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盘点:了解“季节”对健康的影响,你也能做半个大仙!

2016-10-16 Mechront MedSci原创

不仅是昼夜节律,四季变换对我们的健康也会有影响! 【1】出生季节影响Addison病 研究人员对英格兰和威尔士在1963-1972年间出生的(n =8180180)例参与者进行了分析,其中415例为Addison病患者(167例为女性)。此外,研究人员对231例波兰Addison病成年患者与1980、1990、2010和2012年的总出生人口(n=2421384)进行了相似的对比。

不仅是昼夜节律,四季变换对我们的健康也会有影响!

【1】出生季节影响Addison病

研究人员对英格兰和威尔士在1963-1972年间出生的(n =8180180)例参与者进行了分析,其中415例为Addison病患者(167例为女性)。此外,研究人员对231例波兰Addison病成年患者与1980、1990、2010和2012年的总出生人口(n=2421384)进行了相似的对比。两个队列中,46%的英国患者和27%的波兰患者仅患有Addison病,其余参与者至少伴有其他一种自身免疫性疾病

研究人员将性别和出生国家校正后发现,Addison病与出生季节呈现一种周期性趋势(P=0.028),但是当对队列进行单独分析时,这种趋势仅存在于波兰人队列(P=0.042)。十二月出生的人群Addison病患病率最高,患病率最低则在六月份。

在英国队列中,与一般人群相比,Addison病患病OR最高的出生月份为十二月(OR=1.41;95% CI,1.035-1.92),患病OR最低的出生月份则为五月份(OR=0.61;95% CI,0.4-0.93)。在波兰人队列中,与一般人群相比,Addison病的患病OR最高的出生月份为一月份(OR=1.5;95% CI,1.02-2.1),Addison病的患病OR最低月份则为七月(OR=0.56;95% CI,0.31-0.99)。

结果表明,冬季出生的个体Addison病风险增加,而夏季出生则具有保护作用。(文章详见——JCEM:出生季节影响Addison病?

【2】PHPT患者体内维生素D、PTH和钙水平存在季节变化

研究纳入≥18岁的原发性甲状旁腺功能亢进(PHPT)患者(PTH>正常上限(ULN),血清钙>10.5mg %)。

792例PHPT (72.2%为女性)患者,进行了2659次PTH测试、1395次25羟基维生素D和7426次血清钙测试。56%的25羟基维生素D水平<50nmol/L。三个参数均有季节性:夏季平均25羟维生素D比冬季高出13%(P<0.001);平均PTH值则相反,夏季比冬季下降约8.4%(P<0.001);血清钙水平在秋天更高,比春天和夏天高出0.2mg/dL(P<0.001);血清钙水平在11.5mg/dL以上的OR值在秋天最高(OR=1.275, P=0.018)。

结果表明,PHPT患者的25羟维生素D、PTH和钙水平的季节变化;这些季节性的变化,可能涉及病理值,可能一定程度上会影响PHPT的诊断和治疗。(文章详见——Bone:PHPT患者体内维生素D、PTH和钙水平存在季节变化

【3】出生季节对多发性硬化风险的影响有多大?


既往研究已经表明,在春天出生的婴儿多发性硬化(MS)风险更高,不管是在北半球还是南半球。

研究者校正相关因素后,确认了区域性和季节变化对出生率的影响。尽管如此,在调整了时间和区域的影响后,季节对MS患者的出生月份仍有显著影响。

在对大多数在当代出生的队列(1965-1980)进行评估后,风险最高月份(4月)较风险最低月份(11月)的MS风险增加24%。在第二个队列(1938-1980)中,与11月份相比4月份出生的人群的MS风险增加17%。

研究人员在哥伦比亚大学进行了一项研究,涉及超170万来自纽约州的参与者,表明55种疾病可能与出生季节有关,其中16种疾病之前未被报道有出生季节效应。(文章详见——JAMA:出生季节对多发性硬化风险的影响有多大?

【4】出生季节不同可能会造成过敏体质


研究数据表明,秋冬出生的人相比春夏出生的人更容易发生过敏反应。

通过扫描367名参与者DNA的甲基化修饰水平,第一次发现每一个个体由于出生季节的不同,会在基因组上留下特异性的表观遗传学修饰,该修饰能够持续到18岁。该发现意味着该印记能够联系出生季节与过敏反应两者之间的关系。

之后,作者们检测了这些由出生季节不同导致的DNA甲基化修饰差异是否与过敏反应疾病有相关性。结果显示,这些表观遗传修饰中有两组与过敏反应差异有关。

与过敏原相似,其它的研究也发现出生季节的不同会影响其它的表型,比如身高,寿命以及生育能力等。也许出生季节引起的表观遗传学差异还与别的机体表型有关,不过这有待进一步研究。(文章详见——出生季节不同可能会造成过敏体质

【5】心血管死亡在哪个季节高发?

