Ferreira Manuela L, Hunter David J, Fu Allan, Raihana Shahreen, Urquhart Donna, Ferreira Paulo H
The University of Sydney, Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, Sydney, NSW, Australia.
The University of Sydney, Sydney Musculoskeletal Health, The Kolling Institute, Sydney Medical School, Faculty of Medicine and Health, Sydney, NSW, Australia.
Semin Arthritis Rheum. 2024 Apr;65:152392. doi: 10.1016/j.semarthrit.2024.152392. Epub 2024 Jan 28.
The weather is frequently blamed for changes in musculoskeletal health behaviour and adverse events. However, despite the frequency with which this phenomenon is endorsed, past research is largely conflicting. This meta-analysis has reviewed, appraised and summarised case-crossover studies assessing the transient risk of musculoskeletal health events associated with weather parameters (e.g. temperature, relative humidity, air pressure, and precipitation).
A meta-analysis of case-crossover studies was conducted. Two reviewers independently searched MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and PsycINFO from inception to 10/09/2023. Published studies that employed a case-crossover design to evaluate the risk of musculoskeletal health events (e.g. symptoms, hospitalisation) associated with weather parameters were included. Primary outcome was pain (new episodes of pain or flares). Quality of included studies was assessed based on selection bias, exposure assessment, confounding, and outcome assessment. Pooling of results was conducted using random effects models and separately performed for each condition and weather factor. Heterogeneity among included studies was assessed using I measures.
Of the 1,107 studies identified in the search, 11 were included (15,315 participants), providing data on 28,010 events (102,536 control periods), for seven musculoskeletal conditions. Pooled analyses showed no association between relative humidity, air pressure, temperature, or precipitation and the risk of rheumatoid arthritis, knee pain or low back pain. High temperatures combined with low humidity were associated with increased pain, redness, and joint swelling in people with gout (Odds Ratio: 2.04; 95 % Confidence Interval: 1.26 to 3.30).
Despite anecdotal reports from patients, changes in weather factors do not seem to be risk factors for rheumatoid arthritis, knee, hip, or low back pain, but may have a significant influence in gout disease.
天气常被认为是导致肌肉骨骼健康行为变化和不良事件的原因。然而，尽管这种现象被频繁提及，但过去的研究结果大多相互矛盾。本荟萃分析回顾、评估并总结了病例交叉研究，以评估与天气参数（如温度、相对湿度、气压和降水量）相关的肌肉骨骼健康事件的瞬时风险。
对病例交叉研究进行荟萃分析。两名综述员独立检索了从数据库建库至2023年9月10日的MEDLINE、EMBASE、CINAHL、Web of Science、Scopus和PsycINFO数据库。纳入采用病例交叉设计来评估与天气参数相关的肌肉骨骼健康事件（如症状、住院）风险的已发表研究。主要结局是疼痛（新的疼痛发作或疼痛加剧）。根据选择偏倚、暴露评估、混杂因素和结局评估对纳入研究的质量进行评估。使用随机效应模型进行结果合并，并针对每种疾病和天气因素分别进行。使用I统计量评估纳入研究之间的异质性。
在检索到的1107项研究中，纳入了11项研究（15315名参与者），提供了7种肌肉骨骼疾病的28010个事件（102536个对照期）的数据。汇总分析表明，相对湿度、气压、温度或降水量与类风湿性关节炎、膝关节疼痛或腰痛的风险之间无关联。高温与低湿度相结合与痛风患者疼痛、发红和关节肿胀增加相关（优势比：2.04；95%置信区间：1.26至3.30）。
尽管患者有相关传闻报道，但天气因素的变化似乎不是类风湿性关节炎、膝关节、髋关节或腰痛的危险因素，但可能对痛风疾病有重大影响。
