School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
Beijing Municipal Health Commission Information Center, Beijing 100034, China.
Ecotoxicol Environ Saf. 2021 Jul 1;217:112201. doi: 10.1016/j.ecoenv.2021.112201. Epub 2021 Apr 8.
The health effect of particulate matter pollution on stroke has been widely examined; however, the effect among patients with comorbid type 2 diabetes (T2D) in developing countries has remained largely unknown.
A time-series study was conducted to investigate the short-term effect of fine particulate matter (PM) and inhalable particulate matter (PM) on hospital admissions for stroke among patients with T2D in Beijing, China, from 2014 to 2018. An over-dispersed Poisson generalized additive model was employed to adjust for important covariates, such as weather conditions and long-term and seasonal trends.
A total of 159,298 hospital admissions for stroke comorbid with T2D were reported. Approximately linear exposure-response curves were observed for PM and PM in relation to stroke admissions among T2D patients. A 10 μg/m increase in the four-day moving average of PM and PM was associated with 0.14% (95% confidence interval [CI]: 0.05-0.23%) and 0.14% (95% CI: 0.06-0.22%) incremental increases in stroke admissions among T2D patients, respectively. A 10 μg/m increase in PM in the two-day moving average corresponded to a 0.72% (95% CI: 0.02-1.42%) incremental increase in hemorrhagic stroke, and a 10 μg/m increase in PM in the four-day moving average corresponded to a 0.14% (95% CI: 0.06-0.22%) incremental increase in ischemic stroke.
High particulate matter might be a risk factor for stroke among patients with T2D. PM and PM have a linear exposure-response relationship with stroke among T2D patients. The study provided evidence of the risk of stroke due to particulate matter pollution among patients with comorbid T2D.
已有大量研究检验了颗粒物污染对中风的健康影响；然而，在发展中国家，合并 2 型糖尿病（T2D）的患者中，其影响仍知之甚少。
本时间序列研究旨在调查 2014 年至 2018 年期间，中国北京合并 T2D 的中风住院患者中，细颗粒物（PM）和可吸入颗粒物（PM）对中风住院的短期影响。采用过度分散泊松广义加性模型来调整天气条件和长期及季节性趋势等重要协变量。
共报告了 159298 例合并 T2D 的中风住院病例。在 T2D 患者中，PM 和 PM 与中风入院之间存在近似线性的暴露-反应关系。PM 和 PM 的 4 天移动平均值每增加 10μg/m，T2D 患者的中风入院率分别增加 0.14%（95%置信区间：0.05-0.23%）和 0.14%（95%置信区间：0.06-0.22%）。PM 的 2 天移动平均值每增加 10μg/m，出血性中风的发生率增加 0.72%（95%置信区间：0.02-1.42%），PM 的 4 天移动平均值每增加 10μg/m，缺血性中风的发生率增加 0.14%（95%置信区间：0.06-0.22%）。
高颗粒物可能是 T2D 患者中风的一个危险因素。PM 和 PM 与 T2D 患者的中风呈线性暴露-反应关系。该研究为合并 T2D 的患者因颗粒物污染导致中风的风险提供了证据。
