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Relationship between working hours and sleep quality with consideration to effect modification by work style: a community-based cross-sectional study. 工作时间与睡眠质量之间的关系以及工作方式对睡眠质量的影响:一项基于社区的横断面研究。
IF 4.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.23-00252
Aya Yoshida, Keiko Asakura, Haruhiko Imamura, Sachie Mori, Minami Sugimoto, Takehiro Michikawa, Yuji Nishiwaki

Background: Although longer working hours are associated with lower sleep quality, it is still necessary to work a certain number of hours to make a living. In this study, we investigated the relationship between working hours and sleep quality in a community setting. We then explored how to manage work style while maintaining the sleep quality of workers without markedly reducing working hours.

Methods: 4388 day-time workers in various occupations living in Ota ward in Tokyo were included in the analysis. The relationship between working hours and sleep quality measured by the Athens Insomnia Scale was examined by ANOVA and linear regression models. Effect modification by work style (work end time, shift in working start and end time, current work from home status, change in work place) on the relationship between working hours and sleep quality was investigated by multivariate linear regression models.

Results: Longer working hours were significantly associated with lower sleep quality. The magnitude of the relationship between long working hours and low sleep quality was significantly larger when work end time was later (p for trend of interaction < 0.01) and when working start and end time were shifted later (vs no change, p for interaction = 0.03). The relationship was marginally greater when the proportion of work from home was increased (vs no change, p for interaction = 0.07).

Conclusions: A relationship between longer working hours and lower sleep quality was observed among workers. Leaving work earlier or optimizing the work environment at home may diminish the adverse effect of long working hours on sleep quality.

背景:虽然较长的工作时间与较低的睡眠质量有关,但人们仍需要工作一定的时间来维持生计。在这项研究中,我们调查了社区环境中工作时间与睡眠质量之间的关系。方法:分析对象包括居住在东京都大田区的 4388 名不同职业的日间工作者。通过方差分析和线性回归模型研究了工作时间与雅典失眠量表测量的睡眠质量之间的关系。通过多变量线性回归模型研究了工作方式(工作结束时间、工作开始和结束时间的转变、目前在家工作的状态、工作地点的改变)对工作时间与睡眠质量之间关系的影响:结果:工作时间越长,睡眠质量越低。工作时间长与睡眠质量低之间的关系,在工作结束时间较晚(交互作用趋势的 p < 0.01)以及工作开始和结束时间较晚(相对于无变化,交互作用的 p = 0.03)时明显更大。当在家工作的比例增加时,两者之间的关系略大(与无变化相比,交互作用的 p = 0.07):结论:在工人中观察到了工作时间延长与睡眠质量下降之间的关系。提前下班或优化在家的工作环境可减少长时间工作对睡眠质量的不利影响。
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引用次数: 0
Gabapentin improves neuropathic pain in Minamata disease model rats. 加巴喷丁能改善水俣病模型大鼠的神经性疼痛。
IF 4.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00035
Masatake Fujimura

Background: Methylmercury (MeHg), the causative agent of Minamata disease, damages the cranial nervous system and causes specific sensory disturbances, especially hypoesthesia, in the extremities. However, recent reports demonstrate that patients with chronic Minamata disease conversely develop neuropathic pain in the lower extremities. Studies on our established Minamata disease model rats showed that MeHg-mediated neurodegeneration might induce neuropathic pain by over time through inducing rewiring with neuronal activation in the somatosensory cortex via microglial activation in the spinal dorsal horn.

Methods: In this study, the effects of gabapentin, a potentially effective treatment for neuropathic pain, was evaluated using this Minamata disease model rats. To further elucidate the mechanism of its medicinal effects, histochemical and biochemical analyses of the nervous system of Minamata disease model rats were conducted.

Results: Gabapentin treatment restored the reduction in the pain threshold caused by MeHg exposure in rats. Histochemical and biochemical analyses revealed that gabapentin showed no effect on MeHg-induced neurodegeneration in entire nervous system and microglial activation in the spinal dorsal horn. However, it was shown that gabapentin may reduce excessive synaptogenesis through its antagonist action on the alpha2-delta-1 subunit of calcium channels in the somatosensory cortex.

Conclusions: These results indicate that gabapentin may alleviated neuropathic pain in MeHg poisoning, as typified by Minamata disease, by reversibly modulation synaptic rewiring in the somatosensory cortex.

背景:水俣病的病原体甲基汞(MeHg)会损害颅神经系统,并导致特定的感觉障碍,尤其是四肢感觉减退。然而,最近的报告表明,慢性水俣病患者反而会出现下肢神经性疼痛。对我们已建立的水俣病模型大鼠的研究表明,甲基汞介导的神经变性可能会通过脊髓背角的小胶质细胞激活,诱导躯体感觉皮层神经元激活的重新布线,从而诱发神经性疼痛:本研究使用水俣病模型大鼠评估了加巴喷丁(一种治疗神经病理性疼痛的潜在有效药物)的效果。为了进一步阐明其药效机制,研究人员对水俣病模型大鼠的神经系统进行了组织化学和生物化学分析:结果:加巴喷丁治疗可恢复大鼠因接触甲基汞而导致的痛阈降低。组织化学和生化分析表明,加巴喷丁对甲基汞诱导的整个神经系统的神经变性和脊髓背角的小胶质细胞活化没有影响。然而,研究表明,加巴喷丁可通过对躯体感觉皮层钙通道α2-δ-1亚基的拮抗作用减少过度的突触生成:这些结果表明,加巴喷丁可通过可逆地调节躯体感觉皮层的突触重新布线,减轻水俣病典型的甲基汞中毒神经病理性疼痛。
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引用次数: 0
Harnessing the healing power of nature: a review of natural interventions in substance abuse treatment and prevention. 利用大自然的治愈力量:药物滥用治疗和预防中的自然干预综述。
IF 4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00145
Francisco Díaz-Martínez, Miguel F Sánchez-Sauco, Laura T Cabrera-Rivera, Claudia A Ortín-Fernández, Esteban Orenes-Piñero, Juan A Ortega-García

Background: Substance abuse is a global problem that cuts across all sectors of society and requires innovative solutions that go beyond conventional treatments. Contact with nature could be a complementary tool to address drug-related problems. This review aimed to assess the impact of natural environments on drug-related outcomes.

