基于吸烟史评分的老年前吸烟者的死亡率和发病率风险预测：来自 UK Biobank 和 ESTHER 队列的证据。

Mortality and morbidity risk prediction for older former smokers based on a score of smoking history: evidence from UK Biobank and ESTHER cohorts.

机构信息

Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

出版信息

Age Ageing. 2022 Jul 1;51(7). doi: 10.1093/ageing/afac154.

DOI:10.1093/ageing/afac154

PMID:35780433

Abstract

BACKGROUND

Rapid population ageing has raised the proportion of older former smokers considerably, but a comprehensive assessment tool of former smoking-related health risks is absent.

OBJECTIVE

We utilised the large-scale data of UK Biobank and ESTHER study to build a former smoking score (FSS) for older former smokers using three major former smoking traits: pack-years, smoking duration and time since smoking cessation.

DESIGN

UK Biobank and ESTHER study are two cohorts of older adults with 502,528 and 9,940 participants from the UK and Germany, respectively.

METHODS

Smoking history and covariates were retrieved from the self-administrated questionnaires and mortality and morbidity data were obtained through regular linkages to hospital records.

RESULTS

We constructed the FSS based on the 94,446 former smokers of UK Biobank by retrieving the averaged effect estimates of each trait with a 100-time random sampling. This score was robustly associated with higher risks of mortality and incidence of major smoking-related diseases, outperforming each trait. In the validation panel of 2,683 former smokers from ESTHER study, the FSS was highly predictive of mortality and morbidities. Particularly, compared with the 1st quartile of the FSS group, the 4th quartile group had 114.1, 104.5 and 158.9% higher risks of all-cause, CVD and cancer mortality, respectively, and 41.9, 31.9, 52.4 and 831.3% higher risks of incident CVD, type 2 diabetes, any cancers and lung cancer, respectively.

CONCLUSIONS

Our study demonstrates the large potential of refined risk assessment of former smokers by more comprehensive consideration of the major traits of former smoking.

摘要

背景

人口快速老龄化使得老年前吸烟者的比例大幅增加，但目前缺乏综合评估前吸烟相关健康风险的工具。

目的

本研究利用 UK Biobank 和 ESTHER 研究的大规模数据，使用三大前吸烟特征（吸烟包年数、吸烟持续时间和戒烟时间）构建了一个前吸烟者评分（FSS）。

设计

UK Biobank 和 ESTHER 研究分别是来自英国和德国的两个老年队列，参与者分别为 502528 人和 9940 人。

方法

从自我管理问卷中检索吸烟史和协变量，通过定期与医院记录的链接获取死亡率和发病率数据。

结果

我们通过检索每个特征的 100 次随机抽样的平均效应估计值，在前吸烟者中构建了基于 UK Biobank 的 FSS，该评分与死亡率和主要吸烟相关疾病的发病率风险显著相关，优于每个特征。在来自 ESTHER 研究的 2683 名前吸烟者的验证组中，FSS 对死亡率和发病率具有高度预测性。特别是，与 FSS 组的第 1 四分位数相比，第 4 四分位数组的全因、CVD 和癌症死亡率分别高出 114.1%、104.5%和 158.9%，CVD、2 型糖尿病、所有癌症和肺癌的发病率分别高出 41.9%、31.9%、52.4%和 831.3%。