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[中国66个城市日温差对死亡率的滞后效应:一项时间序列研究]

[Lagged effects of diurnal temperature range on mortality in 66 cities in China: a time-series study].

作者信息

Zhao Y Q, Wang L J, Luo Y, Yin P, Huang Z J, Liu T, Lin H L, Xiao J P, Li X, Zeng W L, Ma W J, Zhou M G

机构信息

School of Medicine, Jinan University, Guangzhou 510632, China.

National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Mar 10;38(3):290-296. doi: 10.3760/cma.j.issn.0254-6450.2017.03.004.

Abstract

To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China. A time series study using the data collected from 66 areas in China was conducted, and Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality. Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively. Cumulative excess risk () was used as an index to evaluate the effects. The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011, we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped. In central and south areas of China, the result indicated the obvious acute effect of extremely high DTR, and the mortality effect in central area (=5.1%, 95: 2.4%-7.9%) was significant higher than that in south area (=4.5%, 95: 1.7%-7.3%). Regarding to the modification of seasons, the cumulative mortality effect of DTR in cold season (=5.8%, 95: 2.5%-9.2%) was higher than that in hot season (=3.1%, 95: 1.1%-5.1%). Generally, deaths among the elderly (≥75 years) were associated more strongly with extremely high DTR. The mortality effects of extremely DTR in different areas and seasons showed different characteristics, that in central area and in cold season it was significantly stronger. After modified by season and SES, DTRs were the greatest threat to vulnerable population, especially to the elderly (≥75 years). Therefore, more attention should be paid to vulnerable groups and protection measures should be taken according to the local and seasonal conditions.

摘要

评估中国不同地区日较差(DTR)对死亡率的影响。采用时间序列研究方法,利用从中国66个地区收集的数据,并运用Meta分析来分析DTR与每日死亡率之间的关联估计值。同时分别评估了极低和极高DTR - 死亡率关系受季节和社会经济地位(SES)的修正作用。采用累积超额风险()作为评估影响的指标。收集了2006年1月1日至2011年12月31日期间1260913例登记死亡的信息,我们发现极端DTR与死亡率之间的关系在所有地区均呈非线性,暴露 - 反应曲线呈J形。在中国中部和南部地区,结果表明极高DTR具有明显的急性效应,中部地区的死亡率效应(=5.1%,95%可信区间:2.4% - 7.9%)显著高于南部地区(=4.5%,95%可信区间:1.7% - 7.3%)。关于季节修正,寒冷季节DTR的累积死亡率效应(=5.8%,95%可信区间:2.5% - 9.2%)高于炎热季节(=3.1%,95%可信区间:1.1% - 5.1%)。一般来说,老年人(≥75岁)的死亡与极高DTR的关联更强。不同地区和季节极端DTR的死亡率效应呈现不同特征,中部地区和寒冷季节的效应显著更强。经季节和SES修正后,DTR对弱势群体尤其是老年人(≥75岁)构成最大威胁。因此,应更加关注弱势群体,并根据当地和季节条件采取保护措施。

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