研究表明,有心血管疾病(CVD)病史的中国人在冬日的血压和CVD死亡率增加。

研究者们分析了不同区域有CVD病史的23 000例受试者,对其随访7年,记录了1484例CVD死亡。利用基线调查数据评估收缩压(SBP)的季节性变动和与其相关户外温度。利用Cox回归分析常规SBP与随后的CVD死亡的关联性,利用泊松回归分析CVD死亡的季节变动。所有分析均是在校正年龄、性别和地域后进行的。

结果显示,与夏日相比,受试者冬日的平均SBP显著较高(145对136 mmHg,P< 0.001),尤其是那些不具备中央供暖系统的人们。零上5°C时,户外温度每降低10°C与SBP升高6.2 mmHg有关。SBP可预测随后的CVD死亡,常规SBP每增加10 mmHg与死亡风险增加21%有关。心血管死亡率随季节变化而变化,冬日比夏日的风险高41%。(文章详见——Eur Heart J:心血管死亡在哪个季节高发?

【6】怀孕季节影响胎儿性别


基于中国内蒙古的人口专题调查,在2006-2008年内蒙古地区选取具代表性的近3000个家庭进行回顾式追踪调查。

在依据调查结果进行数学模型推算后,研究者认为,夏季和冬季怀孕的母亲与春季相比,更有可能生女孩,两者相比具有显着的统计学差异。

研究者认为,季节气候因素可以导致出生性别的变异,虽然内在的人类生物学因素有待进一步探索。

两栖类生物的研究已经有确实证据表明温度在出生性别方面的决定性。 哺乳动物也有证据表明性别受到的遗传学、环境因素之间的复杂相互作用。早期基于美国和西伯利亚的人口学观察也有类似的发现。(文章详见——IJERPH:怀孕季节影响胎儿性别

【7】季节对不同的人有不同的情绪影响

我们许多人都对冬季抑郁症比较熟悉,但是夏季抑郁症也是季节性抑郁症的一个种类。

南威尔士大学的心理学教授说,“估计有8%的人会有冬季抑郁症,1%的人有夏季抑郁症。虽然患夏季抑郁症的人占比较小,但是大约10%的人发现他们在夏季的几个月情绪变化情况较糟。”

经典夏季抑郁症症状是人们感到兴奋,失眠,食欲不振,体重减轻。沃克曼教授说:“这是一个更焦虑的抑郁症形式,你会发现坐着都十分困难,更不要说做别的事情了。”

虽然季节性情感障碍的确切原因还无法知晓,但是冬季抑郁症可能是因为阳光没有直射眼睛,所以现在光疗法是一种普遍的疗法。其原理是因为下丘脑功能被破坏,降低了大脑化学血清素的产生,这种化学物质影响着人们的情绪。

“简单地说,血清素使我们更加乐观,”沃克曼教授说,“ 5-羟色胺可以减少褪黑激素,血清素减少了,褪黑激素就多了,所以冬季抑郁症的人们往往会感到疲劳。而相反的是,夏季抑郁症的人们产生太少的褪黑激素,意味着他们难以入睡。最重要的是,5-羟色胺水平和光照同时增加,会导致人的烦躁不安。夏季抑郁症可能是阳光和热造成的。大脑化学物质的季节性变化可能对我们所有人都有不同程度的影响,但是有些人对热量和光特别敏感。对他们的褪黑激素和血清素水平造成很大影响。”

事实上,一些研究表明,在赤道附近的国家,如印度,夏季抑郁症的患病率比冬季抑郁症高(而冬季抑郁症在北半球更常见)。(文章详见——季节对不同的人有不同的情绪影响

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    2016-10-22 cjingjuan

    仔仔细细学习

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    2016-10-18 30397606
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    2016-10-18 雅文博武

    学习了很多医学知识

    0

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    2016-10-17 doctorJiangchao

    继续关注

    0

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    2016-10-17 doctorJiangchao

    继续学习

    0

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    2016-10-17 186****0580(小山羊)

    学习了,知道了!

    0

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    2016-10-17 青龙偃月

    还不错,这研究

    0

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