Abstract：
Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus, which reduces the quality of life. However, the association between PDN and environmental factors, especially ambient humidity, remains unclear. Therefore, this study investigated the impact of extreme humidity events on PDN. Data on PDN-related hospital admissions to two tertiary hospitals in Hefei, China (2014-2019) were obtained. A distributed lag non-linear model with a case-crossover design was used to quantitatively estimate the effects of ambient humidity on PDN, and the results were stratified by sex and age. The 1st, 10th, 90th, and 99th percentiles of relative humidity (RHU) were defined as extreme humidity, and the average relative humidity (74.94%) was set as the reference value. Non-linear exposure-response curves between the RHU and PDN cases were obtained. Extreme humidity (92%) had a significant effect on PDN with a relative risk (RR) of 1.13 (95% confidence interval (CI): 1.01-1.26) on a particular day, which increased with the RHU (RR: 1.21, 95% CI: 1.02-1.45 at 98% extreme humidity). Stratification analysis showed that women (RR: 1.38, 95% CI: 1.07-1.77) and patients aged < 65 years (RR: 1.26, 95% CI: 1.01-1.57) were highly susceptible to this effect on the same day. The results suggest that extreme humidity is a crucial trigger for PDN onset in diabetes patients. Furthermore, the effects vary with sex and age. This study provides detailed evidence of the adverse effects of extreme weather on diabetes patients.
摘要：
痛性糖尿病神经病变（PDN）是糖尿病的常见并发症，这降低了生活质量。然而,PDN与环境因素之间的关联，尤其是环境湿度,尚不清楚。因此,这项研究调查了极端湿度事件对PDN的影响。合肥市两家三级医院PDN相关医院接诊数据，中国（2014-2019）获得。采用案例交叉设计的分布式滞后非线性模型定量估计了环境湿度对PDN的影响,结果按性别和年龄分层。第一,第十,第90,相对湿度(RHU)的第99百分位数定义为极端湿度，以平均相对湿度(74.94%)为参考值。获得了RHU和PDN病例之间的非线性暴露反应曲线。极端湿度（92％）对PDN有显着影响，在特定的一天，相对风险（RR）为1.13（95％置信区间（CI）：1.01-1.26），随RHU增加（RR：1.21，95%CI：1.02-1.45，在98%的极端湿度下）。分层分析表明，女性（RR：1.38，95％CI：1.07-1.77）和年龄<65岁的患者（RR：1.26，95％CI：1.01-1.57）在同一天高度易感。结果表明，极端湿度是糖尿病患者PDN发作的关键触发因素。此外，影响因性别和年龄而异。这项研究提供了极端天气对糖尿病患者不利影响的详细证据。
