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年轻人和老年人暴露于热环境 9 小时的生理反应。第一部分:体温和血液动力学调节。

Physiological responses to 9 hours of heat exposure in young and older adults. Part I: Body temperature and hemodynamic regulation.

机构信息

Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.

Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States.

出版信息

J Appl Physiol (1985). 2023 Sep 1;135(3):673-687. doi: 10.1152/japplphysiol.00227.2023. Epub 2023 Jul 13.

Abstract

Aging is associated with an elevated risk of heat-related mortality and morbidity, attributed, in part, to declines in thermoregulation. However, comparisons between young and older adults have been limited to brief exposures (1-4 h), which may not adequately reflect the duration or severity of the heat stress experienced during heat waves. We therefore evaluated physiological responses in 20 young (19-31 yr; 10 females) and 39 older (61-78 yr; 11 females) adults during 9 h of rest at 40°C and 9% relative humidity. Whole body heat exchange and storage were measured with direct calorimetry during the first 3 h and final 3 h. Core temperature (rectal) was monitored continuously. The older adults stored 88 kJ [95% confidence interval (CI): 29, 147] more heat over the first 3 h of exposure ( = 0.006). Although no between-group differences were observed after 3 h [young: 37.6°C (SD 0.2°C) vs. older: 37.7°C (0.3°C); = 0.216], core temperature was elevated by 0.3°C [0.1, 0.4] (adjusted for baseline) in the older group at [37.6°C (0.2°C) vs. 37.9°C (0.2°C); < 0.001] and by 0.2°C [0.0, 0.3] at [37.7°C (0.3°C) vs. 37.8°C (0.3°C)], although the latter comparison was not significant after multiplicity correction ( = 0.061). Our findings indicate that older adults sustain greater increases in heat storage and core temperature during daylong exposure to hot dry conditions compared with their younger counterparts. This study represents an important step in the use of ecologically relevant, prolonged exposures for translational research aimed at quantifying the physiological and health impacts of hot weather and heat waves on heat-vulnerable populations. We found greater increases in body heat storage and core temperature in older adults than in their younger counterparts during 9 h of resting exposure to hot dry conditions. Furthermore, the age-related increase in core temperature was exacerbated in older adults with common heat-vulnerability-linked health conditions (type 2 diabetes and hypertension). Impairments in thermoregulatory function likely contribute to the increased risk of heat-related illness and injury seen in older adults during hot weather and heat waves.

摘要

随着年龄的增长,与热相关的死亡率和发病率的风险增加,部分原因是体温调节能力下降。然而,年轻人和老年人之间的比较仅限于短暂暴露(1-4 小时),这可能无法充分反映热浪期间经历的热应激的持续时间或严重程度。因此,我们评估了 20 名年轻(19-31 岁;10 名女性)和 39 名老年(61-78 岁;11 名女性)成年人在 40°C 和 9%相对湿度下休息 9 小时期间的生理反应。在最初的 3 小时和最后 3 小时,通过直接量热法测量全身热交换和储存。连续监测核心体温(直肠)。与暴露前 3 小时相比,老年人在最初 3 小时内储存了 88kJ[95%置信区间(CI):29,147]的热量更多( = 0.006)。尽管在 3 小时后没有观察到组间差异[年轻:37.6°C(SD 0.2°C)与老年人:37.7°C(0.3°C); = 0.216],但老年人的核心温度升高了 0.3°C[0.1,0.4](根据基线调整)在老年人组中[37.6°C(0.2°C)与 37.9°C(0.2°C)相比; < 0.001],在 9 小时[37.7°C(0.3°C)与 37.8°C(0.3°C)相比]升高了 0.2°C[0.0,0.3],尽管在多重校正后,后一比较无显著意义( = 0.061)。我们的研究结果表明,与年轻对照组相比,老年人在长时间暴露于干燥炎热的环境中时,身体热量储存和核心温度的增加更大。这项研究是在使用与生态相关的、长时间暴露于热天气和热浪的情况下进行转化研究的重要一步,旨在量化热天气和热浪对热脆弱人群的生理和健康影响。我们发现,在 9 小时的休息暴露于干燥炎热的环境中,与年轻成年人相比,老年人的身体热量储存和核心温度增加更多。此外,在患有常见与热脆弱性相关的健康状况(2 型糖尿病和高血压)的老年人中,核心温度的年龄相关增加更为明显。体温调节功能受损可能导致老年人在热天气和热浪期间出现与热相关的疾病和伤害的风险增加。

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