Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China.
Sci Total Environ. 2021 Feb 20;756:142614. doi: 10.1016/j.scitotenv.2020.142614. Epub 2020 Oct 1.
Although the effect of ambient temperature on cardiovascular disease (CVDs) has been well explored, studies using years of life lost (YLLs) as the outcome especially evaluating the average life loss per death attributable to temperatures were rare. We examine the associations between ambient temperature and YLLs of CVDs, and further quantify temperature-related life loss per death.
Daily YLL rates were calculated using death data from 364 locations across China during 2006-2017, and meteorological data were collected for the same period. A distributed-lag nonlinear model and meta-regression were applied to examine the relationships between temperature and YLL rates of CVDs. Subgroup analyses by age, gender, region, and cause-specific CVDs were investigated. The total YLLs and average YLLs per death attributable to temperature were further quantified to assess life loss caused by non-optimal temperature.
Both high and low temperatures significantly increased YLL rates of CVDs, with greater effects for cold than heat. Cerebrovascular diseases (CEDs) account for the largest proportion (47.17%) of total YLLs of CVDs attributable to non-optimal temperature. On average, life loss per CVD death attributable to non-optimal temperatures was 1.51 (95% eCI: 1.33, 1.69) years, with 1.07 (95% eCI: 1.00, 1.15) years from moderate cold. Average life losses per death were observed higher for males (1.71, 95% eCI: 1.43, 1.99), younger population (3.82, 95% eCI: 2.86, 4.75), central China (1.62; 95% eCI: 1.41, 1.83) and hemorrhagic stroke (2.86, 95% eCI: 2.63, 3.10) than their correspondents.
We found that non-optimal temperature significantly aggravated premature death of CVD, with CEDs being the most affected, and most of temperature-related life loss of CVD was attributed to moderate cold. Our findings imply that peoples with CEDs in moderate cold days are vulnerable populations, which may contribute to a better understanding the adverse effects and pathogenesis of temperature on CVDs.
尽管环境温度对心血管疾病（CVD）的影响已经得到了充分的研究，但使用生命损失年（YLL）作为结果的研究，特别是评估因温度导致的每例死亡的平均生命损失的研究却很少。我们研究了环境温度与 CVD 的 YLL 之间的关系，并进一步量化了与温度相关的每例死亡的生命损失。
使用 2006 年至 2017 年期间中国 364 个地点的死亡数据计算每日 YLL 率，并收集同期的气象数据。应用分布式滞后非线性模型和荟萃回归来研究温度与 CVD 的 YLL 率之间的关系。通过年龄、性别、地区和特定原因的 CVD 进行亚组分析。进一步量化因非最佳温度导致的总 YLL 和每例死亡归因于温度的平均 YLL，以评估由非最佳温度引起的生命损失。
高温和低温均显著增加 CVD 的 YLL 率，低温的影响更大。脑血管疾病（CEDs）占非最佳温度导致的 CVD 总 YLL 的最大比例（47.17%）。平均而言，非最佳温度导致的每例 CVD 死亡归因于温度的生命损失为 1.51 年（95%eCI：1.33，1.69），其中中度寒冷导致 1.07 年（95%eCI：1.00，1.15）。观察到男性（1.71，95%eCI：1.43，1.99）、年轻人群（3.82，95%eCI：2.86，4.75）、中国中部（1.62；95%eCI：1.41，1.83）和出血性中风（2.86，95%eCI：2.63，3.10）的平均生命损失高于其对应人群。
我们发现非最佳温度显著加重了 CVD 的过早死亡，CEDs 受影响最大，而 CVD 与温度相关的大部分生命损失归因于中度寒冷。我们的研究结果表明，中度寒冷天气中患有 CEDs 的人群是易受伤害的人群，这可能有助于更好地理解温度对 CVD 的不良影响和发病机制。