Method: 8205 articles were screened between 2013 and 2023 from 6 databases, of which 21 met the inclusion criteria.

Results: Most studies (12) focused on treatment, followed by incidence/consumption (7), prevention (5) and mortality (1). The main drugs studied were drugs in general (12), followed by alcohol (6), tobacco (6), and other drugs, including cannabis and opioids (4). The results of 85% of the studies showed positive outcomes, supporting the effectiveness of nature-based interventions for drug dependence. While some studies produced neutral or negative results.

Conclusion: The use of nature-based interventions for the prevention and treatment of drug addiction shows considerable potential. However, more research is needed to understand the underlying mechanisms and to improve evidence-based interventions. Integrating health and environmental policies is essential to promote a holistic approach to drug strategies at the national and international levels.

背景:药物滥用是一个全球性问题,横跨社会各个领域,需要超越传统治疗方法的创新解决方案。与大自然接触可以成为解决毒品相关问题的辅助工具。本综述旨在评估自然环境对毒品相关结果的影响。方法:从 6 个数据库中筛选出 2013 年至 2023 年间的 8205 篇文章,其中 21 篇符合纳入标准:大多数研究(12 项)侧重于治疗,其次是发病率/消费(7 项)、预防(5 项)和死亡率(1 项)。研究的主要药物是一般药物(12 项),其次是酒精(6 项)、烟草(6 项)和其他药物,包括大麻和阿片类药物(4 项)。85%的研究结果显示了积极的成果,支持以自然为基础的药物依赖干预措施的有效性。而一些研究则得出了中性或负面的结果:结论:利用基于自然的干预措施预防和治疗药物成瘾具有相当大的潜力。然而,还需要更多的研究来了解潜在的机制,并改进基于证据的干预措施。整合健康和环境政策对于在国家和国际层面推动整体性的禁毒战略至关重要。
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引用次数: 0
Lifestyle factors and urine levels of organophosphorus flame retardants in endometrial cancer: insights from a case-control study. 子宫内膜癌中的生活方式因素和尿液中的有机磷阻燃剂水平:一项病例对照研究的启示。
IF 4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00175
Yu-Che Ou, Fu-Jen Cheng, Wan-Ting Huang, Wen-Chin Lee, Hung-Chun Fu, Chen-Hsuan Wu, Ying-Yi Chen, Kuo-Chung Lan, Xuan-Ping Liou, Hao Lin, Chia-Te Kung

Background: Organophosphate flame retardants (OPFRs) are commonly used in various consumer products to prevent fire hazards. However, OPFRs have been linked to several health problems, including cancer. This study aimed to investigate the association between urine levels of OPFRs and endometrial cancer (EC), and to explore the correlation between concentrations of parent OPFR compounds and their metabolites.

Methods: Urine samples from 76 EC patients and 76 healthy controls were collected and analyzed for the levels of five common parent OPFRs and their respective metabolites. Propensity score matching was applied to account for differences in baseline characteristics between the two participant groups. Significantly higher levels of OPFRs in EC patients were identified, and logistic regression models were used to determine whether elevated OPFRs were associated with EC and to explore whether any lifestyle behaviors contributed to the increased OPFR levels. Spearman's rank correlation coefficients between the concentrations of the parent compounds and their metabolites were calculated.

Results: Out of the ten OPFRs studied, the median urine levels of bis(1,3-dichloro-2-propyl) phosphate (BDCPP), tris(2-butoxyethyl) phosphate (TBEP), and di-(2-butoxyethyl) phosphate (DBEP) were significantly higher in EC patients compared to healthy controls. After matching 41 patients with 41 controls, multiple logistic regression analysis revealed that only BDCPP (OR 4.274; 95% CI 1.172-15.592) was an independent factor associated with EC. A lifestyle questionnaire survey found that urine BDCPP levels were related to age (OR 4.294; 95% CI 1.015-18.164), meals eaten out (OR 4.238; 95% CI 1.454-12.354), and consumption of chilled-ready meals (OR 0.118; 95% CI 0.014-0.985). A positive correlation was only observed between the concentrations of TBEP and its metabolite DBEP; other correlations were not significant.

Conclusion: We concluded that higher urine BDCPP level was an independent factor associated with EC, and higher BDCPP levels were related to aging, more meals eaten out, and fewer chilled-ready meals. These findings highlight the potential hazard of long-term OPFR exposure on the development of EC.

