气温对代谢综合征的影响及其路径分析
Effects of ambient temperature on metabolic syndrome and pathway analysis
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摘要:
背景 近年来我国代谢综合征（MS）的发生率呈显著增加趋势。有研究发现气温与单种代谢指标有关，但缺乏气温对MS影响的机制路径研究。
目的 基于广东省数据，研究气温对人群MS的影响及影响路径。
方法 2015年10月至2016年1月在广东省通过多阶段随机抽样获得8524个样本，通过问卷和体格检查收集了基本特征、行为特征、健康状况及体力活动水平，通过气象监测站点获得气象数据。个体调查数据根据体检日期及地点和当日及滞后14 d的气温暴露数据匹配。使用广义相加模型探索气温与MS及其指标的暴露-效应关系，计算效应值并探索单日滞后气温的滞后效应。基于文献资料和广义相加模型分析的结果采用路径分析探索气温影响MS的路径。
结果 当日及滞后14 d日均气温与MS的发生风险无统计学相关。当日日均气温升高1 ℃，空腹血糖（FBG）、收缩压（SBP）、舒张压（DBP）、高密度脂蛋白胆固醇（HDL-C）的变化值分别为−0.033（95%CI：−0.040~−0.026） mmol·L−1、−0.662（95%CI：−0.741~−0.583） mmHg、−0.277（95%CI：−0.323~-0.230） mmHg和−0.005（95%CI：−0.007~−0.004） mmol·L−1。日均气温对FBG、血压、HDL-C和腰围的影响持续至滞后14 d。日均气温与SBP和DBP的影响效应值在滞后当日是最大的。当日日均气温对FBG和SBP有直接和间接影响，气温对TG有间接影响，中介变量为腰围和FBG，其间接效应为−0.011（95%CI：−0.020~−0.002）。当日日均气温对SBP、FBG、TG的间接效应弱。
结论 气温与MS的发生风险无相关性，当日日均气温会显著影响血压与FBG的水平，且存在滞后效应。当日日均气温存在通路间接影响FBG和TG水平。
Abstract:Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS.
Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway.
Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS.
Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L−1, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L−1 respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak.
Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.
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