环氧乙烷暴露与 COPD 患病率的关联：来自 NHANES 2013-2016 的证据。
Association between ethylene oxide exposure and prevalence of COPD: Evidence from NHANES 2013-2016.
机构信息
Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.
出版信息
Sci Total Environ. 2023 Aug 10;885:163871. doi: 10.1016/j.scitotenv.2023.163871. Epub 2023 May 4.
BACKGROUND
Environmental exposures are major risk factors for chronic obstructive pulmonary disease (COPD). Ethylene oxide (EO) is a ubiquitous organic compound and adversely affects human health. However, it remains unknown whether EO exposure increases the risk of COPD. This study aimed to explore the association between EO exposure and the prevalence of COPD.
METHODS
In this cross-sectional study, 2243 participants were analyzed from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016. Participants were classified into four groups according to quartiles of log10-transformed hemoglobin adducts of EO (HbEO) levels. HbEO levels were measured using the modified Edman reaction and high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). Logistic regression, restricted cubic spline regression model, and subgroup analysis were used to assess whether EO exposure was associated with the risk of COPD. A multivariate linear regression model was used to investigate the correlation between HbEO levels and inflammatory factors. A mediating analysis was conducted to estimate whether inflammatory factors were involved in the effects of HbEO on the prevalence of COPD.
RESULTS
Participants with COPD had higher HbEO levels than those without COPD. Log10-transformed HbEO levels were associated with an increased risk of COPD after adjusting for all covariates. [Q4 vs. Q1 in model II: OR = 2.15, 95 % CI: 1.20-3.85, P = 0.010, P for trend = 0.009]. Moreover, a nonlinear J-shaped relationship was observed between HbEO levels and the risk of COPD. Furthermore, HbEO levels were positively correlated with inflammatory cells. In addition, white blood cells and neutrophils mediated the relationship between HbEO and the prevalence of COPD with mediated proportions of 10.37 % and 7.55 %, respectively.
CONCLUSION
These findings indicate that EO exposure has a J-shaped association with the risk of COPD. Inflammation is a key mediator involved in the effects of EO exposure on COPD.
背景
环境暴露是慢性阻塞性肺疾病（COPD）的主要危险因素。环氧乙烷（EO）是一种普遍存在的有机化合物，对人类健康有不良影响。然而，EO 暴露是否会增加 COPD 的风险尚不清楚。本研究旨在探讨 EO 暴露与 COPD 患病率之间的关系。
方法
在这项横断面研究中，我们对 2013 年至 2016 年期间的国家健康和营养调查（NHANES）中的 2243 名参与者进行了分析。根据对数转化的血红蛋白加合物 EO（HbEO）水平的四分位间距，将参与者分为四组。采用改良 Edman 反应和高效液相色谱-串联质谱（HPLC-MS/MS）法测定 HbEO 水平。采用 logistic 回归、限制性立方样条回归模型和亚组分析来评估 EO 暴露是否与 COPD 风险相关。采用多元线性回归模型来研究 HbEO 水平与炎症因子之间的相关性。进行中介分析以评估炎症因子是否参与 HbEO 对 COPD 患病率的影响。
结果
患有 COPD 的参与者的 HbEO 水平高于无 COPD 的参与者。在校正所有协变量后，log10 转化的 HbEO 水平与 COPD 风险增加相关。[模型 II 中 Q4 与 Q1 相比：OR=2.15，95%CI：1.20-3.85，P=0.010，P 趋势=0.009]。此外，HbEO 水平与 COPD 风险之间存在非线性 J 形关系。此外，HbEO 水平与炎症细胞呈正相关。此外，白细胞和中性粒细胞介导了 HbEO 与 COPD 患病率之间的关系，介导比例分别为 10.37%和 7.55%。
结论
这些发现表明 EO 暴露与 COPD 风险呈 J 形关联。炎症是 EO 暴露对 COPD 影响的关键中介因素。
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