Xiangtong Liu1, Zhiwei Li2, Moning Guo3, Jie Zhang4, Lixin Tao5, Xiaolin Xu6, Aklilu Deginet7, Feng Lu8, Yanxia Luo9, Mengmeng Liu10, Mengyang Liu11, Yue Sun12, Haibin Li13, Xiuhua Guo14. 1. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: xiangtongl@ccmu.edu.cn. 2. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: 15128472546@163.com. 3. Beijing Municipal Health Commission Information Center, Beijing 100034, China. Electronic address: 13581627289@163.com. 4. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: zhangjie@ccmu.edu.cn. 5. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: taolixin.2008@163.com. 6. School of Public Health, Zhejiang University, Hangzhou 310058, China; The University of Queensland, Brisbane, Australia. Electronic address: xiaolin.xu@uq.edu.au. 7. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: dgaklilu2006@gmail.com. 8. Beijing Municipal Health Commission Information Center, Beijing 100034, China. Electronic address: lufeng@wjw.beijng.gov.cn. 9. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: lyx100@ccmu.edu.cn. 10. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: liumengmeng@ccmu.edu.cn. 11. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: 18031864301@163.com. 12. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: sy950523@163.com. 13. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: 15910681644@126.com. 14. School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: statguo@ccmu.edu.cn.
Abstract
BACKGROUND: The health effect of particulate matter pollution on stroke has been widely examined; however, the effect among patients with comorbid type 2 diabetes (T2D) in developing countries has remained largely unknown. METHODS: A time-series study was conducted to investigate the short-term effect of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) on hospital admissions for stroke among patients with T2D in Beijing, China, from 2014 to 2018. An over-dispersed Poisson generalized additive model was employed to adjust for important covariates, such as weather conditions and long-term and seasonal trends. RESULTS: A total of 159,298 hospital admissions for stroke comorbid with T2D were reported. Approximately linear exposure-response curves were observed for PM2.5 and PM10 in relation to stroke admissions among T2D patients. A 10 μg/m3 increase in the four-day moving average of PM2.5 and PM10 was associated with 0.14% (95% confidence interval [CI]: 0.05-0.23%) and 0.14% (95% CI: 0.06-0.22%) incremental increases in stroke admissions among T2D patients, respectively. A 10 μg/m3 increase in PM2.5 in the two-day moving average corresponded to a 0.72% (95% CI: 0.02-1.42%) incremental increase in hemorrhagic stroke, and a 10 μg/m3 increase in PM10 in the four-day moving average corresponded to a 0.14% (95% CI: 0.06-0.22%) incremental increase in ischemic stroke. CONCLUSIONS: High particulate matter might be a risk factor for stroke among patients with T2D. PM2.5 and PM10 have a linear exposure-response relationship with stroke among T2D patients. The study provided evidence of the risk of stroke due to particulate matter pollution among patients with comorbid T2D.
BACKGROUND: The health effect of particulate matter pollution on stroke has been widely examined; however, the effect among patients with comorbid type 2 diabetes (T2D) in developing countries has remained largely unknown. METHODS: A time-series study was conducted to investigate the short-term effect of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) on hospital admissions for stroke among patients with T2D in Beijing, China, from 2014 to 2018. An over-dispersed Poisson generalized additive model was employed to adjust for important covariates, such as weather conditions and long-term and seasonal trends. RESULTS: A total of 159,298 hospital admissions for stroke comorbid with T2D were reported. Approximately linear exposure-response curves were observed for PM2.5 and PM10 in relation to stroke admissions among T2D patients. A 10 μg/m3 increase in the four-day moving average of PM2.5 and PM10 was associated with 0.14% (95% confidence interval [CI]: 0.05-0.23%) and 0.14% (95% CI: 0.06-0.22%) incremental increases in stroke admissions among T2D patients, respectively. A 10 μg/m3 increase in PM2.5 in the two-day moving average corresponded to a 0.72% (95% CI: 0.02-1.42%) incremental increase in hemorrhagic stroke, and a 10 μg/m3 increase in PM10 in the four-day moving average corresponded to a 0.14% (95% CI: 0.06-0.22%) incremental increase in ischemic stroke. CONCLUSIONS: High particulate matter might be a risk factor for stroke among patients with T2D. PM2.5 and PM10 have a linear exposure-response relationship with stroke among T2D patients. The study provided evidence of the risk of stroke due to particulate matter pollution among patients with comorbid T2D.