大气污染与糖尿病相关疾病死亡的时间序列分析

Time-series analysis of air pollution effects on diabetes related mortality

  • 摘要:
    背景  糖尿病是重要的公共卫生问题之一,研究证明大气污染是糖尿病的危险因素之一。
    目的  评价大气污染物短期暴露对上海市静安区居民糖尿病相关疾病死亡的影响。
    方法  收集2013—2019年每日大气污染物数据、气象数据和居民糖尿病相关疾病死亡资料,采用时间序列分析方法的广义相加模型来评估大气污染物对居民糖尿病相关疾病死亡的短期效应;并根据不同性别、年龄进行分层分析,探索不同人群对大气污染物暴露的敏感性。
    结果  PM2.5、PM10、SO2、NO2质量浓度每增加10 μg·m−3,糖尿病相关疾病死亡风险在lag05分别增加2.47%(95%CI: 1.56%~3.38%)、2.02%(95%CI: 1.29%~2.75%)、5.75%(95%CI: 2.99%~8.58%)和3.93%(95%CI: 2.49%~5.39%)(P<0.05)。PM2.5、PM10、SO2、NO2浓度升高会增加男性、女性和≥65岁人群糖尿病相关疾病死亡风险(P<0.05);但大气污染对糖尿病相关疾病死亡的影响在不同性别、年龄组间效应值的差异均无统计学意义。
    结论  上海市静安区大气污染物PM2.5、PM10、SO2、NO2浓度升高会导致人群糖尿病相关疾病死亡风险增加,且存在滞后效应和累积效应,≥65岁人群是受大气污染对糖尿病相关疾病死亡影响的易感人群。

     

    Abstract:
    Background  Diabetes mellitus is a major public health issue at present. Previous studies have shown that ambient air pollution is a risk factor for diabetes.
    Objective  This study aims to explore the acute effects of ambient air pollution on diabetes related death in Shanghai Jing’an District.
    Methods  Daily air pollution data, meteorological data, and diabetes related mortality data in 2013−2019 in Shanghai Jing’an District were collected. A generalized additive model (GAM) was established to conduct time-series analysis on the short-term effect of ambient air pollution on diabetes related mortality, and gender- and age-stratified analysis on susceptibility of various groups to ambient air pollution exposures.
    Results  For every 10 μg·m3 increase of the concentrations of PM2.5, PM10, SO2, and NO2, the diabetes related mortality increased by 2.47% (95%CI: 1.56%−3.38%), 2.02% (95%CI: 1.29%−2.75%), 5.75% (95%CI: 2.99%−8.58%), and 3.93% (95%CI: 2.49%−5.39%) at lag05 respectively (P<0.05). In the stratified analysis, exposures to increased concentrations of PM2.5, PM10, SO2, and NO2 raised the mortality risks from diabetes in male, female, and ≥65 years oldgroups (P<0.05). However, the differences in mortality risks from diabetes due to air pollution within gender and age groups were statistically insignificant.
    Conclusion  In Shanghai Jing'an District, the elevated levels of ambient air pollutants, including PM2.5, PM10, SO2, and NO2, are significantly associated with the increase of diabetes related mortality, and there are lag effects and cumulative effects. The ≥65 years olds are more susceptible to the impact of air pollution on diabetes related deaths.

     

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