Preliminary study of the relationship between the indoor thermal environment in the winter and diabetes

HOU Yuchen; CAO Bin; ZHU Yingxin; CUI Xiuqing; WANG Jing; JIA Xinyu; Zhang Nan

doi:10.16511/j.cnki.qhdxxb.2023.25.035

Journal of Tsinghua University(Science and Technology) >

2023 , Vol. 63 >Issue 12: 1994 - 2004

DOI: https://doi.org/10.16511/j.cnki.qhdxxb.2023.25.035

BUILDING SCIENCE

Preliminary study of the relationship between the indoor thermal environment in the winter and diabetes

HOU Yuchen ,
CAO Bin ,
ZHU Yingxin ,
CUI Xiuqing ,
WANG Jing ,
JIA Xinyu ,
Zhang Nan

Expand

1. School of Architecture, Tsinghua University, Beijing 100084, China;
2. Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China;
3. Key Laboratory of Eco Planning & Green Building, Ministry of Education, Beijing 100084, China;
4. Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China

Received date: 2022-12-30

Online published: 2023-11-06

Fold

Abstract

[Objective] In the past decades, the lifestyle of the Chinese population has changed because of rapid economic development. The incidence and prevalence of diabetes are increasing in China. Diabetes and its complications can cause substantial personal and social burdens. Recent experimental studies have shown that cold exposure may enhance insulin sensitivity and prevent the development of obesity-related insulin resistance and hyperglycemia. However, there is insufficient evidence of the correlation between cold exposure and diabetes in the real environment of daily life. In contrast, although people spend most of their life indoors, existing evidence usually focuses on the relationship between the outdoor thermal environment and diabetes without considering the effect of the indoor thermal environment. This study preliminarily examines the association between the real indoor thermal environment during the winter and the risk of diabetes.[Methods] The study was analyzed from provincial and individual perspectives. At the provincial level, the analysis included 17 provinces. The diabetes prevalence data were obtained from the cross-sectional study on diabetes prevalence in China through Thyroid Disorders, Iodine Status, and Diabetes Epidemiological Survey (TIDE). The level of cold exposure was calculated based on the prevalence of central heating, according to the statistical yearbook data of the country and each region. Spearman correlation analyses were conducted to reveal the correlation between cold exposure and diabetes. The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) database at the individual level. Subjects' age, gender, body mass index (BMI), smoking, drinking, socioeconomic status, and whether they experienced indoor cold exposure in the winter were considered. Subjects were divided into two categories based on whether they experienced indoor cold exposure in the winter from 2011 to 2015. Chi-square and logistic regression analyses were applied to explore the correlation between indoor cold exposure and diabetes at the individual level.[Results] At the provincial level, the results indicated a significant negative correlation between indoor cold exposure in the winter and diabetes prevalence (Spearman's correlation coefficient=0.505, P=0.039). At the individual level, 1) 8 403 subjects were eligible for analysis, and 1 138 (13.5%) had diabetes. 2) A total of 7 879 subjects had experienced indoor cold exposure in the winter. A significant difference was discovered in the prevalence rate between the group with and without cold exposure (P<0.001). 3) After age, gender, BMI, and smoking factors were adjusted, the group with indoor cold exposure in the winter was significantly associated with a 23% reduction in the risk of diabetes compared with the group without indoor cold exposure (OR=0.77, 95% CI:0.61~0.97).[Conclusions] At the provincial and individual levels, indoor cold exposure in the winter is significantly associated with diabetes. This study provides evidence for the correlation between the indoor thermal environment and diabetes prevalence on a long-time scale. This supports the conclusions of laboratory studies on cold exposure and diabetes and guides indoor thermal environment design.

Key words： indoor thermal environment; diabetes mellitus; cold exposure; ong-termthermal experience; indoortemperature

Cite this article

HOU Yuchen , CAO Bin , ZHU Yingxin , CUI Xiuqing , WANG Jing , JIA Xinyu , Zhang Nan . Preliminary study of the relationship between the indoor thermal environment in the winter and diabetes[J]. Journal of Tsinghua University(Science and Technology), 2023 , 63(12) : 1994 -2004 . DOI: 10.16511/j.cnki.qhdxxb.2023.25.035

