背景:多年来,各种流行病学研究发现,急性心肌梗死(AMI)通常表现出季节性节律模式,这通常受到环境因素变化的影响,比如空气污染,环境温度,太阳活动,相对湿度。然而,关于阳光诱发AMI的影响的研究很少,特别是在发展中国家,结果不一致。这项研究旨在研究夏季内阳光照射与AMI之间时间关联的变化。
方法:我们获得了2013-2019年北京市AMI住院数据。我们使用分布式滞后非线性模型(DLNM)结合准泊松回归模型来估计日照时间对AMI发病率的非线性滞后效应。我们评估了在0-21天内暴露于日照时间的AMI入院的总体效果。
结果:我们在夏季(6月至9月)共纳入45,301例AMI病例。发病率最低的是日照时间为3.9小时的日子。我们发现日照时间与AMI之间存在显着的U形关联。短期(第1百分位数)和长期(第99百分位数)日照时间的总体估计相对风险为1.29(95%CI:1.02,1.62)和1.69(95%CI:1.28,2.24),分别。男性和年轻人(<65岁)最容易受到这些影响。
结论:我们的结果表明,短期和长期日照时间都会增加AMI入院的风险,尤其是男性和年轻人。我们建议公共卫生政策制定者应充分考虑阳光照射的利弊平衡,并相应地提供适当的公共卫生建议,以从阳光中获得最大的好处。
BACKGROUND: Over the years, various epidemiological studies found that acute myocardial infarction (AMI) often shows seasonal rhythm patterning, which is usually influenced by the variations of environmental factors, such as air pollution, ambient temperature, solar activity, relative humidity. However, there are few studies on the impact of sunlight-induced AMI especially in developing countries, and they had inconsistent results. This study aimed to examine within-summer variations in the temporal association between sun exposure and AMI.
METHODS: We obtained hospitalization data for AMI of Beijing during 2013-2019. We used a distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model to estimate the non-linear lag effects of sunshine duration on AMI incidences. We evaluated the overall effect of AMI admissions with exposure to sunshine duration in the lag 0-21 days.
RESULTS: A total of 45,301 AMI cases were enrolled in our study during summer (June-September). The minimum of the morbidity was during days with a sunshine duration of 3.9 h. We found significant and U-shaped associations between sunshine duration and AMI, and the overall estimated relative risk was 1.29 (95% CI: 1.02,1.62) and 1.69 (95% CI: 1.28,2.24) for short (1st percentile) and long (99th percentile) sunshine duration, respectively. The males and younger people (<65 years) were most susceptible to these effects.
CONCLUSIONS: Our results suggest that both short and long sunshine duration could increase the risk of AMI admissions, especially for males and younger people. We suggest that public health policymakers should fully consider the balance of the pros and cons of solar exposure, and provide appropriate public health recommendations accordingly to gain the greatest benefits from sunlight.