兰州市短期NO2暴露对2型糖尿病日住院人次的影响  

Effects of short-term NO2 exposure on daily hospital admissions for type 2 diabetes mellitus in Lanzhou City

作　　者：张万成 令江陇 张润平 朱安宁 田恬 董继元[1] 阮烨[1] ZHANG Wan-cheng;LING Jiang-long;ZHANG Run-ping;ZHU An-ning;TIAN Tian;DONG Ji-yuan;RUAN Ye(Institute of Occupational Health and Environmental Health,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院劳动卫生与环境卫生研究所,甘肃兰州730000

出　　处：《现代预防医学》2023年第22期4071-4076,共6页Modern Preventive Medicine

基　　金：甘肃省科技计划项目(20YF3FA027)。

摘　　要：目的本研究分析了兰州市气态污染物NO_(2)短期暴露与2型糖尿病(type 2 diabetes mellitus,T2DM)住院人次间的关系以增加发展中国家NO_(2)对T2DM具有有害影响的数据支持,并探讨了不同性别、年龄T2DM人群对NO_(2)的敏感性的影响。方法收集甘肃省兰州市区内二级及以上公立医院2014—2020年患者住院记录以及同期NO_(2)浓度和相关气象资料。采用广义相加模型结合分布滞后非线性模型,在控制长期趋势、节假日和星期几效应的基础上,定量评估空气中NO_(2)短期暴露与T2DM住院人次关系。结果研究期间,平均每日住院治疗的T2DM患者36.82例;NO_(2)平均浓度为47.50μg/m^(3)。NO_(2)暴露与T2DM日住院人次之间呈正相关,NO_(2)浓度每增加10μg/m^(3),日住院的相对风险(RR)增加1.027(95%CI:1.009~1.045)。经性别、年龄分层后,NO_(2)浓度每增加10μg/m^(3),男性T2DM住院的RR增加1.027(95%CI:1.009~1.046),女性T2DM住院的RR增加1.027(95%CI:1.008~1.046)。<65岁人群T2DM住院的RR增加1.026(95%CI:1.008~1.044),≥65岁人群T2DM的RR增加1.029(95%CI:1.010~1.049)。经冷暖季分层后,冷季NO_(2)暴露与T2DM住院人次间的相关性在各滞后天均无统计学意义,暖季NO_(2)暴露与T2DM住院人次在lag5有着最显著的相关性,RR=1.023(95%CI:1.000~1.046)。结论兰州市区NO_(2)与T2DM日住院量之间呈正相关,暴露于NO_(2)会增加T2DM入院风险,这一效应在女性、老年人、暖季更为明显。Objective To analyze the relationship between short-term exposure to gaseous pollutant NO_(2)and hospitalizations for type 2 diabetes mellitus(T2DM)in Lanzhou to increase data support that NO_(2)has deleterious effects on T2DM in developing countries,and to explore the effects of NO_(2)sensitivity in T2DM populations by gender and age.Methods Patient hospitalization records as well as NO_(2)concentrations and related meteorological data for the same period were collected from 2014-2020 in all public secondary and tertiary hospitals within Lanzhou City,Gansu Province.A generalized additive model combined with a distributed lag model was used to quantitatively assess the relationship between short-term exposure to NO_(2)in air and T2DM hospital admissions,controlling long-term trends,holiday and day-of-week effects.Results During the study period,a mean of 36.82 T2DM patients were hospitalized daily;the mean NO_(2)concentration was 47.50μg/m^(3).There was a positive correlation between short-term exposure to NO_(2)and daily hospitalizations for T2DM,with a 1.027(95%CI:1.009-1.045)increase in the relative risk(RR)of daily hospitalization for every 10μg/m^(3)increase in NO_(2)concentration.After stratification by gender and age,each 10μg/m^(3)increase in NO_(2)concentration increased the RR of T2DM hospitalization by 1.027(95%CI:1.009-1.046)in men and 1.027(95%CI:1.008-1.046)in women.The RR of T2DM hospitalization increased by 1.026(95%CI:1.008-1.044)for those<65 years of age and by 1.029(95%CI:1.010-1.049)for those≥65 years of age.After stratification by cold and warm seasons,the correlation between exposure to NO_(2)in the cold season and T2DM hospitalizations was not statistically significant at all lag days,and exposure to NO_(2)in the warm season had the most significant correlation with T2DM hospitalizations at lag5,RR=1.023(95%CI:1.000-1.046).Conclusion There is a positive correlation between NO_(2)and daily hospital admissions for T2DM in urban Lanzhou,and exposure to NO_(2)increased the risk of hospital

关 键 词：2型糖尿病 空气污染 二氧化氮 分布滞后非线性模型 住院人数 

分 类 号：R587.1[医药卫生—内分泌]