高温和灰尘对科威特糖尿病住院治疗的综合影响。

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM BMJ Open Diabetes Research & Care Pub Date : 2024-08-29 DOI:10.1136/bmjdrc-2024-004320
Barrak Alahmad, Hamad Ali, Yazan Alwadi, Ali Al-Hemoud, Petros Koutrakis, Fahd Al-Mulla
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引用次数: 0

摘要

导言:在科威特,严重的糖尿病和肥胖症流行病与强烈的沙尘暴和酷暑同时存在。虽然从理论上讲,沙尘、高温和糖尿病之间的相互作用带来了严重的公共卫生问题,但对实际风险的经验性了解仍然有限。我们假设,单独或共同暴露于高温和粉尘中的情况增加,会加剧糖尿病患者住院的风险:我们在科威特放置了定制设计的颗粒采样器,从 2017 年到 2019 年的 2 年中每天收集粉尘样本。对样本进行元素浓度分析,以确定和量化粉尘污染日。温度数据由气象站收集。然后,我们收集了科威特所有公立医院非计划糖尿病患者的住院数据。我们采用病例交叉研究设计和条件准泊松模型来比较同一研究对象的住院日和对照日。最后,我们采用广义加法模型来探讨温度和灰尘天数对糖尿病住院的平滑交互作用:研究期间共有 11 155 例非计划糖尿病住院治疗。我们发现,每年都有 282 例糖尿病患者因高温天入院(95% CI:-14 至 473)。此外,粉尘水平每增加 10 µg/m3,每年就会多出约 114 例糖尿病患者(95% CI:11 至 219 例)。与温和的非粉尘天(33°C (0 µg/m3))相比,炎热的粉尘天会共同增加糖尿病患者入院的相对风险,从 42°C (85 µg/m3) 时的 1.11 增加到 42°C (150 µg/m3)时的 1.36:结论:高温和粉尘似乎都是导致糖尿病发病率增加的原因,而高温和粉尘的共同作用则进一步加剧了这些风险。
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Combined impact of heat and dust on diabetes hospitalization in Kuwait.

Introduction: In Kuwait, a severe diabetes and obesity epidemic coexists with intense dust storms and harsh summer heat. While, theoretically, this interplay between dust, heat, and diabetes presents a serious public health problem, the empirical understanding of the actual risks remains limited. We hypothesized that increased exposure to heat and dust, independently and jointly, exacerbates the risk of hospitalization for diabetes patients.

Research design and methods: We placed custom-designed particle samplers in Kuwait to collect daily dust samples for 2 years from 2017 to 2019. Samples were analyzed for elemental concentrations to identify and quantify dust pollution days. Temperature data were collected from meteorological stations. We then collected hospitalization data for unplanned diabetic admissions in all public hospitals in Kuwait. We used a case-crossover study design and conditional quasi-Poisson models to compare hospitalization days to control days within the same subject. Finally, we fitted generalized additive models to explore the smoothed interaction between temperature and dust days on diabetes hospitalization.

Results: There were 11 155 unplanned diabetes hospitalizations over the study period. We found that each year, there was an excess of 282 diabetic admissions attributed to hot days (95% CI: -14 to 473). Additionally, for every 10 µg/m3 increase in dust levels, there were about 114 excess diabetic admissions annually (95% CI: 11 to 219). Compared with mild non-dusty days (33°C (0 µg/m3)), hot-dusty days jointly increased the relative risk of diabetic admissions from 1.11 at 42°C (85 µg/m3) to 1.36 at 42°C (150 µg/m3).

Conclusions: Both heat and dust seem to contribute to the increased diabetes morbidity, with combined hot-dusty conditions exacerbating these risks even further.

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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
期刊最新文献
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