References

[1] International Diabetes Federation. IDF diabetes atlas 9th edition, 2019[EB/OL].[2022-12-22]. https://diabetesatlas.org/atlas/ninth-edition/.
[2] DINESH SHAH A, LANGENBERG C, RAPSOMANIKI E, et al. Type 2 diabetes and incidence of a wide range of cardiovascular diseases:A cohort study in 1.9 million people[J]. The Lancet, 2015, 385:S86.
[3] TANCREDI M, ROSENGREN A, SVENSSON A M, et al. Excess mortality among persons with type 2 diabetes[J]. New England Journal of Medicine, 2015, 373(18):1720-1732.
[4] HOLMAN N, KNIGHTON P, KAR P, et al. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England:A population-based cohort study[J]. The Lancet Diabetes&Endocrinology, 2020, 8(10):823-833.
[5] RONALD KAHN C, WEIR G C, KING G L,等. Joslin糖尿病学[M].潘长玉,陈家伟,陈名道,等,译. 14版.北京:人民卫生出版社, 2007. RONALD KAHN C, WEIR G C, KING G L, et al. Joslin's diabetes mellitus[M]. PAN C Y, CHEN J W, CHEN M D, et al, trans. 14th ed. Beijing:People's Medical Publishing House, 2007.(in Chinese)
[6] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志, 2021, 13(4):315-409. Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)[J]. Chinese Journal of Diabetes, 2021, 13(4):315-409.(in Chinese)
[7] VAN MARKEN LICHTENBELT W, HANSSEN M, PALLUBINSKY H, et al. Healthy excursions outside the thermal comfort zone[J]. Building Research&Information, 2017, 45(7):819-827.
[8] SCHRAUWEN P, VAN MARKEN LICHTENBELT W D. Combatting type 2 diabetes by turning up the heat[J]. Diabetologia, 2016, 59(11):2269-2279.
[9] HANSSEN M J W, VAN DER LANS A A J J, BRANS B, et al. Short-term cold acclimation recruits brown adipose tissue in obese humans[J]. Diabetes, 2016, 65(5):1179-1189.
[10] HANSSEN M J W, HOEKS J, BRANS B, et al. Short-term cold acclimation improves insulin sensitivity in patients with type 2 diabetes mellitus[J]. Nature Medicine, 2015, 21(8):863-865.
[11] GIBAS-DORNA M, CHȨCIAŃSKA Z, KOREK E, et al. Variations in leptin and insulin levels within one swimming season in non-obese female cold water swimmers[J]. Scandinavian Journal of Clinical and Laboratory Investigation, 2016, 76(6):486-491.
[12] 朱颖心.碳中和目标下的建筑环境营造[J].建筑节能(中英文), 2021, 49(8):37-43. ZHU Y X. Construction of the building environment achieving the goal of carbon neutrality[J]. Journal of BEE, 2021, 49(8):37-43.(in Chinese)
[13] 朱颖心.如何营造健康舒适的建筑热环境:建筑环境与人体舒适及健康关系的探索[J].世界建筑, 2021(3):42-45. ZHU Y X. How to create a healthy and comfortable indoor thermal environment:Exploration on the relationship between the built environment and human comfort and health[J]. World Architecture, 2021(3):42-45.(in Chinese)
[14] VAN DER LANS A A J J, HOEKS J, BRANS B, et al. Cold acclimation recruits human brown fat and increases nonshivering thermogenesis[J]. The Journal of Clinical Investigation, 2013, 123(8):3395-3403.
[15] VAN MARKEN LICHTENBELT W D, VANHOMMERIG J W, SMULDERS N M, et al. Cold-activated brown adipose tissue in healthy men[J]. New England Journal of Medicine, 2009, 360(15):1500-1508.
[16] BLAUW L L, AZIZ N A, TANNEMAAT M R, et al. Diabetes incidence and glucose intolerance prevalence increase with higher outdoor temperature[J]. BMJ Open Diabetes Research&Care, 2017, 5(1):e000317.
[17] SPEAKMAN J R, HEIDARI-BAKAVOLI S. Type 2 diabetes, but not obesity, prevalence is positively associated with ambient temperature[J]. Scientific Reports, 2016, 6:30409.
[18] ASUMADU-SAKYI A B, BARNETT A G, THAI P, et al. The relationship between indoor and outdoor temperature in warm and cool seasons in houses in Brisbane, Australia[J]. Energy and Buildings, 2019, 191:127-142.
[19] TAMERIUS J D, PERZANOWSKI M S, ACOSTA L M, et al. Socioeconomic and outdoor meteorological determinants of indoor temperature and humidity in New York City dwellings[J]. Weather, Climate, and Society, 2013, 5(2):168-179.
