石家庄市大气细颗粒物对糖尿病患者住院风险影响的病例交叉研究

曲玥; 曾芳婷; 孙成瑶; 唐大镜; 关茗洋; 陈凤格

doi:10.16462/j.cnki.zhjbkz.2023.07.008

石家庄市大气细颗粒物对糖尿病患者住院风险影响的病例交叉研究

doi: 10.16462/j.cnki.zhjbkz.2023.07.008

曲玥^{1, 2},
曾芳婷^{1, 2},
孙成瑶^{1, 2},
唐大镜^{1, 2},
关茗洋^{2, 3},
陈凤格^{1, 2, 3, ,}

1.
华北理工大学公共卫生学院，唐山 063210
2.
石家庄市疾病预防控制中心环境卫生所，石家庄 050011
3.
中国疾病预防控制中心环境与健康研究基地(石家庄)，石家庄 050011

基金项目:

河北省自然基金 B2020106002

详细信息

通讯作者:
陈凤格，E-mail: chenfengge319@163.com

中图分类号: R181.23
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- 文章访问数: 145
- HTML全文浏览量: 54
- PDF下载量: 17
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-30
- 修回日期: 2022-09-27
- 网络出版日期: 2023-08-08
- 刊出日期: 2023-07-10

A case-crossover study on the effect of fine particulate matter on the risk of hospitalization in patients with diabetes mellitus in Shijiazhuang

QU Yue^{1, 2},
ZENG Fangting^{1, 2},
SUN Chengyao^{1, 2},
TANG Dajing^{1, 2},
GUAN Mingyang^{2, 3},
CHEN Fengge^{1, 2, 3
, ,}

1.
School of Public Health, North China University of Science and Technology, Tangshan 063210, China
2.
Institute of Environmental Health, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China
3.
Research Base for Environment and Health in Shijiazhuang, Chinese Center for Disease Control and Prevention (Shijiazhuang), Shijiazhuang 050011, China

Funds:

Hebei Province Natural Science Funding B2020106002

More Information

Corresponding author: CHEN Fengge, E-mail: chenfengge319@163.com

摘要

摘要: 目的探讨石家庄市大气细颗粒物(fine particulate matter, PM_2.5)对糖尿病患者住院风险的影响。方法收集2019-2021年石家庄市大气污染物浓度、气象因素及糖尿病住院患者的相关资料。开展时间分层病例交叉研究，分别利用单污染物模型、双污染物模型及分层分析探究PM_2.5对糖尿病患者住院风险的影响。结果共收集14 756例糖尿病患者住院资料。单污染物模型结果显示，PM_2.5对糖尿病患者住院风险的影响在lag 01时达到最大，其日均浓度每升高1个IQR(38.750 μg/m³)，糖尿病患者住院风险所对应的OR值为1.044 (95% CI: 1.019~1.070, P=0.001)。分层分析结果显示，PM_2.5对男性糖尿病患者住院风险高于女性，PM_2.5对年龄＜60岁人群的糖尿病患者住院风险高于≥60岁人群，处于采暖期的糖尿病患者住院风险高于非采暖期，差异有统计学意义(P=0.035)。结论石家庄市PM_2.5浓度升高可导致糖尿病患者入院风险增加。
- 大气细颗粒物 /
- 糖尿病 /
- 病例交叉研究 /
- 住院风险
Abstract: Objective This study aimed to investigate the effect of atmospheric fine particulate matter (PM_2.5) on the risk of diabetes hospitalization in Shijiazhuang City. Methods We collected the relevant data of air pollutant concentration, meteorological factors and diabetes inpatients in Shijiazhuang from 2019 to 2021. A time-stratified case crossover study was conducted to explore the effect of atmospheric PM_2.5 on hospitalization risk of diabetes patients using single pollutant model, double pollutant model and stratified analysis, respectively. Results A total of 14 756 hospitalized patients with diabetes mellitus were included in this study. The results of the single pollutant model showed that the association of each IQR increase in PM_2.5 concentration on diabetes hospitalization reached the maximum at lag 01 [OR value (95% CI): 1.044(1.019-1.070), P=0.001]. Stratified analysis revealed that PM_2.5 posed a higher hospitalization risk in male diabetic patients compared to females, in patients < 60 years compared to those 60 years and older, and in diabetic patients during the heating period compared to the non-heating period. And all the differences were statistically significant (P=0.035). Conclusions The increase of PM_2.5 concentration can lead to an increased risk of diabetes hospitalization in Shijiazhuang City.
- Fine particulate matter /
- Diabetes /
- Case-crossover study /
- Risk of hospitalization

