长期暴露于空气污染与帕金森病发病风险的关联。

Causal association between long-term exposure to air pollution and incident Parkinson's disease.

机构信息

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

Shenzhen University General Hospital, Shenzhen, China.

出版信息

J Hazard Mater. 2024 May 5;469:133944. doi: 10.1016/j.jhazmat.2024.133944. Epub 2024 Mar 2.

Abstract

Epidemiological evidence for long-term air pollution exposure and Parkinson's disease (PD) is controversial, and analysis of causality is limited. We identified 293,888 participants who were free of PD at baseline in the UK Biobank (2006-2010). Time-varying air pollution [fine particulate (PM) and ozone (O)] exposures were estimated using spatio-temporal models. Incident cases of PD were identified using validated algorithms. Four methods were used to investigate the associations between air pollution and PD, including (1) standard time-varying Cox proportional-hazard model; (2) Cox models weighted by generalized propensity score (GPS) and inverse-probability weights (IPW); (3) instrumental variable (IV) analysis; and (4) negative control outcome analysis. During a median of 11.6 years of follow-up, 1822 incident PD cases were identified. Based on standard Cox regression, the hazard ratios (95% confidence interval) for a 1 µg/m or ppb increase in PM and O were 1.23 (1.17, 1.30) and 1.02 (0.98, 1.05), respectively. Consistent results were found in models weighted by GPS and IPW, and in IV analysis. There were no significant associations between air pollution and negative control outcomes. This study provides evidence to support a causal association between PM exposure and PD. Mitigation of air pollution could be a protective measure against PD.

摘要

长期暴露于空气污染与帕金森病(PD)之间的流行病学证据存在争议,且因果关系分析受到限制。我们在英国生物库中(2006-2010 年)确定了 293888 名基线时无 PD 的参与者。使用时空模型来估计时变空气污染(细颗粒物(PM)和臭氧(O))暴露情况。使用验证后的算法来确定 PD 的发病情况。我们使用了四种方法来研究空气污染与 PD 之间的关联,包括:(1)标准时变 Cox 比例风险模型;(2)基于广义倾向得分(GPS)和逆概率权重(IPW)加权的 Cox 模型;(3)工具变量(IV)分析;以及(4)负对照结果分析。在中位数为 11.6 年的随访期间,确定了 1822 例新发 PD 病例。基于标准 Cox 回归,PM 和 O 每增加 1µg/m 或 ppb,其风险比(95%置信区间)分别为 1.23(1.17,1.30)和 1.02(0.98,1.05)。GPS 和 IPW 加权模型以及 IV 分析中均得出了一致的结果。空气污染与负对照结果之间没有显著关联。这项研究提供了证据,支持 PM 暴露与 PD 之间存在因果关系。减少空气污染可能是预防 PD 的一项保护措施。

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