大气细颗粒物暴露和体力活动对心力衰竭的影响：一项前瞻性队列研究的风险效益分析。

The effects of ambient fine particulate matter exposure and physical activity on heart failure: A risk-benefit analysis of a prospective cohort study.

机构信息

Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.

出版信息

Sci Total Environ. 2022 Dec 20;853:158366. doi: 10.1016/j.scitotenv.2022.158366. Epub 2022 Aug 29.

DOI:10.1016/j.scitotenv.2022.158366

PMID:36049682

Abstract

BACKGROUND

Evidence supporting the adverse effects of air pollution and the benefits of physical activity (PA) on heart failure (HF) has continued to grow. However, their joint effects remain largely unknown.

METHODS

Our investigation included a total of 321,672 participants free of HF at baseline from the UK Biobank. Participants were followed up till March 2021. Information on participants' PA levels and additional covariates was collected by questionnaire. The annual fine particulate matter (PM) concentration was estimated using a Land Use Regression (LUR) model. Cox proportional hazards models were used to assess the associations of PA and PM exposure with incident HF, as well as their interaction on both additive and multiplicative scales.

RESULTS

During a median follow-up of 12.0 years, 8212 cases of HF were uncovered. Compared with participants with low PA, the hazard ratios (HRs) were 0.69 (95 % CI: 0.65, 0.73) and 0.61 (95 % CI: 0.58, 0.65) for those with moderate and high PA, respectively. PM was associated with an elevated risk of incident HF with an HR of 1.11 (95 % CI: 1.08, 1.14) per interquartile range (IQR) increment. The synergistic additive interaction between low PA and high PM exposure on HF was observed. Compared with participants with high PA and low PM exposure, those with low PA and high PM exposure had the highest risk of HF [HR (95 % CI): 1.90 (1.76, 2.06)].

CONCLUSIONS

Our findings indicate that PA might still be an appropriate strategy to prevent HF for those living in areas with relatively high air pollution. Individuals with low PA may pay more attention to air pollution.

摘要

背景

空气污染对心力衰竭（HF）的不良影响和身体活动（PA）的益处的证据不断增加。然而，它们的联合效应在很大程度上仍然未知。

方法

我们的研究共纳入了英国生物银行 321672 名基线时无 HF 的参与者。参与者随访至 2021 年 3 月。通过问卷调查收集了参与者的 PA 水平和其他协变量的信息。采用土地利用回归（LUR）模型估计每年的细颗粒物（PM）浓度。使用 Cox 比例风险模型评估 PA 和 PM 暴露与 HF 发病的关联，以及在加性和乘法尺度上的相互作用。

结果

在中位随访 12.0 年期间，共发现 8212 例 HF 病例。与低 PA 参与者相比，中 PA 和高 PA 参与者的危险比（HR）分别为 0.69（95%CI：0.65，0.73）和 0.61（95%CI：0.58，0.65）。PM 与 HF 发病风险升高相关，每增加一个四分位间距（IQR），HR 为 1.11（95%CI：1.08，1.14）。低 PA 和高 PM 暴露对 HF 的协同加性相互作用是观察到的。与高 PA 和低 PM 暴露的参与者相比，低 PA 和高 PM 暴露的参与者 HF 发病风险最高[HR（95%CI）：1.90（1.76，2.06）]。