背景:全球变暖似乎通过与许多环境因素的相互作用而引发和加重过敏性呼吸系统疾病。温度,通常被认为是气候变化的一个因素,在这个过程中很重要。过敏性鼻炎,一种常见的呼吸道过敏,正在上升,并影响全球约5亿人。升高的环境温度需要评估其对过敏性鼻炎的影响,考虑到区域气候区。
方法:详细搜索PubMed,EMBASE,Scopus,WebofScience,MEDLINE,和CINAHLPlus数据库,进行了,涵盖1991年至2023年发表的观察性研究。最初的研究检查了温度升高与过敏性鼻炎之间的关系,以评估合格性,然后进行偏倚风险评估。随机效应荟萃分析用于测量温度升高1°C与过敏性鼻炎相关结局之间的关联。
结果:20项研究包括在定性综合中,其中9个随后被选择用于定量合成。根据牛津循证医学中心,20项纳入的研究被评为4级证据,这些证据中的大多数都是根据纽卡斯尔-渥太华质量评定量表报告的高质量证据。在非随机暴露工具研究中使用偏倚风险,大多数研究显示偏倚风险较高.温度每升高1°C,过敏性鼻炎相关结局的风险显著增加29%(RR=1.26,95%CI:1.11至1.50)。相反,体温每升高1°C,发生过敏性鼻炎相关结局的几率没有显著增加7%(OR=1.07,95%CI:0.95~1.21).随后的亚组分析将气候区确定为影响这种关联的影响因素。
结论:明确表明增加温度暴露对过敏性鼻炎的有害影响尚无定论,由于证据的总体确定性很低。需要具有更好方法学质量的进一步原创性研究。
BACKGROUND: Global warming appears to initiate and aggravate allergic respiratory conditions via interaction with numerous environmental factors. Temperature, commonly identified as a factor in climate change, is important in this process. Allergic rhinitis, a common respiratory allergy, is on the rise and affects approximately 500 million individuals worldwide. The increasing ambient temperature requires evaluation regarding its influence on allergic rhinitis, taking into account regional climate zones.
METHODS: A detailed search of PubMed, EMBASE, Scopus, Web of Science, MEDLINE, and CINAHL Plus databases, was conducted, encompassing observational studies published from 1991 to 2023. Original studies examining the relationship between increasing temperature and allergic rhinitis were assessed for eligibility followed by a risk of bias assessment. Random effects meta-analysis was utilized to measure the association between a 1 °C increase in temperature and allergic rhinitis-related outcomes.
RESULTS: 20 studies were included in the qualitative synthesis, with nine of them subsequently selected for the quantitative synthesis. 20 included studies were rated as Level 4 evidence according to the Oxford Centre for Evidence-Based Medicine, and the majority of these reported good-quality evidence based on the Newcastle-Ottawa Quality Rating Scale. Using the Risk of Bias In Non-Randomized Studies of Exposure tool, the majority of studies exhibit a high risk of bias. Every 1 °C increase in temperature significantly raised the risk of allergic rhinitis-related outcomes by 29 % (RR = 1.26, 95 % CI: 1.11 to 1.50). Conversely, every 1 °C rise in temperature showed no significant increase in the odds of allergic rhinitis-related outcomes by 7 % (OR = 1.07, 95 % CI: 0.95 to 1.21). Subsequent subgroup analysis identified climate zone as an influential factor influencing this association.
CONCLUSIONS: It is inconclusive to definitively suggest a harmful effect of increasing temperature exposure on allergic rhinitis, due overall very low certainty of evidence. Further original research with better methodological quality is required.