背景:有机磷阻燃剂(OPFR)通常用于各种消费品,以防止火灾危险。然而,有机磷阻燃剂与包括癌症在内的多种健康问题有关。本研究旨在调查尿液中 OPFRs 水平与子宫内膜癌(EC)之间的关联,并探讨 OPFR 母体化合物及其代谢物浓度之间的相关性:收集了76名子宫内膜癌患者和76名健康对照者的尿液样本,分析了五种常见母体OPFR及其代谢物的水平。为了考虑两组参与者基线特征的差异,采用了倾向得分匹配法。研究发现,心血管疾病患者的 OPFR 水平明显较高,因此采用逻辑回归模型来确定 OPFR 的升高是否与心血管疾病有关,并探讨是否有任何生活方式导致 OPFR 水平升高。计算了母体化合物及其代谢物浓度之间的斯皮尔曼等级相关系数:结果:在所研究的十种 OPFRs 中,与健康对照组相比,EC 患者尿液中磷酸二(1,3-二氯-2-丙基)酯(BDCPP)、磷酸三(2-丁氧基乙基)酯(TBEP)和磷酸二(2-丁氧基乙基)酯(DBEP)的中位数水平明显较高。在对41名患者和41名对照组进行配对后,多元逻辑回归分析表明,只有BDCPP(OR 4.274;95% CI 1.172-15.592)是与EC相关的独立因素。生活方式问卷调查发现,尿液中的 BDCPP 水平与年龄(OR 4.294;95% CI 1.015-18.164)、在外就餐(OR 4.238;95% CI 1.454-12.354)和食用冷藏即食食品(OR 0.118;95% CI 0.014-0.985)有关。仅观察到 TBEP 及其代谢物 DBEP 的浓度之间存在正相关;其他相关性不显著:我们得出的结论是,尿液中 BDCPP 含量较高是诱发心血管疾病的一个独立因素,而 BDCPP 含量较高与年龄增长、外出就餐次数较多和冷藏即食食品较少有关。这些发现凸显了长期暴露于 OPFR 对诱发心肌梗死的潜在危害。
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引用次数: 0
Identification and analysis of differently expressed transcription factors in aristolochic acid nephropathy. 马兜铃酸肾病中不同表达转录因子的鉴定与分析
IF 4.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.23-00245
Yi-Feng Wu, Zhi-Yao Tang, Yi-Xuan Deng, Kun Liu, Xu-Rui Gu, Guang-Liang Zhou, Yu-Jie Huang, Xiao-Qing Lin, Lin-Yun Zhou, Xiao-Cong Zuo

Background: Aristolochic acid nephropathy (AAN) is a rapidly progressive interstitial nephropathy caused by Aristolochic acid (AA). AAN is associated with the development of nephropathy and urothelial carcinoma. It is estimated that more than 100 million people worldwide are at risk of developing AAN. However, the underlying mechanisms driving renal deterioration in AAN remain poorly understood, and the treatment options are limited.

Methods: We obtained GSE27168 and GSE136276 series matrix data from the Gene Expression Omnibus (GEO) related to AAN. Using the R Studio environment, we applied the limma package and WGCNA package to identify co-differently expressed genes (co-DEGs). By GO/KEGG/GSVA analysis, we revealed common biological pathways. Subsequently, co-DEGs were subjected to the String database to construct a protein-protein interaction (PPI) network. The MCC algorithms implemented in the Cytohubba plugin were employed to identify hub genes. The hub genes were cross-referenced with the transcription factor (TF) database to identify hub TFs. Immune infiltration analysis was performed to identify key immune cell groups by utilizing CIBERSORT. The expressions of AAN-associated hub TFs were verified in vivo and in vitro. Finally, siRNA intervention was performed on the two TFs to verify their regulatory effect in AAN.

Results: Our analysis identified 88 co-DEGs through the "limma" and "WGCNA" R packages. A PPI network comprising 53 nodes and 34 edges was constructed with a confidence level >0.4. ATF3 and c-JUN were identified as hub TFs potentially linked to AAN. Additionally, expressions of ATF3 and c-JUN positively correlated with monocytes, basophils, and vessels, and negatively correlated with eosinophils and endothelial cells. We observed a significant increase in protein and mRNA levels of these two hub TFs. Furthermore, it was found that siRNA intervention targeting ATF3, but not c-JUN, alleviated cell damage induced by AA. The knockdown of ATF3 protects against oxidative stress and inflammation in the AAN cell model.

Conclusion: This study provides novel insights into the role of ATF3 in AAN. The comprehensive analysis sheds light on the molecular mechanisms and identifies potential biomarkers and drug targets for AAN treatment.

