State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
School of Geography and Planning, Sun Yat Sen University, Guangzhou, China.
Respir Res. 2020 Sep 29;21(1):251. doi: 10.1186/s12931-020-01517-7.
The association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported.
To examine the association between DTR and daily hospital admissions for exacerbation of CRD and find out the potential effect of modifications on this association.
Data on daily hospitalization for exacerbation of chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis and meteorology measures from 2013 through 2017 were obtained from 21 cities in South China. After controlling the effects of daily mean temperature, relative humidity (RH), particulate matter < 2.5 μm diameter (PM) and other confounding factors, a standard generalized additive model (GAM) with a quasi-Poisson distribution was performed to evaluate the relationships between DTR and daily hospital admissions of CRD in a two-stage strategy. Subgroup analysis was performed to find potential modifications, including seasonality and population characteristics.
Elevated risk of hospitalization for exacerbation of CRD (RR = 1.09 [95%CI: 1.08 to 1.11]) was associated with the increase in DTR (the 75th percentile versus the 25th percentile of DTR at lag0-6). The effects of DTR on hospital admissions for CRD were strong at low DTR in the hot season and high DTR in the cold season. The RR (the 75th percentile versus the 25th percentile of DTR at lag0-6) of hospitalization was 1.11 (95%CI: 1.08 to 1.12) for exacerbations of COPD and 1.09 (95%CI: 1.05 to 1.13) for asthma. The adverse effect of DTR on hospitalization for bronchiectasis was only observed in female patients (RR = 1.06 [95%CI: 1.03 to 1.10]).
Our study provided additional evidence for the association between DTR and daily hospitalization for exacerbation of CRD, and these associations are especially stronger in COPD patients and in the cold season than the hot season. Preventive measures to reduce the adverse impacts of DTR were needed for CRD patients.
日较差（DTR）与慢性呼吸道疾病（CRD）恶化住院之间的关联很少有报道。
研究 DTR 与 CRD 恶化每日住院之间的关联，并找出对这种关联的潜在影响。
本研究从中国南部 21 个城市获取了 2013 年至 2017 年每日慢性阻塞性肺疾病（COPD）、哮喘和支气管扩张住院和气象数据。在控制每日平均温度、相对湿度（RH）、细颗粒物（PM）<2.5 μm 直径和其他混杂因素的影响后，采用具有拟泊松分布的标准广义加性模型（GAM），分两阶段策略评估 DTR 与 CRD 每日住院之间的关系。进行亚组分析，以发现潜在的修饰作用，包括季节性和人口特征。
与 DTR 增加相关的 CRD 恶化住院风险增加（RR=1.09[95%CI：1.08 至 1.11]）（DTR 的第 75 百分位与 lag0-6 时的第 25 百分位相比）。在炎热季节的低 DTR 和寒冷季节的高 DTR 时，DTR 对 CRD 住院的影响较强。COPD 恶化（DTR 的第 75 百分位与 lag0-6 时的第 25 百分位相比）和哮喘（RR=1.09[95%CI：1.05 至 1.13]）住院的 RR（第 75 百分位与第 25 百分位相比）为 1.11（95%CI：1.08 至 1.12）。仅在女性患者中观察到 DTR 对支气管扩张住院的不良影响（RR=1.06[95%CI：1.03 至 1.10]）。
本研究为 DTR 与 CRD 恶化每日住院之间的关联提供了额外证据，并且这种关联在 COPD 患者和寒冷季节比炎热季节更强。需要针对 CRD 患者采取预防措施来减少 DTR 的不利影响。
