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空气污染、肺功能与 COPD:基于人群的英国生物库研究结果。

Air pollution, lung function and COPD: results from the population-based UK Biobank study.

机构信息

Research Institute of the McGill University Health Centre, Montreal, QC, Canada

Swiss Tropical and Public Health Institute, Basel, Switzerland.

出版信息

Eur Respir J. 2019 Jul 25;54(1). doi: 10.1183/13993003.02140-2018. Print 2019 Jul.

Abstract

Ambient air pollution increases the risk of respiratory mortality, but evidence for impacts on lung function and chronic obstructive pulmonary disease (COPD) is less well established. The aim was to evaluate whether ambient air pollution is associated with lung function and COPD, and explore potential vulnerability factors.We used UK Biobank data on 303 887 individuals aged 40-69 years, with complete covariate data and valid lung function measures. Cross-sectional analyses examined associations of land use regression-based estimates of particulate matter (particles with a 50% cut-off aerodynamic diameter of 2.5 and 10 µm: PM and PM, respectively; and coarse particles with diameter between 2.5 μm and 10 μm: PM) and nitrogen dioxide (NO) concentrations with forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), the FEV/FVC ratio and COPD (FEV/FVC <lower limit of normal). Effect modification was investigated for sex, age, obesity, smoking status, household income, asthma status and occupations previously linked to COPD.Higher exposures to each pollutant were significantly associated with lower lung function. A 5 µg·m increase in PM concentration was associated with lower FEV (-83.13 mL, 95% CI -92.50- -73.75 mL) and FVC (-62.62 mL, 95% CI -73.91- -51.32 mL). COPD prevalence was associated with higher concentrations of PM (OR 1.52, 95% CI 1.42-1.62, per 5 µg·m), PM (OR 1.08, 95% CI 1.00-1.16, per 5 µg·m) and NO (OR 1.12, 95% CI 1.10-1.14, per 10 µg·m), but not with PM Stronger lung function associations were seen for males, individuals from lower income households, and "at-risk" occupations, and higher COPD associations were seen for obese, lower income, and non-asthmatic participants.Ambient air pollution was associated with lower lung function and increased COPD prevalence in this large study.

摘要

大气污染增加了呼吸道死亡率的风险,但关于其对肺功能和慢性阻塞性肺疾病(COPD)的影响证据还不充分。本研究旨在评估大气污染是否与肺功能和 COPD 相关,并探讨潜在的易感因素。

我们使用英国生物库(UK Biobank)中 303887 名 40-69 岁个体的数据,这些个体均具有完整的协变量数据和有效的肺功能测量值。横断面分析检测了基于土地使用回归的估计值(粒径为 50%截止值空气动力学直径 2.5μm 和 10μm 的颗粒物:PM 和 PM ;以及直径在 2.5μm 和 10μm 之间的粗颗粒物:PM )和二氧化氮(NO )浓度与 1 秒用力呼气量(FEV )、用力肺活量(FVC )、FEV/FVC 比值和 COPD(FEV/FVC <正常下限)的关系。对性别、年龄、肥胖、吸烟状况、家庭收入、哮喘状况和先前与 COPD 相关的职业进行了效应修饰的检验。

每种污染物的暴露量较高均与较低的肺功能显著相关。PM 浓度每增加 5μg·m ,FEV 降低(-83.13mL,95%CI -92.50- -73.75mL),FVC 降低(-62.62mL,95%CI -73.91- -51.32mL)。PM (OR 1.52,95%CI 1.42-1.62,每 5μg·m )、PM (OR 1.08,95%CI 1.00-1.16,每 5μg·m )和 NO (OR 1.12,95%CI 1.10-1.14,每 10μg·m )浓度较高与 COPD 患病率相关,但与 PM 浓度无关。FEV 与男性、家庭收入较低的个体和“高危”职业的相关性更强,COPD 与肥胖、较低收入和非哮喘患者的相关性更强。

在这项大型研究中,大气污染与较低的肺功能和 COPD 患病率增加相关。

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