背景:马兜铃酸肾病(AAN)是一种由马兜铃酸(AA)引起的快速进展性间质性肾病。AAN 与肾病和尿路癌的发生有关。据估计,全球有 1 亿多人面临罹患 AAN 的风险。然而,人们对导致 AAN 肾功能恶化的潜在机制仍知之甚少,治疗方案也很有限:我们从基因表达总库(Gene Expression Omnibus,GEO)中获得了与 AAN 相关的 GSE27168 和 GSE136276 系列矩阵数据。利用 R Studio 环境,我们使用 limma 软件包和 WGCNA 软件包来识别共差异表达基因(co-DEGs)。通过 GO/KEGG/GSVA 分析,我们发现了共同的生物学通路。随后,共差异表达基因被纳入 String 数据库,以构建蛋白质-蛋白质相互作用(PPI)网络。我们使用 Cytohubba 插件中的 MCC 算法来识别中心基因。将中心基因与转录因子(TF)数据库进行交叉比对,以确定中心 TF。利用 CIBERSORT 进行了免疫浸润分析,以确定关键的免疫细胞群。在体内和体外验证了 AAN 相关枢纽 TF 的表达。最后,对这两个TFs进行了siRNA干预,以验证它们在AAN中的调控作用:我们的分析通过 "limma "和 "WGCNA "R软件包确定了88个共DEGs。我们构建了一个由 53 个节点和 34 条边组成的 PPI 网络,其置信度大于 0.4。ATF3和c-JUN被确定为可能与AAN相关的枢纽TF。此外,ATF3 和 c-JUN 的表达与单核细胞、嗜碱性粒细胞和血管呈正相关,与嗜酸性粒细胞和内皮细胞呈负相关。我们观察到这两种枢纽 TF 的蛋白和 mRNA 水平都有明显增加。此外,我们还发现靶向 ATF3 的 siRNA(而非 c-JUN)能减轻 AA 引起的细胞损伤。在AAN细胞模型中,敲除ATF3可保护细胞免受氧化应激和炎症的影响:本研究为了解 ATF3 在 AAN 中的作用提供了新的视角。综合分析揭示了分子机制,并确定了治疗 AAN 的潜在生物标志物和药物靶点。
{"title":"Identification and analysis of differently expressed transcription factors in aristolochic acid nephropathy.","authors":"Yi-Feng Wu, Zhi-Yao Tang, Yi-Xuan Deng, Kun Liu, Xu-Rui Gu, Guang-Liang Zhou, Yu-Jie Huang, Xiao-Qing Lin, Lin-Yun Zhou, Xiao-Cong Zuo","doi":"10.1265/ehpm.23-00245","DOIUrl":"10.1265/ehpm.23-00245","url":null,"abstract":"<p><strong>Background: </strong>Aristolochic acid nephropathy (AAN) is a rapidly progressive interstitial nephropathy caused by Aristolochic acid (AA). AAN is associated with the development of nephropathy and urothelial carcinoma. It is estimated that more than 100 million people worldwide are at risk of developing AAN. However, the underlying mechanisms driving renal deterioration in AAN remain poorly understood, and the treatment options are limited.</p><p><strong>Methods: </strong>We obtained GSE27168 and GSE136276 series matrix data from the Gene Expression Omnibus (GEO) related to AAN. Using the R Studio environment, we applied the limma package and WGCNA package to identify co-differently expressed genes (co-DEGs). By GO/KEGG/GSVA analysis, we revealed common biological pathways. Subsequently, co-DEGs were subjected to the String database to construct a protein-protein interaction (PPI) network. The MCC algorithms implemented in the Cytohubba plugin were employed to identify hub genes. The hub genes were cross-referenced with the transcription factor (TF) database to identify hub TFs. Immune infiltration analysis was performed to identify key immune cell groups by utilizing CIBERSORT. The expressions of AAN-associated hub TFs were verified in vivo and in vitro. Finally, siRNA intervention was performed on the two TFs to verify their regulatory effect in AAN.</p><p><strong>Results: </strong>Our analysis identified 88 co-DEGs through the \"limma\" and \"WGCNA\" R packages. A PPI network comprising 53 nodes and 34 edges was constructed with a confidence level >0.4. ATF3 and c-JUN were identified as hub TFs potentially linked to AAN. Additionally, expressions of ATF3 and c-JUN positively correlated with monocytes, basophils, and vessels, and negatively correlated with eosinophils and endothelial cells. We observed a significant increase in protein and mRNA levels of these two hub TFs. Furthermore, it was found that siRNA intervention targeting ATF3, but not c-JUN, alleviated cell damage induced by AA. The knockdown of ATF3 protects against oxidative stress and inflammation in the AAN cell model.</p><p><strong>Conclusion: </strong>This study provides novel insights into the role of ATF3 in AAN. The comprehensive analysis sheds light on the molecular mechanisms and identifies potential biomarkers and drug targets for AAN treatment.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"30"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China. 气温与死亡率之间的关系:中国西南部四川盆地多城市时间序列研究。
IF 4.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.23-00118
Yizhang Xia, Chunli Shi, Yang Li, Shijuan Ruan, Xianyan Jiang, Wei Huang, Yu Chen, Xufang Gao, Rong Xue, Mingjiang Li, Hongying Sun, Xiaojuan Peng, Renqiang Xiang, Jianyu Chen, Li Zhang

Background: There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden.

Methods: Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status.

Results: A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status.

Conclusions: Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.

背景:有关盆地气候条件下气温与死亡率之间关系的多城市研究很少。本研究以中国西南部的四川盆地为基础,评估盆地气温与人口非意外死亡以及与气温相关的死亡负担之间的关系:方法:收集了中国西南部四川盆地四个城市的每日死亡率数据、气象和空气污染数据。我们采用两阶段时间序列分析来量化每个城市的气温与非意外死亡之间的关系,并进行多变量荟萃分析以获得总体累积风险。通过计算可归因分数 (AF),我们得出了非最佳温度导致的死亡负担。此外,我们还按性别、年龄组、教育水平和婚姻状况进行了分层分析:我们的研究共收集了 751,930 例非意外死亡。总体而言,10.16%的非意外死亡可归因于非最佳温度。大多数与温度相关的非意外死亡是由低温造成的,占 9.10%(95% eCI:5.50%,12.19%),而热效应仅占 1.06%(95% eCI:0.76%,1.33%)。65岁以下人群、女性、受教育程度低的人群以及另一种婚姻状况的人群因气温不适宜而造成的死亡率较高:我们的研究表明,非最佳温度与非意外死亡率之间存在显著关联。65岁以下人群、女性、受教育程度低或另类婚姻状况者的归因负担最高。
{"title":"Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China.","authors":"Yizhang Xia, Chunli Shi, Yang Li, Shijuan Ruan, Xianyan Jiang, Wei Huang, Yu Chen, Xufang Gao, Rong Xue, Mingjiang Li, Hongying Sun, Xiaojuan Peng, Renqiang Xiang, Jianyu Chen, Li Zhang","doi":"10.1265/ehpm.23-00118","DOIUrl":"10.1265/ehpm.23-00118","url":null,"abstract":"<p><strong>Background: </strong>There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden.</p><p><strong>Methods: </strong>Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status.</p><p><strong>Results: </strong>A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status.</p><p><strong>Conclusions: </strong>Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"1"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk of severe COVID-19 in unvaccinated patients during the period from wild-type to Omicron variant: real-world evidence from Japan. 从野生型到 Omicron 变异型期间未接种疫苗的患者发生严重 COVID-19 的风险:来自日本的实际证据。
IF 4.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.23-00274
Kimiko Tomioka, Kenji Uno, Masahiro Yamada

Background: Many studies have reported that the Omicron variant is less pathogenic than the Delta variant and the wild-type. Epidemiological evidence regarding the risk of severe COVID-19 from the wild-type to the Omicron variant has been lacking.