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表 1 2019-2021年石家庄市糖尿病的患者基本情况

Table 1. Basic information on diabetes inpatients in Shijiazhuang from 2019 to 2021

指标 Index	人数 Number of people	占比/% Proportion/%
性别 Sex
男 Male	8 090	54.83
女 Female	6 666	45.17
年龄组/岁 Age group/years
＜60	5 766	39.08
≥60	8 990	60.92
采暖季 Heating season
是 Yse	5 211	35.31
否 No	9 545	64.69

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表 2 2019-2021年石家庄市每日大气污染物及气象条件描述

Table 2. Description of daily air pollutants and meteorological conditions in Shijiazhuang from 2019 to 2021

指标 Index	最小值 Min	P₂₅	M	P₇₅	最大值 Max	IQR
PM_2.5/(μg·m^-3)	9.000	27.000	41.000	65.750	355.000	38.750
PM₁₀/(μg·m^-3)	13.000	58.000	89.000	131.000	827.000	73.000
NO₂/(μg·m^-3)	7.000	24.000	35.000	50.000	122.000	26.000
SO₂/(μg·m^-3)	2.000	8.000	11.000	15.000	58.000	7.000
O₃/(μg·m^-3)	4.000	58.000	92.500	147.000	310.000	89.000
日均气压/hPa Barometric pressure /hPa	984.400	996.900	1 006.000	1 013.875	1 033.800	34.975
日均温度/℃ Temperature /℃	-9.400	6.125	15.500	24.700	33.200	18.575
相对湿度/% Relative humidity /%	7.000	41.000	58.000	73.000	100.000	32.000

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表 3 2019-2021年石家庄市大气污染物之间的Spearman相关分析

Table 3. Spearman correlation analysis between air pollutants in Shijiazhuang from 2019 to 2021

指标 Index	PM_2.5/(μg·m^-3)	PM₁₀/(μg·m^-3)	SO₂/(μg·m^-3)	NO₂/(μg·m^-3)	O₃/(μg·m^-3)
PM_2.5 /(μg·m^-3)	1.000
PM₁₀/(μg·m^-3)	0.877 ^①	1.000
SO₂/(μg·m^-3)	0.431 ^①	0.583 ^①	1.000
NO₂/(μg·m^-3)	0.573 ^①	0.655 ^①	0.666 ^①	1.000
O₃/(μg·m^-3)	-0.318 ^①	-0.290 ^①	-0.100 ^①	-0.448 ^①	1.000
注：① P＜0.05。 Note: ① P＜0.05.

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表 4 单污染物模型中PM_2.5浓度每增加1个IQR对不同滞后期的糖尿病患者住院风险的影响

Table 4. Effect of each IQR increase in PM_2.5 concentration on the risk of diabetes hospitalization in different lag periods in the single-pollutant model

滞后日 Lag days	OR值(95% CI) OR value(95% CI)	P值 P value
lag 0	1.041(1.017~1.066)	0.001
lag 1	1.029(1.008~1.051)	0.006
lag 2	1.001(0.981~1.026)	0.935
lag 3	1.006(0.987~1.026)	0.517
lag 01	1.044(1.019~1.070)	0.001
lag 02	1.030(1.004~1.057)	0.024
lag 03	1.022(0.996~1.050)	0.099

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表 5 双污染物模型中PM_2.5浓度每增加1个IQR对糖尿病患者住院风险的影响

Table 5. Effect of an IQR increase in PM_2.5 concentration on the risk of diabetes hospitalization in a two-pollutant model

污染物 Pollutant	OR值(95% CI) OR value(95% CI)	P值 P value
PM_2.5	1.044(1.019~1.070)	0.001
O₃	1.044(1.018~1.071)	0.001

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表 6 大气PM_2.5浓度每增加1个IQR对不同人群糖尿病住院风险的影响

Table 6. Effect of each IQR increase in PM_2.5 concentration on the risk of diabetes hospitalization in different populations

指标 Index	OR值(95% CI) OR value(95% CI)	P值 P value
性别 Sex
男 Male	1.054(1.019~1.090)	0.002
女 Female	1.032(0.995~1.071)	0.092
年龄组/岁 Age group/years
＜60	1.068(1.025~1.113)	0.002
≥60	1.031(0.999~1.064)	0.054
采暖季 Heating season
是 Yes	1.036(1.002~1.070)	0.035
否 No	0.997(0.922~1.077)	0.932

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