Negative association between day-to-day temperature difference and outpatient visits for psoriasis with population heterogeneity: a time-series analysis and implications for health education

LU Wuqiang; LIU Hao; WANG Kexue; ZHOU Yumeng; LI Qianqian; XU Wuwei; LI Yuefei; WANG Yi; LIU Qiuqian; CAI Tongjian

doi:10.16016/j.2097-0927.202603109

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Negative association between day-to-day temperature difference and outpatient visits for psoriasis with population heterogeneity: a time-series analysis and implications for health education

Think Tank for Public Health | 更新时间：2026-05-30

- Negative association between day-to-day temperature difference and outpatient visits for psoriasis with population heterogeneity: a time-series analysis and implications for health education
- Journal of Army Medical University Vol. 48, Issue 10, Pages: 1409-1419(2026)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）大坪医院疾病预防控制科，创伤与化学中毒国家重点实验室，医院感染监测与控制重庆市高校重点实验室，重庆
  2.中国人民解放军94587部队全科医学科，江苏连云港
- 作者简介：
  
  LIU Qiuqian， E-mail：yoyoma127@163.com
  CAI Tongjian， E-mail：ctjcsl@netease.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202603109
  CLC： R195.4;R363.123;R758.63
- Received：25 March 2026，
  
  Revised：2026-04-07，
  
  Accepted：08 April 2026，
  
  Published：30 May 2026
- 稿件说明：
移动端阅览
卢务强，刘浩，王科学，等.隔日温差与银屑病门诊就诊量的负向关联及人群异质性：一项时间序列分析与健康教育启示［J］.陆军军医大学学报，2026，48（10）：1409-1419.DOI：10.16016/j.2097-0927.202603109.

LU W Q，LIU H，WANG K X，et al.Negative association between day-to-day temperature difference and outpatient visits for psoriasis with population heterogeneity： a time-series analysis and implications for health education［J］.J Army Med Univ，2026，48（10）：1409-1419.DOI：10.16016/j.2097-0927.202603109.
卢务强，刘浩，王科学，等.隔日温差与银屑病门诊就诊量的负向关联及人群异质性：一项时间序列分析与健康教育启示［J］.陆军军医大学学报，2026，48（10）：1409-1419.DOI：10.16016/j.2097-0927.202603109. DOI：

LU W Q，LIU H，WANG K X，et al.Negative association between day-to-day temperature difference and outpatient visits for psoriasis with population heterogeneity： a time-series analysis and implications for health education［J］.J Army Med Univ，2026，48（10）：1409-1419.DOI：10.16016/j.2097-0927.202603109. DOI：

摘要

目的

当前关于短期剧烈气温波动在银屑病领域的独立健康效应，相关证据仍十分匮乏。本研究旨在探究隔日温差（temperature change between neighboring days，TCN）与银屑病门诊就诊量的关联模式、滞后效应及人群异质性，为银屑病环境风险因素识别提供参考。

方法

本研究采用回顾性时间序列设计。数据来源于重庆市2家综合性医院2013年12月1日至2019年12月31日的银屑病门诊就诊记录，共纳入24 324人次的患者数据，同期气象和空气污染物数据来源于当地气象局和中国环境监测总站。主要暴露指标为TCN，按性别（男性/女性）和年龄（

40岁/≥40岁）进行分层。采用分布滞后非线性模型（distributed Lag nonlinear model，DLNM）分析TCN与日就诊量的关联，以TCN的四分位间距（interquartile range，IQR）为变化单位，以第25百分位数为参考值，计算相对风险（relative risk，

）及其95%

。模型控制长期趋势、气象因素（风速、降水量、相对湿度）、PM

2.5

、星期几及节假日效应等混杂变量。亚组间效应差异采用

检验进行比较。

结果

总人群中，TCN与银屑病门诊就诊量呈现负相关。当TCN每升高2.1 ℃时（即1个IQR），总人群单日滞后效应在Lag1~Lag2时显著，Lag2时RR为0.997（95%

