Lao J H, Liu Z D, Liu Y Y, Zhang J, Jiang B F
Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Nov 10;39(11):1454-1458. doi: 10.3760/cma.j.issn.0254-6450.2018.11.007.
To understand the influence of diurnal temperature range (DTR) on influenza incidence in the elderly in Beijing and to conduct a subgroup analysis. The incidence data of daily influenza cases in the elderly and daily meteorological data from 2014 to 2016 in Beijing were collected for this study. A generalized additive model (GAM) was used to explore whether the relationship between daily influenza cases and DTR is a linear one. A distributed lag non-linear model (DLNM) was established to quantify the lagged effect of DTR on daily influenza incidence in the elderly. The model was also used to estimate the effects of DTR on daily influenza incidence among various subgroups. A total of 4 097 influenza cases in the elderly were notified during study period. The mean DTR was 10.153 ℃. A linear relationship between daily influenza incidence and DTR was detected by using GAM. DTR was significantly associated with daily influenza incidence between lag0 and lag5 with a maximal effect at lag0. An 1 ℃ increase of DTR was associated with a 2.0% increase in daily influenza incidence in the elderly (95: 0.9%-3.0%). The values of males, females, people aged 60-69 years, people aged ≥70 years were 1.018 (95: 1.005-1.032), 1.021(95: 1.007-1.035), 1.012 (95: 1.002-1.022), 1.025 (95: 1.012-1.039), respectively. The influencing time of DTR on females (lag6) was longer than males (lag2). DTR was associated with increased risk of influenza in the elderly in Beijing. It is necessary to take targeted measures in the elderly to control the incidence of influenza when DTR becomes greater.
了解北京地区日较差（DTR）对老年人流感发病率的影响并进行亚组分析。本研究收集了2014年至2016年北京地区老年人每日流感病例的发病数据和每日气象数据。采用广义相加模型（GAM）探讨每日流感病例与DTR之间的关系是否呈线性。建立分布滞后非线性模型（DLNM）以量化DTR对老年人每日流感发病率的滞后效应。该模型还用于估计DTR对各亚组每日流感发病率的影响。研究期间共报告4097例老年人流感病例。平均日较差为10.153℃。通过GAM检测到每日流感发病率与DTR之间存在线性关系。DTR与lag0至lag5之间的每日流感发病率显著相关，在lag0时效应最大。日较差每升高1℃，老年人每日流感发病率增加2.0%（95%可信区间：0.9%-3.0%）。男性、女性、60-69岁人群、≥70岁人群的 值分别为1.018（95%可信区间：1.005-1.032）、1.021（95%可信区间：1.007-1.035）、1.012（95%可信区间：1.002-1.022）、1.025（95%可信区间：1.012-1.039）。DTR对女性（lag6）的影响时间长于男性（lag2）。DTR与北京地区老年人流感风险增加有关。当日较差增大时，有必要针对老年人采取针对性措施以控制流感发病率。