[20] ORMANDY D, EZRATTY V. Health and thermal comfort:From WHO guidance to housing strategies[J]. Energy Policy, 2012, 49:116-121.
[21] KLEPEIS N E, NELSON W C, OTT W R, et al. The national human activity pattern survey (NHAPS):A resource for assessing exposure to environmental pollutants[J]. Journal of Exposure Science&Environmental Epidemiology, 2001, 11(3):231-252.
[22] 曹彬,朱颖心,欧阳沁,等.不同气候区住宅建筑冬季室内热环境及人体热适应性对比[J].清华大学学报(自然科学版), 2012, 52(4):499-503. CAO B, ZHU Y X, OUYANG Q, et al. Indoor thermal environment and human thermal adaptation in residential buildings in various climate zones during the winter[J]. Journal of Tsinghua University (Science and Technology), 2012, 52(4):499-503.(in Chinese)
[23] SONG M J, MAO N, ZHANG H R, et al. Model predictive control applied toward the building indoor climate[M]//PEKAŘ L. Advanced Analytic and Control Techniques for Thermal Systems with Heat Exchangers. Amsterdam:Elsevier, 2020.
[24] NGUYEN J L, DOCKERY D W. Daily indoor-to-outdoor temperature and humidity relationships:A sample across seasons and diverse climatic regions[J]. International Journal of Biometeorology, 2016, 60(2):221-229.
[25] BASU R. High ambient temperature and mortality:A review of epidemiologic studies from 2001 to 2008[J]. Environmental Health, 2009, 8:40.
[26] THAM S, THOMPSON R, LANDEG O, et al. Indoor temperature and health:A global systematic review[J]. Public Health, 2020, 179:9-17.
[27] NGUYEN J L, SCHWARTZ J, DOCKERY D W. The relationship between indoor and outdoor temperature, apparent temperature, relative humidity, and absolute humidity[J]. Indoor Air, 2014, 24(1):103-112.
[28] 朱颖心.建筑环境学[M]. 4版.北京:中国建筑工业出版社, 2016. ZHU Y X. Built environment[M]. 4th ed. Beijing:China Architecture&Building Press, 2016.(in Chinese)
[29] ASHRAE. Thermal environmental conditions for human occupancy:ANSI/ASHRAE 55-2020[S]. Atlanta:American Society of Heating, Refrigeration and Air-Conditioning Engineers, Inc., 2020.
[30] 詹思延.流行病学[M]. 8版.北京:人民卫生出版社, 2017. ZHAN S Y. Epidemiology[M]. 8th ed. Beijing:People's Medical Publishing House, 2017.(in Chinese)
[31] FEINLEIB M. Biases and weak associations[J]. Preventive Medicine, 1987, 16(2):150-164.
[32] 唐成君,刘宏成,唐胜君,等.湖南地区城乡住宅热湿环境对比研究[J].建筑科学, 2015, 31(2):23-28. TANG C J, LIU H C, TANG S J, et al. Study on the contrast of thermal and wet environment between urban and rural residential buildings in Hunan region[J]. Building Science, 2015, 31(2):23-28.(in Chinese)
[33] FAN G T, XIE J C, YOSHINO H, et al. Investigation of indoor thermal environment in the homes with elderly people during heating season in Beijing, China[J]. Building and Environment, 2017, 126:288-303.
[34] 朱轶韵,刘加平.西北农村建筑冬季室内热环境研究[J].土木工程学报, 2010, 43(S2):400-403. ZHU Y Y, LIU J P. Research on the indoor thermal environment of rural architecture in winter in northwestern areas[J]. China Civil Engineering Journal, 2010, 43(S2):400-403.(in Chinese)
[35] 闫海燕,李道一,李洪瑞,等.焦作民居建筑冬季室内热环境测试研究[J].建筑科学, 2016, 32(10):21-28, 72. YAN H Y, LI D Y, LI H R, et al. Research on indoor thermal environment of residential building in Jiaozuo in winter[J]. Building Science, 2016, 32(10):21-28, 72.(in Chinese)
[36] 孟维庆.夏热冬冷地区城镇居住建筑冬季室内热环境研究:以汉中市为例[D].西安:西安建筑科技大学, 2013. MENG W Q. Researching on indoor thermal environment of residential buildings in urban areas in hot summer and cold winter zone in winter season:Taking Han Zhong City as an example[D]. Xi'an:Xi'an University of Architecture and Technology, 2013.(in Chinese)
[37] 韩飞,胡松涛,王海英,等.青岛市集中供暖住宅室内热环境测试与分析[J].青岛理工大学学报, 2017, 38(3):64-69, 73. HAN F, HU S T, WANG H Y, et al. Test and analysis of the central heating residential indoor thermal environment in Qingdao City[J]. Journal of Qingdao University of Technology, 2017, 38(3):64-69, 73.(in Chinese)
