School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, China.
School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
Ecotoxicol Environ Saf. 2021 Dec 15;226:112794. doi: 10.1016/j.ecoenv.2021.112794. Epub 2021 Sep 27.
Scientific studies have identified various adverse effects of particulate matter (PM) on respiratory disease (RD) and type 2 diabetes (T2D). However, whether short-term exposure to PM triggers the onset of RD with T2D, compared with RD without T2D, has not been elucidated.
A two-stage time-series study was conducted to evaluate the acute adverse effects of PM on admission for RD and for RD with and without T2D in Beijing, China, from 2014 to 2020. District-specific effects of PM and PM were estimated using the over-dispersed Poisson generalized addictive model after adjusting for weather conditions, day of the week, and long-term and seasonal trends. Meta-analyses were applied to pool the overall effects on overall and cause-specific RD, while the exposure-response (E-R) curves were evaluated using a cubic regression spline.
A total of 1550,154 admission records for RD were retrieved during the study period. Meta-analysis suggested that per interquartile range upticks in the concentration of PM corresponded to 1.91% (95% CI: 1.33-2.49%), 2.16% (95% CI: 1.08-3.25%), and 1.92% (95% CI: 1.46-2.39%) increments in admission for RD, RD with T2D, and RD without T2D, respectively, at lag 0-8 days, lag 8 days, and lag 8 days. The effect size of PM was statistically significantly higher in the T2D group than in the group without T2D (z = 3.98, P < 0.01). The effect sizes of PM were 3.86% (95% CI: 2.48-5.27%), 3.73% (95% CI: 1.72-5.79%), and 3.92% (95% CI: 2.65-5.21%), respectively, at lag 0-13 days, lag 13 days, and lag 13 days, respectively, and no statistically significant difference was observed between T2D groups (z = 0.24, P = 0.81). Significant difference was not observed between T2D groups for the associations of PM and different RD and could be found between three groups for effects of PM on RD without T2D. The E-R curves varied by sex, age and T2D condition subgroups for the associations between PM and daily RD admissions.
Short-term PM exposure was associated with increased RD admission with and without T2D, and the effect size of PM was higher in patients with T2D than those without T2D.
科学研究已经确定了颗粒物（PM）对呼吸道疾病（RD）和 2 型糖尿病（T2D）的各种不良影响。然而，与没有 T2D 的 RD 相比，短期暴露于 PM 是否会引发 RD 合并 T2D，尚未阐明。
本研究采用两阶段时间序列研究，评估了 2014 年至 2020 年期间中国北京地区 PM 和 PM 短期暴露对 RD 以及 RD 合并和不合并 T2D 入院的急性不良影响。在调整了天气条件、星期几以及长期和季节性趋势后，使用过离散泊松广义加性模型估计了各地区 PM 和 PM 的影响。采用荟萃分析综合评估了 PM 对整体和特定病因 RD 的总体影响，同时使用三次回归样条评估了暴露-反应（E-R）曲线。
研究期间共检索到 1550154 例 RD 入院记录。荟萃分析表明，在滞后 0-8 天、滞后 8 天和滞后 8 天，PM 浓度每增加一个四分位间距，与 RD、RD 合并 T2D 和 RD 合并 T2D 入院分别对应 1.91%（95%CI：1.33-2.49%）、2.16%（95%CI：1.08-3.25%）和 1.92%（95%CI：1.46-2.39%）的增加。PM 的效应大小在 T2D 组显著高于无 T2D 组（z=3.98，P<0.01）。在滞后 0-13 天、滞后 13 天和滞后 13 天，PM 的效应大小分别为 3.86%（95%CI：2.48-5.27%）、3.73%（95%CI：1.72-5.79%）和 3.92%（95%CI：2.65-5.21%），且 T2D 组之间无统计学差异（z=0.24，P=0.81）。在 PM 与不同 RD 之间的关联中，T2D 组之间无显著差异，而在 PM 对无 T2D 的 RD 影响方面，三组之间存在显著差异。PM 与每日 RD 入院人数之间的关联，在性别、年龄和 T2D 状况亚组之间存在 E-R 曲线差异。
短期 PM 暴露与 RD 合并和不合并 T2D 的入院率增加有关，且 PM 对 T2D 患者的影响大于无 T2D 患者。
