我们是否低估了因暴露导致心血管死亡的风险?
Sung Kyun Park1, Xin Wang2, Seulbi Lee2
1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MA, USA.
The Science of the total environment
|March 7, 2024
概括
使用新算法估计的骨含量与心血管死亡率的关联比血含量更强. 这表明当前的风险评估可能低估了.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 毒理学 毒理学 毒理学
背景情况:
- 国家健康和营养检查调查-III (NHANES-III) 数据表明血液中含量和死亡率增加之间的潜在关联.
- 骨,是累积负担的生物标志物,更好地反映了慢性暴露的影响,但需要专门的K-x射线光 (KXRF) 仪器用于体内评估.
- 开发了一种新的算法,利用血液中的含量,年龄和社会经济/行为因素来预测骨的含量.
研究的目的:
- 通过使用NHANES-III数据,检查算法估计的骨含量 (骨和骨) 和死亡率之间的关联.
- 为了比较估计的骨与血液对所有原因和特定原因死亡率的预测能力.
主要方法:
- 包括来自NHANES-III的11,628名成年人,后续数据延长至2019年12月31日.
- 用开发的预测算法计算估计的骨和骨的含量.
- 使用调查加权的考克斯比例危险模型来确定危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 在长达26.8年的中位数随访期间,发生了4900例死亡.
- 估计的骨标志物 (骨和骨) 与血液含量相比,与心血管死亡率的关联明显更强.
- 对于暴露的第90个百分比和第10个百分比的参与者来说,心血管死亡率的HR为3.32的小腿和2.42的膝盖,而血为1.63.
- 与血液中 (22.8%) 相比,骨 (45.8%) 和骨 (33.1%) 的死亡率较高.
结论:
- 估计的骨含量与心血管死亡率的关联比血含量更强.
- 目前仅基于血液中含量的心血管死亡风险评估可能低估了因暴露而导致的总死亡风险.
- 开发的算法为评估慢性暴露和相关死亡风险提供了有价值的工具.
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