罗佳丽, 许燕君, 陈子慧, 陈思齐, 纪桂元, 许晓君, 肖建鹏, 何冠豪, 孟浩蓉, 胡建雄, 曾韦霖, 李杏, 郭凌川, 马文军. 广东省秋冬季气温与人群血清尿酸水平的关联[J]. 环境与职业医学, 2021, 38(2): 113-118, 124. DOI: 10.13213/j.cnki.jeom.2021.20382
引用本文: 罗佳丽, 许燕君, 陈子慧, 陈思齐, 纪桂元, 许晓君, 肖建鹏, 何冠豪, 孟浩蓉, 胡建雄, 曾韦霖, 李杏, 郭凌川, 马文军. 广东省秋冬季气温与人群血清尿酸水平的关联[J]. 环境与职业医学, 2021, 38(2): 113-118, 124. DOI: 10.13213/j.cnki.jeom.2021.20382
LUO Jiali, XU Yanjun, CHEN Zihui, CHEN Siqi, JI Guiyuan, XU Xiaojun, XIAO Jianpeng, HE Guanhao, MENG Haorong, HU Jianxiong, ZENG Weilin, LI Xing, GUO Lingchuan, MA Wenjun. Association between ambient temperature and serum uric acid in autumn and winter in Guangdong Province[J]. Journal of Environmental and Occupational Medicine, 2021, 38(2): 113-118, 124. DOI: 10.13213/j.cnki.jeom.2021.20382
Citation: LUO Jiali, XU Yanjun, CHEN Zihui, CHEN Siqi, JI Guiyuan, XU Xiaojun, XIAO Jianpeng, HE Guanhao, MENG Haorong, HU Jianxiong, ZENG Weilin, LI Xing, GUO Lingchuan, MA Wenjun. Association between ambient temperature and serum uric acid in autumn and winter in Guangdong Province[J]. Journal of Environmental and Occupational Medicine, 2021, 38(2): 113-118, 124. DOI: 10.13213/j.cnki.jeom.2021.20382

广东省秋冬季气温与人群血清尿酸水平的关联

Association between ambient temperature and serum uric acid in autumn and winter in Guangdong Province

  • 摘要: 背景

    以往研究发现血清尿酸呈现季节性变化,高温作业环境增加职业人群高尿酸血症的患病风险,但缺乏气温对普通人群血清尿酸水平急性效应的研究。

    目的

    探讨气温与人群血清尿酸水平的关系,为开展相关的防控工作提供科学依据。

    方法

    2015年10月-2016年2月采用多阶段整群抽样方法,在“广东省居民慢性病与营养监测调查”项目中抽取研究对象,并调查其社会经济学特征、健康状况、饮食情况、体格和实验室检查信息。从中国气象科学数据共享服务平台获取同期全国698个气象监测站点气象资料(日均气温和日相对湿度),使用澳大利亚国立大学薄板样条函数软件插值获取全国的气象资料的栅格数据,尺度为0.01°×0.01°,并从中提取广东省气象栅格数据,根据参与者居住地址匹配气象栅格数据。采用分布滞后非线性模型分析滞后0~14 d日均气温和居民血清尿酸水平的关系,按照性别、年龄(< 65岁和≥ 65岁)、体重指数(< 24 kg·m-2和≥ 24 kg·m-2)、是否患高血压和是否患高血脂进行分层分析,控制日均气温及滞后天数的自由度及PM2.5、PM10、NO2、O3、水产品摄入量,对模型进行敏感性分析。

    结果

    本研究共纳入6 670人。总人群血清尿酸浓度为(335.7±92.4)μmol·L-1,日均气温中位数为17.3(P5~P95:8.5~25.0)℃。日均气温和血清尿酸累积14 d的暴露-反应关系是非线性的,以日均气温最低点(2℃)为参考点,当日均气温上升至25℃(P95),血清尿酸水平累积增加了113.8(95%CI:71.1~156.6)μmol·L-1。日均气温P95(25℃)对人群血清尿酸影响的效应在第1天开始出现,约第4天达最低值后开始上升,约10 d达最高值后开始下降。日均气温P95(25℃)对女性、年龄 < 65岁、超重肥胖、高血压、高血脂人群尿酸水平的累积效应分别大于男性、年龄≥ 65岁、正常体重、血压正常和血脂正常人群,但组间差异没有统计学意义。敏感性分析显示,调整变量后,模型的结果均较稳定。

    结论

    气温对人群血清尿酸水平的影响具有一定的滞后效应,且气温上升可能会增加人群血清尿酸水平。

     

    Abstract: Background

    Previous studies have reported seasonal variation in serum uric acid, and a higher hyperglycemia risk is observed in workers exposed to high temperature. However, there is limited evidence on the acute effect of temperature exposure on serum uric acid among general population.

    Objective

    This study estimates the association between temperature exposure and serum uric acid, and provides evidence for disease prevention and control.

    Methods

    From October 2015 to February 2016, a multi-stage cluster sampling method was adopted to select study subjects from the Guangdong Provincial Residents' Chronic Disease and Nutrition Monitoring Survey, and retrieved their socioeconomic characteristics, health status, dietary status, physical fitness, and laboratory test information. Meteorological data including daily mean temperature (MT) and relative humidity (RH) in 698 monitoring stations across China were collected from the China Meteorological Science Data Sharing Service Platform. The Australian National University Splines (ANUSPLN) plugin was employed to interpolate the daily MT and RH grid at 0.01°×0.01° resolution. Daily gridded meteorological data of Guangdong Province were extracted and then matched with participants' residential addresses. Distributed lag nonlinear model (DLNM) was used to investigate the relationship between daily MT and serum uric acid, and stratified analysis was conducted by sex, age (< 65 and ≥ 65 years), body mass index (< 24 and ≥ 24 kg·m-2), hypertension (yes and no), or hyperlipidemia (yes and no). The degree of freedom of daily MT and the number of lag days, PM2.5, PM10, NO2, O3, and the intake of aquatic products were adjusted in the model. A sensitivity analysis of the model was performed.

    Results

    A total of 6670 people were included in this study. The concentration of total population serum uric acid was (335.7±92.4) μmol·L-1, and the median of daily MT was 17.3 (P5-P95: 8.5-25.0)℃. There was a non-linear exposure-response relationship between MT and 14day serum uric acid level. Taking the lowest MT (2℃) as reference, when the MT rose to 25℃ (P95), the serum uric acid level increased by 113.8 (95% CI: 71.1-156.6) μmol·L-1. The effect of P95 of MT (25℃) on serum uric acid appeared since the first day, then rose after reaching the lowest value on the fourth day, and finally decreased after reaching the highest value on the fourteenth day. The effects of P95 temperature (25℃) on serum uric acid among females, age < 65 years, overweight-obesity, hypertensive, hyperlipidemia groups were greater than among males, age ≥ 65 years, normal weight, normotensive, non-hyperlipidemia groups, respectively, but with no statistically significance. The sensitivity analysis results showed that after adjusting above mentioned variables, the results of the model were still stable.

    Conclusion

    Temperature has a certain lag effect on human serum uric acid, and rising temperature may increase the population's serum uric acid level.

     

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