空气质量改善与2型糖尿病发病关系的前瞻性队列研究  

The relationship between improved air pollution and incidence of Type 2 Diabetes Mellitus:a prospective cohort study

作　　者：于浩 冯利红[1] 侯常春[1] 曾强[1] 王菲[1] 赵岩[1] 王玉雯[1] 张献伟 张经纬[1] YU Hao;FENG Lihong;HOU Changchun;ZENG Qiang;WANG Fei;ZHAO Yan;WANG Yuwen;ZHANG Xianwei;ZHANG Jingwei(Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《公共卫生与预防医学》2020年第1期11-15,共5页Journal of Public Health and Preventive Medicine

基　　金：国家自然科学基金面上项目(81872590);天津市卫生行业重点攻关项目(16KG170)。

摘　　要：目的探索空气污染物浓度降低对2型糖尿病(Type 2 Diabetes Mellitus,T2DM)发病的影响。方法采用了前瞻性队列研究方法,以2014—2018年空气质量逐渐改善的天津市作为研究现场,在2013—2014年共募集5077名社区居民(18~90岁)作为基线人群,2014—2018年逐年开展随访,观察队列人群T2DM新发病情况,使用Cox比例风险回归分析随访年中天津市逐年降低的二氧化硫(SO 2)、二氧化氮(NO 2)、可吸入颗粒物(PM 10)、细颗粒物(PM 2.5)4类典型空气污染物浓度对T2DM发病的影响。结果队列在2014—2018年逐年开展随访,5年累计随访25385人年,同时期天津市空气质量明显改善,经协变量校正后统计分析结果显示,SO 2、PM 10、PM 2.5年均浓度水平每下降10μg/m 3,人群T2DM发病风险分别降低0.172、0.124、0.210倍(SO 2:HR=0.828,95%CI:0.757~0.907;PM 10:HR=0.876,95%CI:0.816~0.941;PM 2.5:HR=0.790,95%CI:0.694~0.899)。结论实施环境保护措施改善空气污染情况能够降低人群T2DM发病风险,控制患病率持续增长。Objective To explore the relationship between decreased air pollutants concentrations and incidence of Type 2 Diabetes Mellitus(T2DM).Methods A prospective cohort was designed in Tianjin,which improved the air pollution from 2014 to 2018.5077 community residents(18~90 years old)were collected as baseline population beginning from 2013 to 2014.With 5~years follow-up,the baseline data of incidence of T2DM were collected.The HR and 95%CI(95%confidence interval)were calculate with the multiple Cox proportional hazard regression model to evaluate the effect of decrease of SO 2,NO 2,particulate matter with diameters<10μm and<2.5μm(PM 10,PM 2.5)concentrations on incidence of T2DM.Results 25385 person-year follow-up were carried out during 2014-2018,when the air pollution of Tianjin was improved.After covariates adjusted,analysis results revealed that,the HR of T2DM decreased with a per 10μg/m 3 concentrations decreased of SO 2,PM 2.5 and PM 10.(SO 2:HR=0.828,95%CI:0.757~0.907.PM 10:HR=0.876,95%CI:0.816~0.941.PM 2.5:HR=0.790,95%CI:0.694~0.899),respectively.Conclusion Carry out environmental protection measures and improve air pollution could reduce the risk of incidence of T2DM,and control the increasing prevalence.

关 键 词：前瞻性研究 队列 空气污染 2型糖尿病 

分 类 号：R122.7[医药卫生—环境卫生学]