Division of Rheumatology, Department of Internal Medicine, Gachon University College of Medicine Gil Medical Center, 21 Namdongdae-ro 774-gil, Namdong-gu, Incheon, 21565, Republic of Korea.
School of Medicine, University of Auckland, 22-30 Park Ave, Grafton, Auckland, New Zealand; Institute of Human Complexity and Systems Science, Yonsei University, 85 Songdogwahak-ro, Yeonsu-gu, Incheon, Republic of Korea; Institute for Environmental Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
Joint Bone Spine. 2021 Mar;88(2):105108. doi: 10.1016/j.jbspin.2020.105108. Epub 2020 Nov 19.
This study aimed to investigate the effect of short-term exposure to ambient particulate matter less than 10μm in diameter (PM) on occurrence of acute gout flares in the general population and identify susceptible groups accordingly.
The data of emergency department (ED) cases with acute gout flare in Incheon city, Korea between January 1st 2008 and December 31st 2015 were collected from the National Health Insurance Service claims data. The levels of PM and meterological measurements were provided by the Ministry of Environment and the National Meterological Office, respectively. To estimate the risk of daily ED visits due to acute gout flare, these time-series data set were analyzed using generalized additive models with Poisson distribution, including daily average PM level, temperature, relative humidity, day of the week, national holiday, season, and date.
The risk of daily ED visits for acute gout flares per interquartile range increment of the average daily PM levels significantly increased in the cumulative lag 0-7 model (relative risk, 1.018; 95% confidence interval, 1.008-1.027, P<0.001). In particular, men aged≥40 years and those with a history of diabetes mellitus or gout were significantly at a high risk of acute gout flares by subgroup analysis.
Our time-series study demonstrated a modest, but significant effect of short-term exposure to PM on ED visits for acute gout flares. Ambient PM may be a newly identified environmental risk factor for acute gout flares.
本研究旨在探讨短期暴露于直径小于 10μm 的环境颗粒物（PM）对普通人群急性痛风发作的影响，并据此确定易感人群。
本研究从韩国仁川市 2008 年 1 月 1 日至 2015 年 12 月 31 日的国家健康保险服务索赔数据中收集了急诊（ED）急性痛风发作病例的数据。PM 水平和气象测量数据分别由环境部和国家气象局提供。为了估计因急性痛风发作而每天到 ED 就诊的风险，使用具有泊松分布的广义加性模型对这些时间序列数据集进行了分析，包括每日平均 PM 水平、温度、相对湿度、星期几、国定假日、季节和日期。
在累积滞后 0-7 模型中，每日平均 PM 水平每增加一个四分位距，ED 急性痛风发作的每日就诊风险显著增加（相对风险，1.018；95%置信区间，1.008-1.027，P<0.001）。特别是年龄≥40 岁的男性和患有糖尿病或痛风病史的患者，通过亚组分析显示出急性痛风发作的高风险。
我们的时间序列研究表明，短期暴露于 PM 对 ED 急性痛风发作就诊有适度但显著的影响。环境 PM 可能是急性痛风发作的一个新确定的环境风险因素。
