文献类型：期刊文献

中文题名：长期臭氧暴露与2型糖尿病发病风险的队列研究的meta分析

英文题名：Effect of long-term exposure to ozone on type 2 diabetes mellitus:A meta-analysis of cohort studies

作者：张少娟[1];刘永乐[2];杨转过[1];王金羊[3]

第一作者：张少娟

机构：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000;[2]兰州大学大气科学学院,甘肃兰州730100;[3]甘肃省人民医院内分泌科,甘肃兰州730000

第一机构：甘肃中医药大学临床医学院

年份：2026

卷号：43

期号：1

起止页码：43

中文期刊名：环境与职业医学

外文期刊名：Journal of Environmental and Occupational Medicine

收录：;北大核心:【北大核心2023】；

基金：国家自然科学基金项目(81760147,81560143,82360163);甘肃省自然科学基金项目(24JRRA589);甘肃省卫生健康行业科研项目(GSWSQN2024-01)。

语种：中文

中文关键词：臭氧;2型糖尿病;队列研究;长期暴露;meta分析

外文关键词：ozone;type 2 diabetes;cohort study;long-term exposure;meta-analysis

摘要：[背景]全球2型糖尿病(T2D)的患病人数在过去几十年中持续增加,已成为重要的公共卫生问题。毒理学研究表明,臭氧(O_(3))会导致氧化应激和炎症反应,从而引起代谢变化和T2D的形成。现有关于长期O_(3)暴露对T2D发病风险影响的部分队列研究得出了相互矛盾的结论,并且研究结果显示出显著的异质性。[目的]总结长期O_(3)暴露与T2D发病风险的队列研究现有证据,探讨长期O_(3)暴露与T2D发病风险之间关联的异质性来源。[方法]本研究通过PubMed、Embase和Web of Science数据库检索队列研究,检索时间截至2025年4月25日。由2位研究者独立筛选文献、提取数据并评价纳入研究的文献质量。采用Stata18.0软件进行meta分析,采用随机效应模型计算标准化风险估计的总体相对危险度(RR)及其95%置信区间(95%CI)。同时,本研究还进行了敏感性分析、亚组分析、meta回归分析和发表偏倚检验,以探讨O_(3)与T2D之间关联的异质性来源。[结果]最终8篇文献纳入,涉及11项队列研究,54887070名参与者。meta分析结果显示,长期O_(3)暴露与T2D的高发病率相关[标准化RR=1.04(95%CI:1.01~1.07),P<0.001,I^(2)=97.3%],并且存在异质性。亚组分析显示,女性[标准化RR=1.08(95%CI:1.03~1.13)]和亚洲人群[标准化RR=1.09(95%CI:1.06~1.11)]对O_(3)的易感性更高。包含研究区域和O_(3)平均浓度变量的meta回归模型可以解释研究间异质性的60.33%。经过综合评估漏斗图形态、Egger检验(P=0.437)、Begg检验(P=0.640)以及剪补法的结果,未观察到明显地发表偏倚证据。[结论]长期O_(3)暴露会增加T2D的发病风险,其中女性和亚洲人群更加敏感。O_(3)与T2D之间关联的异质性来源可以部分解释为平均O_(3)浓度和地理位置等因素。
[Background]The global number of type 2 diabetes(T2D)cases has been steadily increasing over the past few decades,becoming a major public health issue.Available toxicological research has indicated that ozone(O_(3))can lead to oxidative stress and inflammatory responses,thereby causing metabolic changes and the development of T2D.Existing cohort studies on the impact of long-term O_(3)exposure on the risk of developing T2D have reached contradictory conclusions,and the results have shown significant heterogeneity.[Objective]To summarize cohort studies on long-term O_(3)exposure and T2D risk,and investigate heterogeneity sources in the association between O_(3)and T2D.[Methods]Cohort studies on O_(3)and T2D were searched through PubMed,Embase,and the Web of Science,with the search deadline set for 25 April,2025.After two researchers independently screened the literature,extracted data,and evaluated the quality of the included studies,metaanalysis was conducted using Stata 18.0 software.We used a random effects model to calculate the overall relative risk(RR)of the standardized risk estimates and its 95%confidence interval(CI).Additionally,sensitivity analysis,subgroup analysis,meta-regression,and publication bias testing were performed to explore the sources of heterogeneity in the association between O_(3)and T2D.[Results]In the 8 articles meeting predetermined inclusion criteria,a total of 11 cohort studies involving 54887070 participants were finally included.The results of the meta-analysis indicated that long-term exposure to O_(3)was associated with a higher incidence of type 2 diabetes[standardized RR=1.04(95%CI:1.01,1.07),P<0.001,I^(2)=97.3%],and significant heterogeneity existed.The subgroup analysis showed that females(standardized RR=1.08,95%CI:1.03,1.13)and the Asian population(standardized RR=1.09,95%CI:1.06,1.11)were are more susceptible to O_(3).The meta-regression model that included study region and average O_(3)concentration variables explained 60.33%of the heterogeneity between studies.No significant evidence of publication bias was observed after the funnel plot test,Egger's test(P=0.437),Begg's test(P=0.640),and the trim-and-fill method.[Conclusion]Long-term exposure to O_(3)could increase the risk of developing T2D,with females and Asian populations being particularly sensitive.The heterogeneity in the association between O_(3)and T2D can be partly explained by factors such as average O_(3)concentration and geographic location.