Methods: Study participants were COVID-19 patients aged 18 and older without previous COVID-19 infection who were notified to the Nara Prefecture Chuwa Public Health Center from January 2020 to March 2023, during the periods from the wild-type to the Omicron variant. The outcome variable was severe COVID-19 (i.e., ICU admission or COVID-19-related death). The explanatory variable was SARS-CoV-2 variant type or the number of COVID-19 vaccinations. Covariates included gender, age, risk factors for aggravation, and the number of general hospital beds per population. The generalized estimating equations of negative binomial regression models were used to estimate the adjusted incidence proportion (AIP) with 95% confidence interval (CI) for severe COVID-19.

Results: Among 77,044 patients included in the analysis, 14,556 (18.9%) were unvaccinated and 520 (0.7%) developed severe COVID-19. Among unvaccinated patients, the risk of severe COVID-19 increased in the Alpha/Delta variants and decreased in the Omicron variant compared to the wild-type (AIP [95% CI] was 1.55 [1.06-2.27] in Alpha/Delta and 0.25 [0.15-0.40] in Omicron), but differed by age. Especially in patients aged ≥80, there was no significant difference in the risk of severe COVID-19 between the wild-type and the Omicron variant (AIP [95% CI] = 0.59 [0.27-1.29]). Regarding the preventive effect of vaccines, among all study participants, the number of vaccinations was significantly associated with the prevention of severe COVID-19, regardless of variant type. After stratified analyses by age, patients aged ≥80 remained a significant association for all variant types. On the other hand, the number of vaccinations had no association in Omicron BA.5 of patients aged 18-64.

Conclusions: Patients aged ≥80 had less reduction in risk of severe COVID-19 during the Omicron variant period, and a greater preventive effect of vaccines against severe COVID-19, compared to younger people. Our findings suggest that booster vaccination is effective and necessary for older people, especially aged ≥80.

背景:许多研究报告称,Omicron变体的致病性低于Delta变体和野生型。有关从野生型到 Omicron 变体的严重 COVID-19 风险的流行病学证据尚缺:研究对象为 2020 年 1 月至 2023 年 3 月期间向奈良县中和公共卫生中心通报的、年龄在 18 岁及以上、既往未感染过 COVID-19 的患者。结果变量为严重 COVID-19(即入住重症监护室或与 COVID-19 相关的死亡)。解释变量为 SARS-CoV-2 变异类型或 COVID-19 疫苗接种次数。协变量包括性别、年龄、病情恶化的风险因素和人均综合医院床位数。采用负二项回归模型的广义估计方程来估计重症COVID-19的调整发病率比例(AIP)和95%置信区间(CI):在纳入分析的 77,044 名患者中,14,556 人(18.9%)未接种疫苗,520 人(0.7%)罹患重症 COVID-19。在未接种疫苗的患者中,与野生型相比,Alpha/Delta 变体发生重症 COVID-19 的风险增加,Omicron 变体发生重症 COVID-19 的风险降低(Alpha/Delta 的 AIP [95% CI] 为 1.55 [1.06-2.27],Omicron 为 0.25 [0.15-0.40]),但因年龄而异。特别是在年龄≥80 岁的患者中,野生型和 Omicron 变异型患者发生严重 COVID-19 的风险没有显著差异(AIP [95% CI] = 0.59 [0.27-1.29])。关于疫苗的预防效果,在所有研究参与者中,接种疫苗的次数与预防严重COVID-19显著相关,而与变异类型无关。按年龄进行分层分析后,年龄≥80岁的患者与所有变异类型仍有显著相关性。另一方面,在 18-64 岁的患者中,接种疫苗的次数与 Omicron BA.5 没有关系:结论:与年轻人相比,年龄≥80 岁的患者在 Omicron 变异期间患重症 COVID-19 的风险降低较少,而疫苗对重症 COVID-19 的预防效果更大。我们的研究结果表明,加强接种疫苗对老年人,尤其是≥80岁的老年人是有效且必要的。
{"title":"Risk of severe COVID-19 in unvaccinated patients during the period from wild-type to Omicron variant: real-world evidence from Japan.","authors":"Kimiko Tomioka, Kenji Uno, Masahiro Yamada","doi":"10.1265/ehpm.23-00274","DOIUrl":"10.1265/ehpm.23-00274","url":null,"abstract":"<p><strong>Background: </strong>Many studies have reported that the Omicron variant is less pathogenic than the Delta variant and the wild-type. Epidemiological evidence regarding the risk of severe COVID-19 from the wild-type to the Omicron variant has been lacking.</p><p><strong>Methods: </strong>Study participants were COVID-19 patients aged 18 and older without previous COVID-19 infection who were notified to the Nara Prefecture Chuwa Public Health Center from January 2020 to March 2023, during the periods from the wild-type to the Omicron variant. The outcome variable was severe COVID-19 (i.e., ICU admission or COVID-19-related death). The explanatory variable was SARS-CoV-2 variant type or the number of COVID-19 vaccinations. Covariates included gender, age, risk factors for aggravation, and the number of general hospital beds per population. The generalized estimating equations of negative binomial regression models were used to estimate the adjusted incidence proportion (AIP) with 95% confidence interval (CI) for severe COVID-19.</p><p><strong>Results: </strong>Among 77,044 patients included in the analysis, 14,556 (18.9%) were unvaccinated and 520 (0.7%) developed severe COVID-19. Among unvaccinated patients, the risk of severe COVID-19 increased in the Alpha/Delta variants and decreased in the Omicron variant compared to the wild-type (AIP [95% CI] was 1.55 [1.06-2.27] in Alpha/Delta and 0.25 [0.15-0.40] in Omicron), but differed by age. Especially in patients aged ≥80, there was no significant difference in the risk of severe COVID-19 between the wild-type and the Omicron variant (AIP [95% CI] = 0.59 [0.27-1.29]). Regarding the preventive effect of vaccines, among all study participants, the number of vaccinations was significantly associated with the prevention of severe COVID-19, regardless of variant type. After stratified analyses by age, patients aged ≥80 remained a significant association for all variant types. On the other hand, the number of vaccinations had no association in Omicron BA.5 of patients aged 18-64.</p><p><strong>Conclusions: </strong>Patients aged ≥80 had less reduction in risk of severe COVID-19 during the Omicron variant period, and a greater preventive effect of vaccines against severe COVID-19, compared to younger people. Our findings suggest that booster vaccination is effective and necessary for older people, especially aged ≥80.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"10"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lower regional urbanicity and socioeconomic status attenuate associations of green spaces with hypertension and diabetes mellitus: a national representative cross-sectional study in China. 较低的地区城市化程度和社会经济地位削弱了绿地与高血压和糖尿病的关系:一项在中国进行的全国代表性横断面研究。
IF 4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00121
Wanzhou Wang, Chao Yang, Jinwei Wang, Fulin Wang, Ze Liang, Yueyao Wang, Feifei Zhang, Chenyu Liang, Chenshuang Li, Yiqun Lan, Shuangcheng Li, Pengfei Li, Ying Zhou, Luxia Zhang, Lieyun Ding

