长期暴露于空气污染和风湿性关节炎中的心血管疾病进展:使用多状态模型分析的前性队列研究
Yu-Xuan Zhang1, Bin-Bin Feng1, Ma Ruo-Wei1
1School of Nursing, Anhui Medical University, 15 Feicui Road, Hefei, Anhui 230032, China.
Ecotoxicology and environmental safety
|April 16, 2025
概括
长期暴露于空气污染,特别是PM2.5和NO2,与英国生物库参与者的类风湿性关节炎 (RA) 发病,心血管疾病 (CVD) 发展和死亡风险增加有关. 这些发现凸显了控制空气污染的必要性,以防止RA及其并发症.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 心血管研究研究心血管研究
背景情况:
- 类风湿性关节炎 (RA) 患者面临心血管疾病 (CVD) 的高风险,这是导致死亡的主要原因.
- 环境因素,特别是空气污染对RA进展和随后的心血管疾病发展的影响尚不清楚.
研究的目的:
- 研究长期暴露于环境空气污染物和从健康状态到RA发作,然后到CVD,最后到死亡的多阶段进展之间的联系.
- 在不同疾病过渡阶段量化与特定空气污染物 (PM2.5,PM10,NO2,NOx) 相关的风险.
主要方法:
- 一个单向的多态马尔科夫比例危险模型被应用到英国生物库数据 (n=326,059).
- 分析检查了从健康状态到RA发病,RA到CVD,RA到死亡的过渡.
- 使用土地利用回归模型估计了长期空气污染暴露,并计算了每四分位数间范围 (IQR) 增加的危险比率.
主要成果:
- 暴露于PM2.5与较高的RA发病风险 (HR:1.08) 和导致死亡的RA风险 (HR:1.20) 相关.
- 暴露于NO2与RA发病风险增加有关 (HR: 1.10) 和RA与心血管疾病发展的风险增加 (HR: 1.13).
- 门疾病与多种污染物有关,女性和老年人受到的影响更大.
结论:
- 长期暴露于空气污染与RA进展的多个阶段的风险增加显著相关,包括发病,心血管疾病发展和死亡率.
- 虽然影响大小各不相同,但研究结果强调了空气污染减轻策略对于预防RA及其心血管后果的重要性.
- 易受影响的人群,包括妇女和老年人,可能会经历更明显的不良影响.
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