Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea.
Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Incheon, Republic of Korea.
BMC Nephrol. 2021 Dec 2;22(1):402. doi: 10.1186/s12882-021-02614-5.
To identify the association of meteorological factors/ambient air pollutants with medical care utilization for urolithiasis and estimate the effect size/time lags.
This is a population-based time-series analysis of 300,000 urolithiasis cases from eight large metropolitan areas in Korea. Seventeen meteorological factors and ambient air pollutants were measured daily during 2002-2017 for each metropolis. Data on daily medical utilization owing to urolithiasis were collected. A generalized additive model was used while factoring in the nonlinear relationship between meteorological factors/ambient air pollutants and urolithiasis and a time lag of ≤10 days. A multivariate analysis was performed. Backward elimination with an Akaike information criterion was used for fitting the multivariate model.
Urolithiasis was significantly associated with average temperature, diurnal temperature range, sunshine duration, particulate matter (PM) ≤2.5 μm, and carbon monoxide (CO) levels. The incidence of ureteral stones was positively correlated with average temperature, PM ≤2.5 μm level, and CO level (time lags 0-9, 2-4, and 0-9 days, respectively). The incidence of renal stones was positively correlated with PM ≤2.5 μm and CO levels (time lags 2-4 and 0-9 days, respectively). PM ≤2.5 μm (0.05 and 0.07% per 10 μg/m and CO (2.05 and 2.25% per 0.1 ppm) conferred the highest excess risk on ureteral and renal stones.
Urolithiasis is affected by various meteorological factors and ambient air pollutants, PM ≤2.5 μm, and CO levels may be novel potential risk factors for this condition.
本研究旨在确定气象因素/环境空气污染物与尿路结石医疗利用之间的关联，并估计其效应大小/时滞。
本研究是对韩国 8 个大都市区的 30 万名尿路结石患者进行的基于人群的时间序列分析。2002-2017 年期间，每个大都市的每日均测量了 17 种气象因素和环境空气污染物。收集了因尿路结石导致的每日医疗利用数据。使用广义相加模型，同时考虑气象因素/环境空气污染物与尿路结石之间的非线性关系以及≤10 天的时滞。进行了多变量分析。使用向后消除法和赤池信息量准则（Akaike information criterion）拟合多变量模型。
尿路结石与平均温度、日较差、日照时间、细颗粒物（PM）≤2.5μm 和一氧化碳（CO）水平显著相关。输尿管结石的发病率与平均温度、PM≤2.5μm 水平和 CO 水平呈正相关（时滞分别为 0-9、2-4 和 0-9 天）。肾结石的发病率与 PM≤2.5μm 和 CO 水平呈正相关（时滞分别为 2-4 和 0-9 天）。PM≤2.5μm（每 10μg/m 增加 0.05 和 0.07%）和 CO（每 0.1ppm 增加 2.05 和 2.25%）对输尿管结石和肾结石的超额风险最高。
尿路结石受多种气象因素和环境空气污染物影响，PM≤2.5μm 和 CO 水平可能是该疾病的新的潜在危险因素。
