Chen Pei-Yun, Tsan Yu-Tse, Yang Chao-Tung, Lee Yun-Mei, Chen Li-Li, Ho Wen-Chao, Lu Shu-Hua
Departmant of public Health, China Medical University, Taichung, Taiwan.
Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
BMC Rheumatol. 2023 Jun 8;7(1):14. doi: 10.1186/s41927-023-00337-8.
Air pollution is a key public health factor with the capacity to induce diseases. The risk of ischemia heart disease (IHD) in those suffering from systemic lupus erythematosus (SLE) from air pollution exposure is ambiguous. This study aimed to: (1) determine the hazard ratio (HR) of IHD after the first-diagnosed SLE and (2) examine the effects of air pollution exposure on IHD in SLE for 12 years.
This is a retrospective cohort study. Taiwan's National Health Insurance Research Database and Taiwan Air Quality Monitoring data were used in the study. Cases first diagnosed with SLE in 2006 cases without IHD were recruited as the SLE group. We randomly selected an additional sex-matched non-SLE cohort, four times the size of the SLE cohort, as the control group. Air pollution indices by residence city per period were calculated as the exposure. Life tables and Cox proportional risk models of time-dependent covariance were used in the research.
This study identified patients for the SLE group (n = 4,842) and the control group (n = 19,368) in 2006. By the end of 2018, the risk of IHD was significantly higher in the SLE group than in the control group, and risks peaked between the 6th and 9th year. The HR of incidence IHD in the SLE group was 2.42 times that of the control group. Significant correlations with risk of developing IHD were noted for sex, age, CO, NO, PM, and PM, of which PM exposure had the highest risk of IHD incidence.
Subjects with SLE were at a higher risk of IHD, especially those in the 6th to 9th year after SLE diagnosis. The advanced cardiac health examinations and health education plan should be recommended for SLE patients before the 6th year after SLE diagnosed.
空气污染是诱发疾病的关键公共卫生因素。系统性红斑狼疮（SLE）患者因接触空气污染而患缺血性心脏病（IHD）的风险尚不明确。本研究旨在：（1）确定首次诊断为SLE后患IHD的风险比（HR）；（2）研究12年来空气污染暴露对SLE患者IHD的影响。
这是一项回顾性队列研究。研究使用了台湾国民健康保险研究数据库和台湾空气质量监测数据。将2006年首次诊断为SLE且无IHD的病例纳入SLE组。我们随机选择了一个性别匹配的非SLE队列，其规模是SLE队列的四倍，作为对照组。计算每个时期居住城市的空气污染指数作为暴露因素。研究中使用了生命表和时间依赖性协方差的Cox比例风险模型。
本研究在2006年确定了SLE组（n = 4842）和对照组（n = 19368）。到2018年底，SLE组患IHD的风险显著高于对照组，且风险在第6年至第9年达到峰值。SLE组IHD发病率的HR是对照组的2.42倍。发现IHD发病风险与性别、年龄、一氧化碳、一氧化氮、细颗粒物和可吸入颗粒物显著相关，其中细颗粒物暴露导致IHD发病的风险最高。
SLE患者患IHD的风险较高，尤其是在SLE诊断后的第6年至第9年。建议在SLE诊断后的第6年之前，对SLE患者进行高级心脏健康检查和健康教育计划。
