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中国合肥气象因素短期暴露与糖尿病死亡率风险的关系:一项时间序列分析。

The relationship of short-term exposure to meteorological factors on diabetes mellitus mortality risk in Hefei, China: a time series analysis.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.

The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.

出版信息

Int Arch Occup Environ Health. 2024 Nov;97(9):991-1005. doi: 10.1007/s00420-024-02102-x. Epub 2024 Oct 6.

Abstract

OBJECTIVES

The study aims to explore whether short-term exposure to meteorological factors has a potential association with the risk of diabetes mellitus (DM) mortality.

METHODS

During the period 2015-2018, we collected daily data on meteorological factors and deaths of diabetic patients in Hefei. A total of 1101 diabetic deaths were recorded. We used structural equation modeling to initially explore the relationships among air pollutants, meteorological variables, and mortality, and generalized additive modeling (GAM) and distributional lag nonlinear modeling (DLNM) to explore the relationship between meteorological factors and the mortality risk of DM patients. We also stratified by age and gender. The mortality risk in diabetic patients was expressed by relative risks (RR) and 95% confidence intervals (CI) for both single and cumulative days.

RESULTS

Single-day lagged results showed a high relative humidity (RH) (75th percentile, 83.71%), a fairly high average temperature (T mean) (95th percentile, 30.32 °C), and an extremely low diurnal temperature range (DTR) (5th percentile, 3.13 °C) were positively related to the mortality risk of DM. Stratified results showed that high and very high levels of T mean were significantly positively linked to the mortality risk of DM among females and the elderly, while very high levels of DTR were linked to the mortality risk in men and younger populations.

CONCLUSION

In conclusion, this study found that short-duration exposure to quite high T mean, high RH, and very low DTR were significantly positively related to the mortality risk of DM patients. For women and older individuals, exposure to high and very high T mean environments should be minimized. Men and young adults should be aware of daily temperature changes.

摘要

目的

本研究旨在探讨短期暴露于气象因素是否与糖尿病(DM)死亡率的风险相关。

方法

在 2015-2018 年期间,我们收集了合肥市气象因素和糖尿病患者死亡的每日数据。共记录了 1101 例糖尿病死亡病例。我们使用结构方程模型初步探讨了空气污染物、气象变量与死亡率之间的关系,并使用广义相加模型(GAM)和分布滞后非线性模型(DLNM)探讨了气象因素与 DM 患者死亡率风险之间的关系。我们还按年龄和性别进行了分层。糖尿病患者的死亡率风险用相对风险(RR)和 95%置信区间(CI)表示,包括单天和累积天数。

结果

单日滞后结果显示,高相对湿度(RH)(第 75 百分位数,83.71%)、相当高的平均温度(Tmean)(第 95 百分位数,30.32°C)和极低的日温差(DTR)(第 5 百分位数,3.13°C)与 DM 死亡率风险呈正相关。分层结果显示,Tmean 高水平和极高水平与女性和老年人的 DM 死亡率风险显著正相关,而 DTR 极高水平与男性和年轻人群的死亡率风险相关。

结论

总之,本研究发现,短期暴露于相当高的 Tmean、高 RH 和极低的 DTR 与 DM 患者的死亡率风险显著正相关。对于女性和老年人群,应尽量减少暴露于高和极高 Tmean 环境中。男性和年轻成年人应注意每日温度变化。

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