[38] 李念平,方雪苗,卫兆欣,等.湘西地区冬季住宅热环境与老年人热舒适研究[J].湖南大学学报(自然科学版), 2019, 46(7):123-128. LI N P, FANG X M, WEI Z X, et al. Research on thermal environment of residences and thermal comfort sensation of elderly in rural areas of western Hunan in winter[J]. Journal of Hunan University (Natural Sciences), 2019, 46(7):123-128.(in Chinese)
[39] 董旭娟,闫增峰,王智伟.夏热冬冷地区城市住宅供暖方式调查与室内热环境测试研究[J].建筑科学, 2014, 30(12):1-7. DONG X J, YAN Z F, WANG Z W. Heating modes investigation and indoor thermal environment test research on city residential in hot summer and cold winter zone[J]. Building Science, 2014, 30(12):1-7.(in Chinese)
[40] 李凤娟.南京供暖住宅室内热环境及居民热舒适的研究[D].南京:南京师范大学, 2017. LI F J. Research on Indoor Thermal Environment and Residents' Thermal Comfort of Heating Residential Buildings in Nanjing[D]. Nanjing:Nanjing Normal University, 2017.(in Chinese)
[41] 杨茜.寒冷地区室内热舒适研究[D].西安:西安建筑科技大学, 2010. YANG Q. Study on the indoor thermal comfort in the cold zone[D]. Xi'an:Xi'an University of Architecture and Technology, 2010.(in Chinese)
[42] 蒲萌萌.大连老旧住宅室内热舒适评价及改善策略研究[D].大连:大连理工大学, 2020. PU M M. Research on indoor thermal comfort evaluation and improvement strategies of old residential buildings in Dalian[D]. Dalian:Dalian University of Technology, 2020.(in Chinese)
[43] YAN H Y, YANG L, ZHENG W X, et al. Influence of outdoor temperature on the indoor environment and thermal adaptation in Chinese residential buildings during the heating season[J]. Energy and Buildings, 2016, 116:133-140.
[44] ZHANG H B, CHEN Y, RUI J W, et al. Effects of thermal environment on elderly in urban and rural houses during heating season in a severe cold region of China[J]. Energy and Buildings, 2019, 198:61-74.
[45] LI Y Z, TENG D, SHI X G, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American diabetes association:National cross sectional study[J]. BMJ, 2020, 369:m997.
[46] CHEN Y L, SHEN H Z, SMITH K R, et al. Estimating household air pollution exposures and health impacts from space heating in rural China[J]. Environment International, 2018, 119:117-124.
[47] 刘亚非,张有,焦铭泽,等.北方农村地区供暖现状与对策[J].煤气与热力, 2019, 39(1):29-32. LIU Y F, ZHANG Y, JIAO M Z, et al. Current status and countermeasures of heating in rural areas of Northern China[J]. Gas&Heat, 2019, 39(1):29-32.(in Chinese)
[48] ZHUANG Z, LI Y G, CHEN B, et al. Chinese Kang as a domestic heating system in rural northern China:A review[J]. Energy and Buildings, 2009, 41(1):111-119.
[49] 张钱,罗美莲.夏热冬冷地区农村住宅供暖现状及影响因素研究[J].建筑热能通风空调, 2018, 37(7):21-24. ZHANG Q, LUO M L. Heating status and heating mode in hot summer and cold winter area of rural residential building[J]. Building Energy&Environment, 2018, 37(7):21-24.(in Chinese)
[50] 万学红,卢雪峰,刘成玉,等.诊断学[M]. 9版.北京:人民卫生出版社, 2018. WAN X H, LU X F, LIU C Y, et al. Diagnostics[M]. 9th ed. Beijing:People's Medical Publishing House, 2018.(in Chinese)
[51] 葛均波,徐永健,王辰,等.内科学[M]. 9版.北京:人民卫生出版社, 2018. GE J B, XU Y J, WANG C, et al. Internal medicine[M]. 9th ed. Beijing:People's Medical Publishing House, 2018.(in Chinese)
[52] American Diabetes Association. 2. Classification and diagnosis of diabetes:Standards of medical care in diabetes-2021[J]. Diabetes Care, 2021, 44(S1):S15-S33.
[53] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志, 2018, 38(4):292-344. Chinese Diabetes Society. Guidelines for the prevention and control of type 2 diabetes in China (2017 edition)[J]. Chinese Journal of Practical Internal Medicine, 2018, 38(4):292-344.(in Chinese)
[54] YANG A M, HU X B, LIU S M, et al. Occupational exposure to heavy metals, alcohol intake, and risk of type 2 diabetes and prediabetes among Chinese male workers[J]. Chronic Diseases and Translational Medicine, 2019, 5(2):97-104.
[55] LUO W S, GUO Z R, WU M, et al. Interaction of smoking and obesity on type 2 diabetes risk in a Chinese cohort[J]. Physiology&Behavior, 2015, 139:240-243.
