠心病（CHD）死亡率之间的关系已得到充分证实，但目前尚不清楚 1 日内的温度变化（即昼夜温差）是否是急性 CHD 死亡的独立危险因素。
我们使用时间序列和病例交叉方法来评估 2001 年至 2004 年期间上海昼夜温差与每日 CHD 死亡率之间的关系。具体而言，我们使用了 1 至 5 天不等的时间间隔内的暴露平均值来评估昼夜温差对 CHD 死亡率的影响。我们在调整了每日气象条件（温度和相对湿度）和室外空气污染物水平后，估计了与昼夜温差相关的每日 CHD 死亡人数的增加百分比。
时间序列和病例交叉分析均表明昼夜温差与与 CHD 相关的每日死亡人数显著相关。在时间序列分析中，2 天滞后的昼夜温差每升高 1°C，CHD 死亡率相应增加 2.46%（95%CI，1.76%至 3.16%），在单向病例交叉分析中增加 3.21%（95%CI，2.23%至 4.19%），在双向病例交叉分析中增加 2.13%（95%CI，1.04%至 3.22%）。
我们的研究结果表明昼夜温差是急性 CHD 死亡的独立危险因素。
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