Background: High blood pressure (HBP) and diabetes mellitus (DM) are two of the most prevalent cardiometabolic disorders globally, especially among individuals with lower socio-economic status (SES). Studies have linked residential greenness to decreased risks of HBP and DM. However, there has been limited evidence on whether SES may modify the associations of residential greenness with HBP and DM.

Methods: Based on a national representative cross-sectional study among 44,876 adults, we generated the normalized difference vegetation index (NDVI) at 1 km spatial resolution to characterize individuals' residential greenness level. Administrative classification (urban/rural), nighttime light index (NLI), individual income, and educational levels were used to characterize regional urbanicity and individual SES levels.

Results: We observed weaker inverse associations of NDVI with HBP and DM in rural regions compared to urban regions. For instance, along with per interquartile range (IQR, 0.26) increment in residential NDVI at 0∼5 year moving averages, the ORs of HBP were 1.04 (95%CI: 0.94, 1.15) in rural regions and 0.85 (95%CI: 0.79, 0.93) in urban regions (P = 0.003). Along with the decrease in NLI levels, there were continuously decreasing inverse associations of NDVI with DM prevalence (P for interaction <0.001). In addition, weaker inverse associations of residential NDVI with HBP and DM prevalence were found among individuals with lower income and lower education levels compared to their counterparts.

Conclusions: Lower regional urbanicity and individual SES could attenuate the associations of residential greenness with odds of HBP and DM prevalence.

背景:高血压(HBP)和糖尿病(DM)是全球最常见的两种心脏代谢疾病,尤其是在社会经济地位(SES)较低的人群中。研究表明,住宅绿化与降低 HBP 和 DM 风险有关。然而,关于社会经济地位是否会改变住宅绿化与 HBP 和 DM 的相关性,目前的证据还很有限:方法:基于一项对 44876 名成年人进行的具有全国代表性的横断面研究,我们生成了空间分辨率为 1 公里的归一化差异植被指数(NDVI),以描述个人的居住绿化水平。行政区划(城市/农村)、夜间光照指数(NLI)、个人收入和教育水平用于描述地区城市化和个人社会经济水平:我们观察到,与城市地区相比,农村地区的 NDVI 与 HBP 和 DM 的反比关系较弱。例如,以 0∼5 年移动平均值计算,住宅 NDVI 每增加 0.26,农村地区 HBP 的 ORs 为 1.04(95%CI:0.94, 1.15),城市地区为 0.85(95%CI:0.79, 0.93)(P = 0.003)。随着 NLI 水平的降低,NDVI 与 DM 患病率的反比关系也不断降低(P 为交互作用结论):较低的地区城市化程度和个人社会经济地位会降低居住区绿化程度与 HBP 和 DM 患病率的相关性。
{"title":"Lower regional urbanicity and socioeconomic status attenuate associations of green spaces with hypertension and diabetes mellitus: a national representative cross-sectional study in China.","authors":"Wanzhou Wang, Chao Yang, Jinwei Wang, Fulin Wang, Ze Liang, Yueyao Wang, Feifei Zhang, Chenyu Liang, Chenshuang Li, Yiqun Lan, Shuangcheng Li, Pengfei Li, Ying Zhou, Luxia Zhang, Lieyun Ding","doi":"10.1265/ehpm.24-00121","DOIUrl":"10.1265/ehpm.24-00121","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (HBP) and diabetes mellitus (DM) are two of the most prevalent cardiometabolic disorders globally, especially among individuals with lower socio-economic status (SES). Studies have linked residential greenness to decreased risks of HBP and DM. However, there has been limited evidence on whether SES may modify the associations of residential greenness with HBP and DM.</p><p><strong>Methods: </strong>Based on a national representative cross-sectional study among 44,876 adults, we generated the normalized difference vegetation index (NDVI) at 1 km spatial resolution to characterize individuals' residential greenness level. Administrative classification (urban/rural), nighttime light index (NLI), individual income, and educational levels were used to characterize regional urbanicity and individual SES levels.</p><p><strong>Results: </strong>We observed weaker inverse associations of NDVI with HBP and DM in rural regions compared to urban regions. For instance, along with per interquartile range (IQR, 0.26) increment in residential NDVI at 0∼5 year moving averages, the ORs of HBP were 1.04 (95%CI: 0.94, 1.15) in rural regions and 0.85 (95%CI: 0.79, 0.93) in urban regions (P = 0.003). Along with the decrease in NLI levels, there were continuously decreasing inverse associations of NDVI with DM prevalence (P for interaction <0.001). In addition, weaker inverse associations of residential NDVI with HBP and DM prevalence were found among individuals with lower income and lower education levels compared to their counterparts.</p><p><strong>Conclusions: </strong>Lower regional urbanicity and individual SES could attenuate the associations of residential greenness with odds of HBP and DM prevalence.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"47"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The global burden of vascular intestinal diseases: results from the 2021 Global Burden of Disease Study and projections using Bayesian age-period-cohort analysis. 血管性肠道疾病的全球负担:来自2021年全球疾病负担研究的结果和使用贝叶斯年龄-时期-队列分析的预测
IF 4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00206
Xiqiang Zhang, Longchao Wu, Yu Li, Ze Tao, Na Li, Haoyang Zhang, Ming Ren, Kexin Wang

