Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
Beijing Anding Hospital, Capital Medical University, Beijing, China.
Sci Total Environ. 2023 Dec 1;902:166004. doi: 10.1016/j.scitotenv.2023.166004. Epub 2023 Aug 5.
Epidemiologic evidence on whether iron accumulation in brain modified the association between artificial light at night (ALAN) and incident mental disorders is lacking. The authors aims to investigate modification of brain iron deposition on the associations of ALAN with multiple mental disorders in the middle-aged and older adults.
This prospective study used data from the UK Biobank. ALAN was drawn from satellite datasets. Susceptibility-weighted magnetic resonance imaging was used to ascertain iron content of each brain region. T2* signal loss was used as indices of iron deposition. The main outcomes are impacts of ALAN exposure on onset of wide spectrum of physician-diagnosed mental disorders, which was estimated by time-varying Cox proportional hazard model. The authors further conducted stratified analyses by levels of iron brain deposition to examine the potential modifying effects.
Among 298,283 participants followed for a median of 10.91 years, higher ALAN exposure was associated with increased risk of mental disorders. An IQR (11.37 nW/cm/sr) increase in annual levels of ALAN was associated with an HR of 1.050 (95 % CI: 1.034,1.066) for any mental disorder, 1.076 (95 % CI: 1.053,1.099) for substance use disorder, and 1.036 (95 % CI: 1.004,1.069) for depression disorder in fully adjusted models. The exposure-response curves showed steeper trends at lower ALAN levels and a plateau at higher exposures. The associations were stronger in participants with high iron deposition in left hippocampus, left accumbens and left pallidum.
ALAN was associated with multiple mental disorders in the middle-aged and older adults, and the findings indicated stricter standards of ALAN is needed and targeted preventive measures are warranted, especially with high brain iron deposition.
关于铁在大脑中的积累是否改变了夜间人工光照（ALAN）与精神障碍事件之间的关联，流行病学证据尚缺乏。作者旨在研究大脑铁沉积对中年和老年人中 ALAN 与多种精神障碍关联的修饰作用。
本前瞻性研究使用了英国生物库的数据。ALAN 是从卫星数据集得出的。使用基于敏感性加权的磁共振成像来确定每个脑区的铁含量。T2*信号损失被用作铁沉积的指标。主要结局是评估 ALAN 暴露对广泛的医生诊断的精神障碍的发生的影响，这是通过时变 Cox 比例风险模型来估计的。作者进一步根据铁脑沉积的水平进行了分层分析，以检验潜在的修饰作用。
在 298283 名参与者中，中位随访时间为 10.91 年，较高的 ALAN 暴露与精神障碍风险增加相关。每年 ALAN 水平增加一个 IQR（11.37 nW/cm/sr）与任何精神障碍的 HR 为 1.050（95%CI：1.034，1.066），物质使用障碍为 1.076（95%CI：1.053，1.099），抑郁障碍为 1.036（95%CI：1.004，1.069）。在完全调整的模型中，暴露-反应曲线在较低的 ALAN 水平下呈现出更陡峭的趋势，在较高的暴露水平下呈现出一个平台。在左侧海马体、左侧伏隔核和左侧苍白球铁沉积较高的参与者中，这些关联更强。
ALAN 与中年和老年人的多种精神障碍有关，研究结果表明，需要更严格的 ALAN 标准，需要采取有针对性的预防措施，特别是对于大脑铁沉积较高的人群。
