The association of outdoor temperature and self-reported Raynaud's phenomenon severity among people with systemic sclerosis: a Scleroderma Patient-centered Intervention Network Cohort study

IF 15 1区 医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-08-28 DOI:10.1016/S2665-9913(24)00189-9
Gabrielle Virgili-Gervais MSc , Bianca Matthews BSc , Elsa-Lynn Nassar MSc , Marie-Eve Carrier MSc , Linda Kwakkenbos PhD , John D Pauling MD , Prof Susan J Bartlett PhD , Amy Gietzen , Karen Gottesman BA , Geneviève Guillot PDt , Marie Hudson MD , Laura K Hummers MD , Amanda Lawrie-Jones , Prof Vanessa L Malcarne PhD , Prof Maureen D Mayes MD , Michelle Richard DSW , Maureen Sauvé BA , Robyn K Wojeck PhD , Prof Luc Mouthon MD , Andrea Benedetti PhD , Sabrina Provencher
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引用次数: 0

Abstract

Background

Raynaud's phenomenon is the earliest and most common systemic sclerosis manifestation. Episodes can be triggered by cold exposure and ambient temperature changes. Small studies have found that Raynaud's phenomenon outcomes were associated with season. We aimed to map the degree that differences in ambient temperature are associated with Raynaud's phenomenon outcomes across the temperature spectrum.

Methods

People with Raynaud's phenomenon secondary to systemic sclerosis in the Scleroderma Patient-centered Intervention Network Cohort completed past-week Raynaud's phenomenon severity assessments (0–10 numerical rating scale) at enrolment and longitudinally at 3-month intervals. Mean daily temperature and feels like temperature, which incorporates wind chill and humidity, for the week before each assessment were extracted for each participant from a weather site close to the participant's recruiting centre via the Iowa Environmental Mesonet. We used linear mixed models with basis splines to flexibly model non-linear changes in Raynaud's phenomenon severity across the temperature spectrum. People with lived experience of systemic sclerosis contributed to the study design and interpretation.

Findings

Between April 15, 2014 and Aug 1, 2023, we included data on 20 233 Raynaud's phenomenon severity assessments from 2243 participants. 1964 (88%) of 2243 participants were women, 279 (12%) were men, and 1813 (82%) were White. Mean age was 54·8 (SD 12·7) years. The maximum predicted Raynaud's phenomenon severity score was 6·8 points (95% CI 5·6–8·1), which occurred at –25°C. Severity scores decreased minimally from –15°C to 5°C (0·05–0·21 points per 5°C difference), then decreased in larger steps between 5°C and 25°C (0·37–0·54 points per 5°C difference). The minimum predicted score was at 25°C (2·6 points [95% CI 2·5–2·7]). Scores increased at temperatures above 25°C to 3·5 points (3·0–4·1) at 35°C and 5·6 points (4·5–6·8) at 40°C. Results were similar for feels like temperature.

Interpretation

Raynaud's phenomenon severity is worst at very cold temperatures but also increases with very warm temperatures, presumably due to air conditioning. Clinical management and Raynaud's phenomenon intervention trial designs should consider temperature patterns.

Funding

Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, the Canadian Institutes of Health Research, the Arthritis Society, the Lady Davis Institute for Medical Research of the Jewish General Hospital, the Jewish General Hospital Foundation, and McGill University.
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室外温度与系统性硬皮病患者自述雷诺现象严重程度的关系:以硬皮病患者为中心的干预网络队列研究。
背景:雷诺现象是最早和最常见的系统性硬化症表现。寒冷暴露和环境温度变化可诱发发作。一些小型研究发现,雷诺现象的结果与季节有关。我们的目的是了解环境温度的差异与雷诺现象在整个温度范围内的结果的相关程度:方法:硬皮病患者中心干预网络队列中继发于系统性硬化症的雷诺现象患者在入组时完成了过去一周的雷诺现象严重程度评估(0-10 分数字评分表),并每隔 3 个月进行一次纵向评估。每次评估前一周的日平均气温和 "感觉温度"(包含风寒和湿度)是通过爱荷华州环境中间网从靠近参与者招募中心的气象站点提取的。我们使用带有基础样条的线性混合模型来灵活模拟雷诺现象严重程度在不同温度范围内的非线性变化。有系统性硬化症生活经验的人参与了研究的设计和解释:2014年4月15日至2023年8月1日期间,我们纳入了2243名参与者的20 233次雷诺现象严重程度评估数据。在 2243 名参与者中,1964 名(88%)为女性,279 名(12%)为男性,1813 名(82%)为白人。平均年龄为 54-8 岁(标准差为 12-7 岁)。预测的雷诺现象严重程度最高分为 6-8 分(95% CI 5-6-8-1),发生在零下 25 摄氏度时。从-15°C到5°C,严重程度得分的下降幅度很小(每相差5°C下降0-05-0-21分),然后在5°C到25°C之间以更大的步幅下降(每相差5°C下降0-37-0-54分)。最低预测分数为 25°C(2-6 分 [95% CI 2-5-2-7])。温度超过 25°C 时,预测得分会增加,35°C 时为 3-5 分(3-0-4-1),40°C 时为 5-6 分(4-5-6-8)。感觉温度的结果类似:解释:雷诺现象的严重程度在气温很低时最严重,但在气温很高时也会加重,这可能是空调造成的。临床管理和雷诺现象干预试验设计应考虑温度模式:安大略硬皮病协会、加拿大硬皮病协会、魁北克硬皮病协会、马尼托巴硬皮病协会、大西洋硬皮病协会、不列颠哥伦比亚硬皮病协会、SASK 硬皮病协会、澳大利亚硬皮病协会、新南威尔士硬皮病协会、维多利亚硬皮病协会、加拿大健康研究所、关节炎协会、犹太综合医院戴维斯夫人医学研究所、犹太综合医院基金会和麦吉尔大学。
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来源期刊
Lancet Rheumatology
Lancet Rheumatology RHEUMATOLOGY-
CiteScore
34.70
自引率
3.10%
发文量
279
期刊介绍: The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.
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