Background: Vascular intestinal disease is a major health concern that often requires emergency surgery in patients with intestinal obstruction, perforation, or bowel necrosis. We aimed to provide data on the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of vascular intestinal diseases from 1990 to 2021, thereby contributing to the development of health policies.

Methods: Using standardized methods from the 2021 Global Burden of Disease study, we analyzed the incidence, prevalence, mortality, and DALYs of vascular intestinal disease from the perspectives of the sociodemographic index (SDI), regional, and country, along with the corresponding estimated annual percentage changes. Additionally, we used join-point regression to identify the key time points for disease burden changes.

Results: In 2021, a total of 169,432 cases [95% uncertainty interval (UI): 155,127-185,189] of vascular intestinal disease were identified worldwide. The age-standardized incidence rate decreased from 18.81 (95% UI: 16.07-21.73) in 1990 to 15.98 (95% UI: 13.99-19.10) in 2021. In 2021, the age-standardized mortality rate was 1.12/100,000 people (95% UI: 1.00-1.21). Over the 32-year period, the global DALYs rate declined by 1.44 (95% Confidence Interval: -1.55 to -1.34). Within the five SDI regions, the high-middle SDI areas recorded the peak standardized mortality rates in 2021. Regionally, the greatest increase in incidence occurred in North Africa and the Middle East. Canada recorded the greatest national incidence rate [58.35 (95% UI: 50.05-67.37)] in 2021 among 204 countries, while Russia exhibited the highest related mortality [5.64/100,000 people (95% UI: 5.19-6.11)] and DALYs rate [101.48/100,000 people (95% UI: 93.83-109.66)].

Conclusions: Despite a global decline in the burden of vascular intestinal disease from 1990 to 2021, significant regional and national disparities persist and the disease burden among the elderly has increased.

背景:血管性肠疾病是一个主要的健康问题,通常需要对肠梗阻、穿孔或肠坏死患者进行紧急手术。我们旨在提供1990年至2021年血管性肠道疾病的发病率、患病率、死亡率和残疾调整生命年(DALYs)的数据,从而为卫生政策的制定做出贡献。方法:采用2021年全球疾病负担研究的标准化方法,从社会人口指数(SDI)、地区和国家的角度分析血管性肠道疾病的发病率、患病率、死亡率和DALYs,以及相应的估计年百分比变化。此外,我们使用联结点回归来确定疾病负担变化的关键时间点。结果:2021年,全球共确诊血管性肠道疾病169,432例[95%不确定区间(UI): 155,127-185,189]。年龄标准化发病率从1990年的18.81 (95% UI: 16.07-21.73)下降到2021年的15.98 (95% UI: 13.99-19.10)。2021年,年龄标准化死亡率为1.12/10万人(95%死亡率:1.00-1.21)。在32年期间,全球DALYs率下降了1.44(95%置信区间:-1.55至-1.34)。在五个SDI区域内,SDI中高区域的标准化死亡率在2021年达到峰值。从区域来看,发病率增幅最大的是北非和中东。在204个国家中,加拿大在2021年的全国发病率最高[58.35 (95% UI: 50.05-67.37)],俄罗斯的相关死亡率最高[5.64/10万人(95% UI: 5.19-6.11)], DALYs率最高[101.48/10万人(95% UI: 93.83-109.66)]。结论:尽管1990年至2021年全球血管性肠道疾病负担下降,但显著的区域和国家差异仍然存在,老年人的疾病负担有所增加。
{"title":"The global burden of vascular intestinal diseases: results from the 2021 Global Burden of Disease Study and projections using Bayesian age-period-cohort analysis.","authors":"Xiqiang Zhang, Longchao Wu, Yu Li, Ze Tao, Na Li, Haoyang Zhang, Ming Ren, Kexin Wang","doi":"10.1265/ehpm.24-00206","DOIUrl":"10.1265/ehpm.24-00206","url":null,"abstract":"<p><strong>Background: </strong>Vascular intestinal disease is a major health concern that often requires emergency surgery in patients with intestinal obstruction, perforation, or bowel necrosis. We aimed to provide data on the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of vascular intestinal diseases from 1990 to 2021, thereby contributing to the development of health policies.</p><p><strong>Methods: </strong>Using standardized methods from the 2021 Global Burden of Disease study, we analyzed the incidence, prevalence, mortality, and DALYs of vascular intestinal disease from the perspectives of the sociodemographic index (SDI), regional, and country, along with the corresponding estimated annual percentage changes. Additionally, we used join-point regression to identify the key time points for disease burden changes.</p><p><strong>Results: </strong>In 2021, a total of 169,432 cases [95% uncertainty interval (UI): 155,127-185,189] of vascular intestinal disease were identified worldwide. The age-standardized incidence rate decreased from 18.81 (95% UI: 16.07-21.73) in 1990 to 15.98 (95% UI: 13.99-19.10) in 2021. In 2021, the age-standardized mortality rate was 1.12/100,000 people (95% UI: 1.00-1.21). Over the 32-year period, the global DALYs rate declined by 1.44 (95% Confidence Interval: -1.55 to -1.34). Within the five SDI regions, the high-middle SDI areas recorded the peak standardized mortality rates in 2021. Regionally, the greatest increase in incidence occurred in North Africa and the Middle East. Canada recorded the greatest national incidence rate [58.35 (95% UI: 50.05-67.37)] in 2021 among 204 countries, while Russia exhibited the highest related mortality [5.64/100,000 people (95% UI: 5.19-6.11)] and DALYs rate [101.48/100,000 people (95% UI: 93.83-109.66)].</p><p><strong>Conclusions: </strong>Despite a global decline in the burden of vascular intestinal disease from 1990 to 2021, significant regional and national disparities persist and the disease burden among the elderly has increased.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"71"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethylene oxide exposure increases impaired glucose metabolism in the US general population: a national cross-sectional study. 环氧乙烷暴露增加美国普通人群葡萄糖代谢受损:一项全国性横断面研究。
IF 4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1265/ehpm.24-00199
Yuqi Zhao, Deliang Liu, Xiaogao Pan, Yuyong Tan

