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    冯达, 张翼, 马润美, 路凤, 李湉湉. 热浪与北京市2型糖尿病患者入院和再入院关系的病例交叉研究[J]. 环境卫生学杂志, 2023, 13(1): 10-19. DOI: 10.13421/j.cnki.hjwsxzz.2023.01.002
    引用本文: 冯达, 张翼, 马润美, 路凤, 李湉湉. 热浪与北京市2型糖尿病患者入院和再入院关系的病例交叉研究[J]. 环境卫生学杂志, 2023, 13(1): 10-19. DOI: 10.13421/j.cnki.hjwsxzz.2023.01.002
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    FENG Da, ZHANG Yi, MA Run-mei, LU Feng, LI Tian-tian. A case-crossover study of relationship between heat wave and hospital admission and readmission for type 2 diabetes in Beijing, China[J]. Journal of Environmental Hygiene, 2023, 13(1): 10-19. DOI: 10.13421/j.cnki.hjwsxzz.2023.01.002
    Citation: FENG Da, ZHANG Yi, MA Run-mei, LU Feng, LI Tian-tian. A case-crossover study of relationship between heat wave and hospital admission and readmission for type 2 diabetes in Beijing, China[J]. Journal of Environmental Hygiene, 2023, 13(1): 10-19. DOI: 10.13421/j.cnki.hjwsxzz.2023.01.002
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    热浪与北京市2型糖尿病患者入院和再入院关系的病例交叉研究

    A case-crossover study of relationship between heat wave and hospital admission and readmission for type 2 diabetes in Beijing, China

      摘要
    • 摘要:
      目的 探讨北京市热浪对当地居民每日2型糖尿病入院和再入院的影响。
      方法 运用时间分层的病例交叉设计方法, 收集北京市2013—2017年期间, 每年夏季(6至8月)2型糖尿病入院和再入院记录、同期气象因素数据和大气污染物数据, 应用条件Logistic回归模型定量分析研究期间热浪对北京市居民每日2型糖尿病入院和再入院的影响及其滞后效应, 比较热浪事件(温和热浪事件、极端热浪事件)对不同性别、年龄、居住地居民的影响程度。分别选择入院和再入院发生前后至少1周作为时间间隔给病例匹配相应的对照, 以优势比(odds ratio, OR)及其对应的危险置信区间反映热浪对居民2型糖尿病入院和再入院影响的大小。
      结果 2013—2017年夏季北京市16个市辖区因2型糖尿病入院患者34 378例, 其中后续发生再入院的患者6 501例。与非热浪天相比, 持续2天及以上的温和热浪事件发生当日, 2型糖尿病入院和再入院风险显著增加, 其效应值OR分别为1.03(95%CI: 0.99, 1.07)和1.10(95%CI: 1.01, 1.20)。在不同亚组暴露于温和热浪事件的分层分析中, 女性因2型糖尿病入院或再入院的风险均高于男性, 40~59岁人群较其他年龄组人群的入院或再入院的风险更高。
      结论 (1) 热浪对居民2型糖尿病入院和再入院有显著影响, 在热浪暴露当天(即lag0时)居民2型糖尿病入院和再入院风险最大; (2)温和热浪事件较极端热浪事件对居民2型糖尿病入院和再入院风险大; (3)热浪事件发生期间, 2型糖尿病患者再入院的风险高于入院的风险。

       

      Abstract:
      Objective To investigate the effect of heatwaves on daily hospital admissions and readmissions for type 2 diabetes among local residents in Beijing, China.
      Methods A time-stratified case-crossover design was used to collected data on hospital admissions and readmissions for type 2 diabetes, meteorological factors, and air pollutants in Beijing during each summer(June to August) of 2013—2017. A conditional logistic regression model was used to quantitatively analyze the influence of heat waves on daily admissions and readmissions for type 2 diabetes and its lag effects during the study period among Beijing residents, and further compare the effects of heat waves (mild and extreme heat wave events) on different sexes, ages, and places of residence. With at least one week before or after admission and readmission were selected as a time interval to match the cases with the corresponding control, the odds ratio (OR) and its confidence interval (CI) were calculated to reflect the degree of impact of heat waves on hospital admissions and readmissions for type 2 diabetes.
      Results During summer of 2013 to 2017, there were 34 378 admissions and 6 501 readmissions for type 2 diabetes in 16 municipal districts of Beijing. On the day of a mild heatwave lasting more than 2 days, the risks of admission and readmission for type 2 diabetes relative to non-heatwave days significantly increased, with OR being 1.03 (95%CI: 0.99, 1.07) and 1.10 (95%CI: 1.01, 1.20), respectively. The stratified analyses of mild heatwave exposure in different subgroups revealed that female residents had a higher risk of hospital admission or readmission for type 2 diabetes than male residents, and those aged 40 to below 59 years showed a higher risk of admission or readmission for type 2 diabetes than other age groups.
      Conclusion Heat waves had a significant impact on admission and readmission of type 2 diabetes, with the greatest risk occurring on the first day (lag 0) of heat wave exposure. Mild heat waves imposed a higher risk of type 2 diabetes admission and readmission than extreme heat waves. During heat waves, the risk of readmission for type 2 diabetes was higher than the risk of admission for type 2 diabetes.

       

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