《生命的基础 8 项指标、遗传易感性与成年起病哮喘的发病风险：一项前瞻性队列研究》
Life's Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study.
机构信息
Clinical Research Center, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China.
Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang, China.
出版信息
Am J Clin Nutr. 2024 Jan;119(1):100-107. doi: 10.1016/j.ajcnut.2023.11.009. Epub 2023 Nov 21.
BACKGROUND
Adult-onset asthma (AOA) and cardiovascular diseases shared common risk factors and similar pathophysiologic resemblances. The American Heart Association (AHA) unveiled the life's essential 8 (LE8) to promote cardiovascular health (CVH). This study aimed to assess the overall impact of LE8 implementation on AOA prevention.
METHODS
According to the guideline of AHA's Construct of CVH in 2022, LE8 score was calculated from 8 health status concerning diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional-hazards models were used to estimate effect sizes of associations between CVH, asthma genetic risk, and risk of incident AOA in participants selected from the UK Biobank study.
RESULTS
A total of 6180 incident AOA cases occurred in 249,713 participants during an average of 11.60 y' follow-up. A higher LE8 score was associated with a lower risk of incident AOA with a significant linear trend (P < 0.0001). Every standard deviation increment of LE8 was associated with a 17% (HR: 0.83; 95% CI: 0.81, 0.85) lower risk of incident AOA. Compared with participants with low-CVH score, participants with moderate (HR: 0.72; 95% CI: 0.67, 0.78) and high CVH scores (HR: 0.52; 95% CI: 0.47, 0.58) were associated with a lower risk of incident AOA (P-trend < 0.0001). No significant multiplicative or additive interaction was found between LE8 score and genetic risks. Stratified analysis showed a consistent association between CVH and risk of incident AOA across different asthma polygenic risk score (PRS) levels. Compared with participants with high PRS and low CVH, participants with low PRS and high CVH experienced the lowest risk (HR: 0.28; 95% CI: 0.23, 0.34) of incident AOA.
CONCLUSIONS
Our findings suggest that maintaining optimal CVH should be recommended as a preventive strategy for AOA, regardless of their asthma genetic risks.
背景
成人哮喘（AOA）和心血管疾病具有共同的危险因素和相似的病理生理相似性。美国心脏协会（AHA）公布了生命的基本 8 项（LE8），以促进心血管健康（CVH）。本研究旨在评估 LE8 实施对 AOA 预防的总体影响。
方法
根据 2022 年 AHA 的 CVH 构建指南，从饮食、身体活动、尼古丁暴露、睡眠健康、体重指数、血脂、血糖和血压等 8 项健康状况计算 LE8 评分。使用 Cox 比例风险模型估计从英国生物库研究中选择的参与者的 CVH、哮喘遗传风险与 AOA 发病风险之间的关联的效应大小。
结果
在平均 11.60 年的随访中，在 249713 名参与者中发生了 6180 例新发 AOA 病例。LE8 评分越高，新发 AOA 的风险越低，呈显著线性趋势（P < 0.0001）。LE8 的每一个标准差增加与新发 AOA 的风险降低 17%（HR：0.83；95%CI：0.81，0.85）相关。与低 CVH 评分的参与者相比，中（HR：0.72；95%CI：0.67，0.78）和高 CVH 评分（HR：0.52；95%CI：0.47，0.58）的参与者新发 AOA 的风险较低（P 趋势 < 0.0001）。LE8 评分和遗传风险之间没有发现显著的乘法或加法交互作用。分层分析表明，CVH 与不同哮喘多基因风险评分（PRS）水平的新发 AOA 风险之间存在一致的关联。与高 PRS 和低 CVH 的参与者相比，低 PRS 和高 CVH 的参与者新发 AOA 的风险最低（HR：0.28；95%CI：0.23，0.34）。
结论
我们的研究结果表明，无论哮喘遗传风险如何，保持最佳的 CVH 都应作为 AOA 的预防策略。
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