Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China.
Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China.
Environ Int. 2024 Sep;191:108961. doi: 10.1016/j.envint.2024.108961. Epub 2024 Aug 15.
The climate change scenario has witnessed an increase in extreme temperature events (ETEs), including heat waves and cold spells, and a heightened occurrence of compounding with fine particulate matter (PM). However, the impact of this phenomenon on the sensitivity to thyroid hormones (THs) in humans is unclear, especially in a group as specific as schizophrenia.
A longitudinal study was constructed using longitudinal measurements of thyroid function in schizophrenia in the Anhui Mental Health Center. The latent growth mixture model was applied to assess the optimal trajectory of change in impaired THs sensitivity. We then used logistic regression to explore associations between heat waves, cold spells, and PM with impaired THs sensitivity trajectories in the total population and different gender and age subgroups. Furthermore, the effect of the frequency, intensity, and duration of ETEs in the above associations was explored, as well as an assessment of the interaction between ETEs and PM.
Among 931 participants, we identified two classifications of trajectories of impaired THs sensitivity: "Low-stable" (n = 836, 89.80 %) and "Rise-slight down" (n = 95, 10.20 %). Logistic regression showed significant associations between each additional day of heat waves (≥3 days with temperature thresholds above the 95th percentile) and cold spells (≥3 days with temperature thresholds below the 5th percentile) and "Rise-slight down" trajectory, with odds ratios (95 % confidence intervals) of 1.06 (1.02, 1.10) and 1.19 (1.14, 1.24), respectively, and the strength of this association increased with the intensity and duration of ETEs. Subgroup analyses indicated that the association was more pronounced in males and the age group above 40 years. Furthermore, PM was found to interact with heat waves, with high concentrations exacerbating the effects of heat waves.
Our findings suggest that mitigating both ETEs and PM exposures may bring health co-benefits in preventing thyroid impairment in schizophrenia.
气候变化情景见证了极端温度事件（ETEs）的增加，包括热浪和寒冷期，以及与细颗粒物（PM）复合的发生率增加。然而，这种现象对人类甲状腺激素（THs）敏感性的影响尚不清楚，尤其是在精神分裂症这样特定的群体中。
使用安徽精神卫生中心精神分裂症患者甲状腺功能的纵向测量数据构建了一项纵向研究。应用潜在增长混合模型来评估受损 THs 敏感性变化的最佳轨迹。然后，我们使用逻辑回归来探索热浪、寒冷期和 PM 与总人群以及不同性别和年龄亚组中受损 THs 敏感性轨迹之间的关联。此外，还探讨了 ETEs 的频率、强度和持续时间对上述关联的影响，以及评估 ETEs 和 PM 之间的相互作用。
在 931 名参与者中，我们确定了受损 THs 敏感性的两种轨迹分类：“低稳定”（n=836，89.80%）和“上升-轻微下降”（n=95，10.20%）。逻辑回归显示，热浪（温度阈值超过第 95 百分位的天数≥3 天）和寒冷期（温度阈值低于第 5 百分位的天数≥3 天）与“上升-轻微下降”轨迹之间存在显著关联，优势比（95%置信区间）分别为 1.06（1.02，1.10）和 1.19（1.14，1.24），且这种关联的强度随着 ETEs 的强度和持续时间的增加而增加。亚组分析表明，这种关联在男性和年龄大于 40 岁的人群中更为明显。此外，发现 PM 与热浪相互作用，高浓度加剧了热浪的影响。
我们的研究结果表明，减轻 ETEs 和 PM 暴露可能会带来健康协同效益，以预防精神分裂症中的甲状腺损伤。
