广州市大气污染物对2型糖尿病人群死亡的影响  

The impact of air pollution on death from type 2 diabetes in Guangzhou.

作　　者：陈素娟 黄琳 董航[2] 林国帧[2] 王伯光 杨军 CHEN Su-juan;HUANG Lin;DONG Hang;LIN Guo-zhen;WANG Bo-guang;YANG Jun(Institute for Environmental and Climate Research,Jinan University,Guangzhou,511443,China;Guangzhou Center for Disease Control and Prevention,Guangzhou,5104403;School of Public Health,Guangzhou Medical University,Guangzhou 511436,China)

机构地区：[1]暨南大学环境与气候研究院,广东广州511443 [2]广州市疾病预防控制中心,广东广州51044 [3]广州医科大学公共卫生学院,广东广州511436

出　　处：《中国环境科学》2023年第2期973-980,共8页China Environmental Science

基　　金：国家自然科学基金资助项目(82003552);广东省基础与应用基础研究基金项目(2020A1515011161);国家重点研发计划项目(2018YFC0213600);广州市基础与应用基础研究项目(项目编号:202201010400)。

摘　　要：为探讨空气污染物与2型糖尿病的联系,本研究通过收集广州市2013~2018年空气污染物监测数据、2型糖尿病逐日死亡人数以及气象资料,使用时间序列广义相加模型的方法探究了空气污染物(PM_(2.5)、NO_(2)、O_(3)、PM_(10)、SO_(2)和CO)暴露对2型糖尿病人群逐日死亡人数的影响,同时探讨了0~64岁与65岁以上人群、男性与女性及冷季(11月~次年4月)与暖季(5~10月)下空气污染影响的差异.结果表明空气污染物的影响急促短暂,通常持续3d,且在累积滞后2d时,PM_(2.5)、NO_(2)、PM_(10)、O_(3)、SO_(2)及CO的浓度每升高一个IQR,2型糖尿病逐日死亡人数分别上升6.3%(RR=1.063;95%CI:1.017,1.112)、4.7%(RR=1.047;95%CI:1.008,1.088)、6.7%(RR=1.067;95%CI:1.020,1.116)、0.5%(RR=1.005;95%CI:0.956,1.058)、5.6%(RR=1.056;95%CI:1.007,1.107)和4.5%(RR=1.045;95%CI:1.007,1.085).此外,老年人及女性为易感人群,在冷季下空气污染物对2型糖尿病逐日死亡人数的影响更大.本研究表明,尽管我国空气污染状况有所改善,但空气污染暴露依然与2型糖尿病死亡结局存在统计学关联.因此当地政府依然需要加强空气污染的管控,并通过教育宣传来增强糖尿病人群的防护意识.To investigate the associations between air pollution and the type 2 diabetes,daily data on air pollution,deaths from type 2diabetes,and meteorological conditions from 2013 to 2018 in Guangzhou were collected.Then,generalized additive models(GAM)was applied to examine effects of air pollutants(PM_(2.5),NO_(2),O_(3),PM_(10),SO_(2)and CO)on deaths from type 2diabetes.Stratification analysis was further conducted by age group(0~64 years old,65+years old),sex,and seasons(cold season:November to the following April;warm season:May to October).This study found that the effects of air pollutants were generally acute,which usually lasted for three days.Each inter-quantile range(IQR)increase in the concentrations of PM_(2.5),NO_(2),PM_(10),O_(3),SO_(2),and CO was respectively associated with increments in deaths from type 2 diabetes of 6.3%(RR=1.063;95%CI:1.017,1.112),4.7%(RR=1.047;95%CI:1.008,1.088),6.7%(RR=1.067;95%CI:1.020,1.116),0.5%(RR=1.005;95%CI:0.956,1.058),5.6%(RR=1.056;95%CI:1.007,1.107)and 4.5%(RR=1.045;95%CI:1.007,1.085)at the lag 0~2 days.Moreover,the elderly and females were more vulnerable to air pollutants.And higher effect estimates of air pollutants were observed in cold season than in warm season.Although air quality has been greatly improved in China,this study still observed statistically significant associations between various air pollutants and deaths from type 2 diabetes.Therefore,more stringent measures are recommended to manage the level of air pollution and improve the awareness of protecting diabetes patients from the adverse effect of air pollution.

关 键 词：糖尿病 大气污染物 广义相加模型 季节效应 敏感人群 

分 类 号：X18[环境科学与工程—环境科学]