Extreme temperature events, functional dependency, and cardiometabolic multimorbidity: Insights from a national cohort study in China.

IF 6.2 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES Ecotoxicology and Environmental Safety Pub Date : 2024-09-05 DOI:10.1016/j.ecoenv.2024.117013

Pengsen Mou, Huiyan Qu, Jiaxin Guan, Yuxin Yao, Zhongbo Zhang, Jing Dong

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Abstract

Background: Extreme temperature events (ETEs), including heatwaves and cold spells, are attracting increasing attention because of their impacts on human health. However, the association between ETEs and cardiometabolic multimorbidity (CMM) and the role of functional dependency in this relationship remain unclear.

Methods: A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, considering 12 definitions each for heatwaves and cold spells, and three levels of functional dependency. Mixed Cox models with time-varying variables were used to comprehensively assess the independent and combined effects of ETEs and functional dependency on CMM. Additionally, subgroup analyses were conducted to investigate whether the relationship between ETEs and CMM was modified by the baseline characteristics.

Results: Heatwave and cold spell exposures were associated with an increased risk of CMM (HR range: 1.028-1.102 and 1.046-1.187, respectively). Compared to participants with normal functional abilities, the risk of CMM increased with higher levels of functional dependency (HR range: 1.938-2.185). ETEs exposure and functional dependency are jointly associated with CMM risk. Participants with high-intensity ETEs exposure and high functional dependency had the greatest risk of developing CMM. Participants aged 60 and above were more susceptible to the effects of ETEs on CMM. Additionally, urban residents and those in northern regions were more vulnerable to heatwaves.

Conclusion: Both ETEs exposure and functional dependency increase the risk of developing CMM. Participants with functional dependency exposed to high-intensity ETEs faced the highest risk of developing CMM. These findings highlight the significant impact of ETEs on CMM and the importance of protecting vulnerable populations during periods of extreme temperature.

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极端温度事件、功能依赖性和心脏代谢多病症：中国全国队列研究的启示。

背景：极端温度事件（ETEs），包括热浪和寒流，因其对人类健康的影响而日益受到关注。然而，极端温度事件与心脏代谢多病症（CMM）之间的关系以及功能依赖性在这种关系中的作用仍不清楚：利用中国健康与退休纵向研究（CHARLS）2011 年至 2020 年的数据开展了一项前瞻性队列研究，考虑了热浪和寒流的 12 种定义以及三种级别的功能依赖。研究采用了具有时变变量的混合 Cox 模型来全面评估 ETE 和功能依赖对 CMM 的独立和综合影响。此外，还进行了分组分析，以研究ETE与CMM之间的关系是否会因基线特征而改变：结果：热浪和寒流与CMM风险增加有关（HR范围分别为1.028-1.102和1.046-1.187）。与功能正常的参与者相比，功能依赖程度越高，患 CMM 的风险越高（HR 范围：1.938-2.185）。ETE暴露和功能依赖与CMM风险共同相关。暴露于高强度电磁辐射和功能依赖程度高的参与者罹患CMM的风险最大。60 岁及以上的参与者更容易受到 ETEs 对 CMM 的影响。此外，城市居民和北方地区的居民更容易受到热浪的影响：结论：暴露于ETEs和功能依赖都会增加罹患CMM的风险。暴露于高强度ETE的有功能依赖的参与者患CMM的风险最高。这些发现凸显了ETE对CMM的重大影响，以及在极端温度期间保护弱势群体的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.