新墨西哥州西班牙裔烟民患慢性阻塞性肺病的几率比非西班牙裔白人低，肺功能下降的幅度也较小。
New Mexican Hispanic smokers have lower odds of chronic obstructive pulmonary disease and less decline in lung function than non-Hispanic whites.
机构信息
Lovelace Respiratory Research Institute, Albuquerque, NM 87108, USA.
出版信息
Am J Respir Crit Care Med. 2011 Dec 1;184(11):1254-60. doi: 10.1164/rccm.201103-0568OC. Epub 2011 Sep 8.
RATIONALE
The epidemiology of cigarette smoking-related chronic obstructive pulmonary disease (COPD) is not well characterized in Hispanics in the United States. Understanding how ethnicity influences COPD is important for a number of reasons, from informing public health policies to dissecting the genetic and environmental effects that contribute to disease.
OBJECTIVES
The present study assessed differences in risk between Hispanics and non-Hispanic whites for longitudinal and cross-sectional COPD phenotypes. Genetic ancestry was used to verify findings based on self-reported ethnicity. Hispanics in New Mexico are primarily differentiated from non-Hispanic whites by their proportion of Native American ancestry.
METHODS
The study was performed in a New Mexican cohort of current and former smokers. Self-reported Hispanic and non-Hispanic white ethnicity was validated by defining genetic ancestry proportions at the individual level using 48 single-nucleotide polymorphism markers. Self-reported ethnicity and genetic ancestry were independently used to assess associations with cross-sectional and longitudinal measures of lung function. Multivariable models were adjusted for indicators of smoking behavior.
MEASUREMENTS AND MAIN RESULTS
Self-reported Hispanic ethnicity was significantly associated with lower odds of COPD (odds ratio, 0.49; 95% confidence interval, 0.35-0.71; P = 0.007), and this protection was validated by the observation that Hispanic smokers have reduced risk of rapid decline in lung function (odds ratio, 0.48; 95% confidence interval, 0.30-0.78; P = 0.003). Similar findings were noted when Native American genetic ancestry proportions were used as predictors instead of self-report of Hispanic ethnicity.
CONCLUSIONS
Hispanic ethnicity is inversely associated with cross-sectional and longitudinal spirometric COPD phenotypes even after adjustment for smoking. Native American genetic ancestry may account for this "Hispanic protection."
背景
在美国的西班牙裔人群中，吸烟相关的慢性阻塞性肺疾病（COPD）的流行病学特征尚不清楚。了解种族如何影响 COPD 对于许多原因都很重要，从制定公共卫生政策到剖析导致疾病的遗传和环境影响。
目的
本研究评估了西班牙裔和非西班牙裔白种人在 COPD 纵向和横断面表型方面的风险差异。遗传血统被用于根据自我报告的种族验证研究结果。新墨西哥州的西班牙裔主要通过其美洲原住民血统的比例与非西班牙裔白人区分开来。
方法
该研究在新墨西哥州的当前和以前的吸烟者队列中进行。使用 48 个单核苷酸多态性标记物定义个体水平的遗传血统比例，从而验证自我报告的西班牙裔和非西班牙裔白种人种族。自我报告的种族和遗传血统被独立用于评估与肺功能横断面和纵向测量的关联。多变量模型调整了吸烟行为指标。
测量和主要结果
自我报告的西班牙裔种族与 COPD 的低发病几率显著相关（比值比，0.49；95%置信区间，0.35-0.71；P = 0.007），并且这种保护作用通过观察到西班牙裔吸烟者的肺功能快速下降风险降低得到验证（比值比，0.48；95%置信区间，0.30-0.78；P = 0.003）。当使用美洲原住民遗传血统比例而不是自我报告的西班牙裔种族作为预测指标时，也观察到了类似的发现。
结论
即使在调整了吸烟因素后，西班牙裔种族也与横断面和纵向肺活量测定 COPD 表型呈负相关。美洲原住民遗传血统可能解释了这种“西班牙裔保护”现象。
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