[56] WHO. Obesity:Preventing and managing the global epidemic[M]. Geneva:World Health Organization, 2000.
[57] COCKERHAM W C. Health lifestyle theory and the convergence of agency and structure[J]. Journal of Health and Social Behavior, 2005, 46(1):51-67.
[58] 刘丽杭,唐景霞.社会经济地位对居民健康公平的影响[J].中国卫生经济, 2004, 23(6):40-42. LIU L H, TANG J X. Research of socioeconomic status effects health disparity[J]. Chinese Health Economics, 2004, 23(6):40-42.(in Chinese)
[59] 仲亚琴,高月霞,王健.不同社会经济地位老年人的健康公平研究[J].中国卫生经济, 2013, 32(12):21-23. ZHONG Y Q, GAO Y X, WANG J. Study on the health equity in the elderly with different socioeconomic status[J]. Chinese Health Economics, 2013, 32(12):21-23.(in Chinese)
[60] STRINGHINI S, DUGRAVOT A, SHIPLEY M, et al. Health behaviours, socioeconomic status, and mortality:Further analyses of the British Whitehall II and the French GAZEL prospective cohorts[J]. PLoS Medicine, 2011, 8(2):e1000419.
[61] DINSA G D, GORYAKIN Y, FUMAGALLI E, et al. Obesity and socioeconomic status in developing countries:A systematic review[J]. Obesity Reviews, 2012, 13(11):1067-1079.
[62] YEN I H, MOSS N. Unbundling education:A critical discussion of what education confers and how it lowers risk for disease and death[J]. Annals of the New York Academy of Sciences, 1999, 896(1):350-351.
[63] XU Y, WANG L M, HE J, et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013, 310(9):948-959.
[64] 张政.老年人出行行为特征及其分析方法研究[D].北京:北京交通大学, 2009. ZHANG Z. Travel behavior characteristics with analysis for the elderly[D]. Beijing:Beijing Jiaotong University, 2009.(in Chinese)
[65] HYLANDER B L, REPASKY E A. Thermoneutrality, mice, and cancer:A heated opinion[J]. Trends in Cancer, 2016, 2(4):166-175.
[66] HENSEL M, STUHR M, GEPPERT D, et al. Reduced frequency of severe hypoglycemia at mild ambient temperatures between 10 and 20℃:A population-based study under marine west coast climate conditions[J]. Journal of Diabetes and its Complications, 2017, 31(7):1212-1214.
[67] ZUO H, SHI Z M, HUSSAIN A. Prevalence, trends and risk factors for the diabetes epidemic in China:A systematic review and meta-analysis[J]. Diabetes Research and Clinical Practice, 2014, 104(1):63-72.
[68] ZHOU T, LIU X, LIU Y Y, et al. Spatio-temporal patterns of the associations between type 2 diabetes and its risk factors in mainland China:A systematic review and meta-analysis[J]. The Lancet, 2018, 382(S1):S32.
[69] TYROVOLAS S, CHALKIAS C, MORENA M, et al. High relative environmental humidity is associated with diabetes among elders living in Mediterranean islands[J]. Journal of Diabetes&Metabolic Disorders, 2014, 13(1):25.
[70] LIN Y, ZHOU S J, LIU H Y, et al. Risk analysis of air pollution and meteorological factors affecting the incidence of diabetes in the elderly population in Northern China[J]. Journal of Diabetes Research, 2020, 2020:3673980.
[71] EZE I C, HEMKENS L G, BUCHER H C, et al. Association between ambient air pollution and diabetes mellitus in Europe and north America:Systematic review and meta-analysis[J]. Environmental Health Perspectives, 2015, 123(5):381-389.
[72] CHEN Y Y, EBENSTEIN A, GREENSTONE M, et al. Evidence on the impact of sustained exposure to air pollution on life expectancy from China's Huai River policy[J]. Proceedings of the National Academy of Sciences of the United States of America, 2013, 110(32):12936-12941.
[73] XIAO Q Y, MA Z W, LI S S, et al. The impact of winter heating on air pollution in China[J]. PLoS One, 2015, 10(1):e0117311.
[74] MORISKE H J, DREWS M, EBERT G, et al. Indoor air pollution by different heating systems:Coal burning, open fireplace and central heating[J]. Toxicology Letters, 1996, 88(1-3):349-354.

Options

Outlines

模态框（Modal）标题

Abstract

Cite this article

References

Visited