百万人群数据显示夜间接触较高水平光暴露会增加心血管代谢性疾病风险

Association of light at night with cardiometabolic disease: A systematic review and meta-analysis

夜间光暴露与心血管代谢性疾病的关联：一项系统综述和Meta分析

Authors: Yu-xiang Xu, Jiang-hui Zhang, Wen-qin Ding

Source: Environmental Pollution. 2023 Dec 9, 342: 123130.

DOI: 10.1016/j.envpol.2023.123130.

Graphical Abstract

Abstract

Light at night (LAN) is a significant but underappreciated risk factor contributing to cardiometabolic disease (CMD). We therefore conducted the review examining the relationship of LAN exposure with CMD in order to investigate the effects of LAN exposure on CMD. We searched PubMed, Web of Science, Embase, and Scopus for eligible studies published from database inception to August 17, 2023. The pooled effect size was calculated using random-effects models. Heterogeneity among the studies was quantified by Cochran's Q test and I2 statistic. A total of 1,019,739 participants from 14 studies (5 cohort studies and 9 cross-sectional) were included. Among the 14 eligible studies, 9 on obesity, 4 on diabetes, 2 on hypertension, 1 on dyslipidemia, and 1 on coronary heart disease. Exposure to higher levels of LAN were associated with 21% higher risk of CMD (Summary risk ratio, SRR: 1.21, 95% CI = 1.16–1.27), accompanied by substantial heterogeneity (I2 = 61%; tau2 = 0.004; Cochran’s Q = 41.02). Specifically, individuals in the highest category of LAN exposure exhibited 23% higher risk of obesity (SRR: 1.23, 95% CI = 1.14–1.32), 46% higher risk of diabetes (SRR: 1.46, 95% CI = 1.05–2.03) and 21% higher risk of other CMDs (SRR: 1.21, 95% CI = 1.10–1.34). Subgroup analyses revealed that the pooled-effect size of LAN and CMD was higher for indoor LAN than outdoor LAN (indoor LAN: SRR = 1.36; outdoor LAN: SRR = 1.17, P = 0.03). The overall quality was rated as moderate using GRADE guideline. Our study strengthens the evidence on the increase in CMD risk due to LAN exposure. Findings from this study have important implications for identifying modifiable risk factor of CMD, future prevention strategy development, and resource allocation for high-risk group.

Keywords: Cardiometabolic disease; Diabetes; Light at night; Obesity.

摘要

夜间光暴露（light at night，LAN）是导致心血管代谢性疾病（cardiometabolic disease，CMD）的一个重要但未被充分了解的危险因素。因此，我们对LAN与CMD的关联研究进行了综述，以调查LAN暴露对CMD的具体影响。我们检索了PubMed, Web of Science, Embase和Scopus截止2023年8月17日发表的符合条件的文献。使用随机效应模型合并效应大小。研究间的异质性通过Cochran Q检验和I²统计进行量化。纳入的14项研究（5项队列研究、9项横断面研究）共包括1,019,739名受试者。在符合标准的14项研究中，有9项研究关注肥胖、4项研究关注糖尿病、2项研究关注高血压、1项研究关注血脂异常、1项研究关注冠心病。结果显示暴露于较高水平的LAN与CMD风险增加21%相关（SRR:1.21，95%CI=1.16-1.27），伴有显著的异质性（I²=61%；tau²=0.004；Cochran’s Q=41.02）。具体而言，LAN暴露最高强度组个体肥胖风险增加23%（SRR: 1.23，95%CI=1.14-1.32），糖尿病的风险增加46%（SRR: 1.46，95%CI=1.05-2.03），其他CMD的风险增加21%（SRR:1.21，95%CI=1.10-1.34）。亚组分析显示，室内LAN暴露与CMD的关联效应显著高于室外LAN暴露（室内LAN: SRR=1.36；室外LAN: SRR=1.17，P=0.03）。基于GRADE指南，本综述总体证据等级被评为中等。本研究提供了LAN暴露致CMD风险增加的证据。本研究的结果对识别CMD可修饰的危险因素、未来预防策略的制定及高危人群的资源分配具有重要意义。

关键词：加速度计；夜间光暴露；光污染；睡眠参数；睡眠问题。