空氣污染對於健康的影響，近年來已是公共衛生一門重要的課題，過去研究已建立空氣污染物與腦血管疾病的關係。由於國人生活型態的改變，糖尿病盛行率逐年上升，如今已有許多流行病學研究顯示，糖尿病與腦血管疾病的發生有顯著相關。本研究為探討空氣污染物暴露與腦血管疾病發生，糖尿病族群是否為特殊敏感性族群。本研究是以時間配對病例交叉研究設計，以Conditional Logistic Regression並校正溫度及溼度後進行統計分析，探討糖尿病與非糖尿病族群暴露空氣污染物與腦血管疾病住院發生之關係，結果顯示糖尿病族群每增加一四分位差細懸浮微粒(Fine particle, PM2.5)暴露，發生腦血管住院勝算比為1.13 (95%CI= 1.01-1.27)，非糖尿病族群則為0.92 (95%CI= 0.84-1.01)；且經雙汙染物模式校正後糖尿病族群勝算比為1.18 (95%CI= 1.04-1.34)，非糖尿病族群則為0.91 (95%CI= 0.81-1.03)。進一步進行性別分層，則發現糖尿病女性每增加一四分位差PM2.5暴露，其勝算比為1.26 (95%CI= 1.06-1.49)，經雙汙染物模式校正後則為1.34 (95%CI= 1.11-1.63)。本研究結論為糖尿病族群對空氣污染物暴露為易感受族群，糖尿病可修飾PM2.5暴露對腦血管疾病發生之效應。
The impact of air pollution on health in recent years has been an important public health issue. There has been increasing epidemiological evidence to show that fine particle (PM2.5) could be association with mortality and morbidity of cerebrovascular diseases. Because of the change of life style, diabetes prevalence has been increased year by year in Taiwan. Previous epidemiological studies showed diabetes was also significantly associated with cerebrovascular disease. Our study examined whether diabetes modified the effect of PM2.5 on cerebrovascular disease hospitalization. We used time-stratified case-crossover study design and conditional logistic regression adjusted by temperature and relative humidity to investigate the relationship between air pollutant exposure and cerebrovascular disease hospital admissions in diabetes and non-diabetes groups. The result showed that for each interquartile range increase exposure to PM2.5, the odds ratio (OR) of cerebrovascular disease hospitalization was 1.13 (95%CI= 1.10-1.27) in the diabetes group, but 0.92 (95%CI= 0.84-1.01) in the non-diabetes group. The OR was even higher in diabetic females, 1.26 (95%CI= 1.06-1.49). In a two-pollutant model, the odds ratio after adjusted by SO2 was 1.18 (95%CI= 1.04-1.34) in diabetes and 0.91 (95%CI= 0.81-1.03) in non-diabetes. Similar result was also found in the two-pollutant model with gender specific analysis, that the OR was higher in diabetic females, 1.34 (95%CI= 1.11-1.63). We conclude that persons with diabetes are a susceptible population to air pollution. Diabetes may further modify the effect of fine particle exposure on cerebrovascular disease mobility.