：0.995~0.999，

0.001），累积效应在Lag01~Lag07均显著，Lag07时

为0.986（95%

：0.983~0.989，

0.001）。分层分析显示，男性及≥40岁人群在单日滞后Lag0~Lag1及累积滞后Lag00~Lag07时效应显著，男性在Lag07时

为0.983（95%

：0.979~0.986，

0.001），≥40岁人群Lag07时

为0.981（95%

：0.977~0.985，

0.001）。女性与

40岁人群效应相对较弱，仅部分滞后天具有统计学意义。异质性检验显示，性别间效应差异在Lag0、Lag00及Lag07时差异具有统计学意义，年龄间效应差异在Lag7及Lag07时差异具有统计学意义，提示年龄≥40岁及男性银屑病患者在TCN升高时的就诊行为减少更为明显。

结论

TCN升高与银屑病门诊就诊量下降存在统计学关联。性别和年龄对效应存在提示性修饰作用，男性及年龄≥40岁人群的关联强度更高，但差异效应量极小。对策　未来可将气温剧烈波动监测纳入慢性皮肤病社区健康管理体系，依托气象预警建立分人群、分性别的环境暴露风险沟通机制，向银屑病患者精准推送户外活动时段建议，以此优化行为干预策略，指导患者就诊选择。

Abstract

Objective Evidence regarding the independent health effects of short-term

acute temperature fluctuations on psoriasis remains scarce. This study aimed to investigate the association pattern

Lagged effects

and population heterogeneity between the temperature change between neighboring days (TCN) and outpatient visits for psoriasis

providing a reference for identifying environmental risk factors for psoriasis.

Methods

This was a retrospective time-series study. Data on psoriasis outpatient visits were collected from 2 general hospitals in Chongqing between December 1

2013 and December 31

2019

encompassing 24 324 patient visits. Concurrent meteorological and air pollutant data were obtained from the local meteorological bureau and the China National Environmental Monitoring Centre. The primary exposure was TCN

with stratification by sex (male/female) and age (

40 years / ≥40 years). A distributed Lag nonlinear model (DLNM) was used to analyze the association between TCN and daily outpatient visits. Using the inte

rquartile range (IQR) of TCN as the unit of change and the 25th percentile as the reference

the relative risk (

) and its 95% confidence interval (

) were calculated. Models were adjusted for long-term trends

meteorological factors (wind speed

rainfall

relative humidity)

2.5

day of the week

and public holidays. Differences in effects between subgroups were tested using the

-test.

Results

In the total population

TCN was negatively associated with psoriasis outpatient visits. For each 2.1 ℃ increase in TCN (one IQR)

significant single-day Lagged effects were observed at Lag1 and Lag2

with an

of 0.997 (95%

: 0.995 to 0.999

0.001) at Lag2; cumulative effects were significant from Lag01 to Lag07

with an

of 0.986 (95%

: 0.983 to 0.989

0.001) at Lag07. Stratified analyses showed significant effects in males and those aged ≥40 years at single-day Lags Lag0 and Lag1 and cumulative Lags from Lag00 to Lag07

with an RR of 0.983 (95%

: 0.979 to 0.986

0.001) at Lag07 for males and an RR of 0.981 (95%

: 0.977 to 0.985

0.001) at Lag07 for those aged ≥40 years. Effects were weaker in females and those aged

40 years

with statistical significance observed only for certain Lag days. Heterogeneity tests indicated significant differences between sexes at Lag0

Lag00

and Lag07

and between age groups at Lag7 and Lag07

suggesting that reductions in healthcare-seeking behavior associated with higher TCN were more pronounced in male patients and those aged ≥40 years.

Conclusion

Higher TCN is statistically associated with a reduction in psoriasis outpatient visits. Sex and age showed suggestive modifying effects

with stronger associations observed in males and individuals aged≥40 years

although the magnitude of the effect differences was very small. Countermeasures　In the future

monitoring acute temperature fluctuations could be integrated into community-based health management systems for chronic skin diseases. Using meteorological warnings

an environmental exposure risk communication mechanism stratified by population and sex can be established to deliver precise recommendations regarding optimal times for outdoor activities to psoriasis patients

thereby optimizing behavioral intervention strategies and guiding patients’ decisions on seeking medical care.

关键词

Keywords

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