空气污染,肺功能和死亡率:英国生物银行的生存和中介分析
Anna L Guyatt1,2, Yutong Samuel Cai1,3,4,5,2, Dany Doiron6
1Department of Population Health Sciences, University of Leicester, Leicester, UK.
ERJ open research
|April 30, 2024
概括
肺功能受损部分介于空气污染与死亡率或心血管疾病 (CVD) 之间的联系. 这项研究量化了下肺功能如何解释空气污染的程度.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 肺部病理学 肺部病理学
背景情况:
- 空气污染与肺功能下降,过早死亡和心血管疾病 (CVD) 有关.
- 关于肺功能受损是否介导空气污染与死亡率或心血管疾病之间的关联的证据有限.
研究的目的:
- 调查肺功能在空气污染暴露与死亡率和CVD事件之间的关系中扮演的调解角色.
- 量化肺功能介导的关联比例.
主要方法:
- 利用英国生物库数据 (n≈200,000),对死亡率和发生的心血管疾病进行了8年的随访.
- 使用土地利用回归建模评估对PM10,PM2.5和NO2的暴露.
- 测量肺功能 (FEV1,FVC,FEV1/FVC比率) 并使用Cox比例危险和调解模型分析相关性,按吸烟状况分层.
主要成果:
- 较低的FEV1和FVC与增加全因和心血管疾病死亡率,以及发生心血管疾病相关,在常吸烟者中影响更强.
- 长期暴露于PM2.5或NO2与发生心血管疾病有关.
- FEV1介导了PM2.5所有原因死亡率的18%和NO2所有原因死亡率的27%. FEV1调解了PM2.5事件的CVD协会的9%,NO2事件的CVD协会的16%.
结论:
- 肺功能在空气污染与死亡率和心血管疾病结局之间的关联中中介的比例很小.
- 研究结果表明,空气污染对肺部功能的共同机制或直接影响有助于这些结果.
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