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气象因素与 PM 对年龄相关性黄斑变性的联合作用:中国的一项全国性横断面研究。

Joint effects of meteorological factors and PM on age-related macular degeneration: a national cross-sectional study in China.

机构信息

Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University.

Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University.

出版信息

Environ Health Prev Med. 2023;28:3. doi: 10.1265/ehpm.22-00237.

Abstract

BACKGROUND

Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM) on AMD.

METHODS

Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM on AMD.

RESULTS

The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM level during the study period was 63.1 ± 15.3 µg/m. A significant positive association was detected between AMD and PM level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM and atmospheric pressure.

CONCLUSIONS

This study is among the first to characterize the coordinated effects of meteorological factors and PM on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.

摘要

背景

天气条件可能是导致年龄相关性黄斑变性(AMD)的一个因素,AMD 是导致不可逆转视力丧失的主要原因。本研究评估了气象因素和细颗粒物(PM)对 AMD 的共同影响。

方法

本研究数据来自中国农村地区进行的一项全国性横断面调查。共招募了 36081 名年龄在 40 岁及以上的参与者。AMD 通过裂隙灯显微镜、眼底照相和光谱域光相干断层扫描(OCT)进行临床诊断。气象数据由欧洲中期天气预报中心(ECMWF)再分析计算,并通过经纬度与参与者的家庭住址相匹配。参与者的个体 PM 暴露浓度通过基于卫星的模型在 1 公里的分辨率水平上计算。采用多变量调整的逻辑回归模型与交互分析相结合,研究气象因素和 PM 对 AMD 的共同影响。

结果

研究人群中 AMD 的患病率为 2.6%(95%CI 2.42-2.76%)。研究期间的平均年 PM 水平为 63.1±15.3µg/m。在独立和联合效应模型中,AMD 与 PM 水平、温度(T)和相对湿度(RH)均呈显著正相关。对于 PM,与最低四分位数相比,四分位数递增的比值比(OR)及其 95%置信区间(CI)分别为 0.828(0.674,1.018)、1.105(0.799,1.528)和 2.602(1.516,4.468)。AMD 与温度呈正相关,四分位数递增的 OR(95%CI)分别为 1.625(1.059,2.494)、1.619(1.026,2.553)和 3.276(1.841,5.830)。在交互分析中,由于相互作用导致的估计相对超额风险(RERI)和可归因比例(AP)分别为 0.864(0.586,1.141)和 1.180(0.768,1.592),表明 PM 和大气压之间存在协同作用。

结论

本研究首次对气象因素和 PM 对 AMD 的协同作用进行了特征描述。这些发现需要进一步研究来阐明环境与 AMD 之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9412/9845061/fb749d0f134a/ehpm-28-003-g001.jpg

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