Background: Current experimental evidence supports that ethylene oxide (EO) exposure-related pathophysiologies may affect glucose metabolism, but few population-based studies have explored the potential links.

Methods: This study used cross-sectional data from 15560 participants in the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. EO exposure levels were calculated by testing hemoglobin adducts of EO (HbEO) via a modified Edman reaction. We focused on the association of EO exposure with prediabetes and diabetes as well as indicators of impaired glucose metabolism and further analyzed the potential pathogenic mechanisms. Statistics included logistic regression, generalized additive model fitting, penalized spline method, two-piecewise linear regression, recursive algorithm, mediation analysis, and Pearson's analysis.

Results: EO exposure was associated with changes in glucose metabolic indicators and increased prevalence of prediabetes and diabetes, showing age-consistency and being more pronounced in obese and non-smoking populations. For each one pmol/g Hb, one SD, or two-fold SD increase in log2-HbEO, the risk of prediabetes increased by 12%, 16%, and 33%, with an increased risk of diabetes by 18%, 26%, and 61%, respectively. Dose-response curves revealed that this positive correlation was approximately linear with prediabetes and "J" shaped with diabetes. When log2-HbEO > 8.03 pmol/g Hb, the risk of diabetes would be further increased. Pearson's correlation revealed that EO exposure was associated with reduced fasting insulin and elevated HbA1c in the prediabetic stage. While in the diabetes stage, EO exposure was correlated with elevated fasting glucose, HbA1c, and HOMA-IR, suggesting an exacerbation of diabetes progression by EO exposure. A potential mechanism that the early stages of impaired glucose metabolism may be initiated by EO-related inflammation and oxidative stress damaging pancreatic β-cells, resulting in decreased insulin secretion. These speculations were partially supported by mediation analysis and mediators' Pearson analysis.

Conclusion: Elevated ethylene oxide exposure increases the incidence of impaired glucose metabolism in the general U.S. population and a potential intervention may be to effectively suppress inflammation and oxidative stress imbalances.

背景:目前的实验证据支持环氧乙烷(EO)暴露相关的病理生理可能会影响葡萄糖代谢,但很少有基于人群的研究探讨其潜在联系:本研究使用了 2017 年至 2020 年美国国家健康与营养调查(NHANES)中 15560 名参与者的横截面数据。通过改良埃德曼反应检测环氧乙烷血红蛋白加合物(HbEO),计算环氧乙烷暴露水平。我们重点研究了环氧乙烷暴露与糖尿病前期和糖尿病以及糖代谢受损指标的关联,并进一步分析了潜在的致病机制。统计方法包括逻辑回归、广义加性模型拟合、惩罚性样条法、二片线性回归、递归算法、中介分析和皮尔逊分析:结果:暴露于环氧乙烷与葡萄糖代谢指标的变化以及糖尿病前期和糖尿病患病率的增加有关,显示出年龄一致性,在肥胖和非吸烟人群中更为明显。log2-HbEO 每增加 1 pmol/g Hb、1 SD 或 2 倍 SD,糖尿病前期风险分别增加 12%、16% 和 33%,糖尿病风险分别增加 18%、26% 和 61%。剂量-反应曲线显示,这种正相关性与糖尿病前期呈近似线性关系,与糖尿病呈 "J "形关系。当 log2-HbEO > 8.03 pmol/g Hb 时,患糖尿病的风险会进一步增加。皮尔逊相关性显示,在糖尿病前期,接触环氧乙烷与空腹胰岛素降低和 HbA1c 升高有关。而在糖尿病阶段,暴露于环氧乙烷与空腹血糖、HbA1c 和 HOMA-IR 升高相关,表明暴露于环氧乙烷会加剧糖尿病的发展。糖代谢受损的早期阶段可能是由环氧乙烷相关的炎症和氧化应激损伤胰腺β细胞,导致胰岛素分泌减少而引发的。这些推测得到了中介分析和中介因子皮尔逊分析的部分支持:结论:环氧乙烷暴露增加了美国普通人群糖代谢受损的发病率,有效抑制炎症和氧化应激失衡可能是一种潜在的干预措施。
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引用次数: 0
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Environmental Health and Preventive Medicine
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