空气污染暴露方式,吸烟和慢性呼吸道疾病的遗传风险:一项前性研究
Ting Wang1,2, Linfang Lyu3, Ru Yuan4
1Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
NPJ primary care respiratory medicine
|December 5, 2025
概括
这项研究表明,空气污染和吸烟的联合暴露显著增加了慢性呼吸道疾病的风险,特别是肺癌和COPD. 遗传倾向进一步放大了这些风险,突出了因素的复杂相互作用.
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:
- 以前关于慢性呼吸道疾病 (CRD) 风险的研究往往忽视了现实世界的混合污染物暴露.
- 了解环境和生活方式因素的结合对于准确的风险评估至关重要.
研究的目的:
- 在一个大群体中识别不同的空气污染暴露模式.
- 调查这些模式与吸烟和基因风险对CRDs的独立和相互作用影响.
- 量化主要呼吸道疾病的联合暴露的可归因风险.
主要方法:
- 隐性类分析 (LCA) 用于在英国生物银行中定义空气污染暴露档案.
- 考克斯的比例危险模型评估了暴露档案与发生的肺癌 (LC),异常性肺纤维化 (IPF),慢性阻塞性肺病 (COPD) 和喘之间的关联.
- 相互作用分析探讨了空气污染,吸烟和遗传风险得分的综合影响.
主要成果:
- LCA确定了五个不同的空气污染暴露组,其中一个"高空气污染"组显示LC (HR 1.28),IPF (HR 1.23),COPD (HR 1.28) 和喘 (HR 1.09) 的风险增加.
- 在高空气污染和吸烟之间发现了显著的附加相互作用,用于LC和COPD.
- 具有高遗传风险,吸烟和高空气污染暴露的个体对LC (2.74),IPF (3.93) 和COPD (1.68) 的相互作用 (RERI) 呈现出相当大的相对过度风险.
结论:
- 混合空气污染暴露模式显著增加了主要慢性呼吸道疾病的风险.
- 空气污染和吸烟之间的协同作用,进一步因遗传倾向而改变,大大增加了CRD风险.
- 综合空气污染和吸烟暴露占LC,IPF和COPD病例的40%以上,强调需要综合预防策略.
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