Lee SeoYeon, Kim Min-Su, Kim Jung Hoon, Kwon Jong Kyou, Chi Byung Hoon, Kim Jin Wook, Chang In Ho
Department of Urology, Seonam University College of Medicine, Myongji Hospital, Goyang, Korea .
Department of Urology, Seoul Medical Center, Seoul, Korea .
J Korean Med Sci. 2016 May;31(5):750-6. doi: 10.3346/jkms.2016.31.5.750. Epub 2016 Mar 18.
This study aimed to investigate the overall cumulative exposure-response and the lag response relationships between daily temperature and urolithiasis presentation in Seoul. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of urolithiasis presentation associated with mean daily temperature, including the cumulative RR for a 20 days period, and RR for individual daily lag through 20 days. We analyzed data from 14,518 patients of 4 hospitals emergency department who sought medical evaluation or treatment of urolithiasis from 2005-2013 in Seoul. RR was estimated according to sex and age. Associations between mean daily temperature and urolithiasis presentation were not monotonic. Furthermore, there was variation in the exposure-response curve shapes and the strength of association at different temperatures, although in most cases RRs increased for temperatures above the 13°C reference value. The RRs for urolothiasis at 29°C vs. 13°C were 2.54 in all patients (95% confidence interval [CI]: 1.67-3.87), 2.59 in male (95% CI, 1.56-4.32), 2.42 in female (95% CI, 1.15-5.07), 3.83 in male less than 40 years old (95% CI, 1.78-8.26), and 2.47 in male between 40 and 60 years old (95% CI, 1.15-5.34). Consistent trends of increasing RR of urolithiasis presentation were observed within 5 days of high temperatures across all groups. Urolithiasis presentation increased with high temperature with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days, in Seoul, a metropolitan city in Korea.
本研究旨在调查首尔每日气温与尿石症发病之间的总体累积暴露-反应及滞后反应关系。采用时间序列设计和分布滞后非线性方法，我们估计了与日平均气温相关的尿石症发病相对风险（RR），包括20天期间的累积RR以及20天内各日滞后的RR。我们分析了2005年至2013年期间首尔4家医院急诊科14518例因尿石症寻求医疗评估或治疗的患者的数据。RR根据性别和年龄进行估计。日平均气温与尿石症发病之间的关联并非单调。此外，尽管在大多数情况下，高于13°C参考值的温度下RR会增加，但不同温度下的暴露-反应曲线形状和关联强度存在差异。在所有患者中，29°C与13°C时尿石症的RR为2.54（95%置信区间[CI]：1.67 - 3.87），男性为2.59（95% CI，1.56 - 4.32），女性为2.42（95% CI，1.15 - 5.07），40岁以下男性为3.83（95% CI，1.78 - 8.26），40至60岁男性为2.47（95% CI，1.15 - 5.34）。在韩国大都市首尔，所有组在高温后的5天内均观察到尿石症发病RR增加的一致趋势。尿石症发病随高温及更高的日平均气温而增加，在仅滞后几天时估计的关联最强。
