Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China.
Environ Res. 2024 Nov 15;261:119695. doi: 10.1016/j.envres.2024.119695. Epub 2024 Aug 3.
Available evidence suggests that air pollutants can cause stroke, but little research has investigated the confounding effects of urban-rural differences. Here, we investigated the urban-rural difference in the correlation between particulate matter (PM and PM) exposure and stroke. This cohort study was based on a prospective multi-city community-based cohort (Guizhou Population Health Cohort Study (GPHCS)) in Guizhou Province, China. A total of 7988 eligible individuals (≥18 years) were enrolled with baseline assessments from November 2010 to December 2012, and follow-up was completed by June 2020. Two major particulate matters (PMs, including PM and PM) were assessed monthly from 2000 by using satellite-based spatiotemporal models. The risk of stroke was estimated using a Cox proportional hazard regression model. The association between particulate matters' exposure and stroke in different areas (total, urban, and rural) and the potential modification effect of comorbidities (hypertension, diabetes, and dyslipidemia) and age (≤65/>65 years) were examined using stratified analyses. The risk of stroke increased for every 10 μg/m increase in mean PMs' concentrations during the previous 1 year at the residential address (HR: 1.26, 95%CI: 1.24, 1.29 (PM); HR: 1.13, 95%CI: 1.11, 1.15 (PM)). The presence of diabetes and dyslipidemia increased the risk of PM-induced stroke in whole, urban, and rural areas. Specifically, people living in rural areas were more likely to experience the effects of PMs in causing a stroke. The risk of stroke due to PMs was statistically increased in the young and older populations living in rural areas. In conclusion, long-term exposure to PMs increased the risk of stroke and such association was more pronounced in people living in rural areas with lower income levels. Diabetes and dyslipidemia seemed to strengthen the association between PMs and stroke.
现有证据表明，空气污染物会导致中风，但很少有研究调查城乡差异的混杂影响。在这里，我们研究了颗粒物（PM 和 PM ）暴露与中风之间的城乡差异。这项队列研究基于中国贵州省的一个前瞻性多城市社区队列（贵州人口健康队列研究（GPHCS））。共有 7988 名符合条件的个体（≥18 岁）参加了这项研究，他们在 2010 年 11 月至 2012 年 12 月进行了基线评估，并在 2020 年 6 月完成了随访。通过基于卫星的时空模型，每月评估两次主要颗粒物（PM ，包括 PM 和 PM ）。使用 Cox 比例风险回归模型估计中风的风险。使用分层分析检查了不同地区（整体、城市和农村）中颗粒物暴露与中风之间的关联，以及共病（高血压、糖尿病和血脂异常）和年龄（≤65/>65 岁）的潜在修饰作用。在居住地址上，前 1 年平均 PMs 浓度每增加 10μg/m，中风风险增加（HR：1.26，95%CI：1.24，1.29（PM）；HR：1.13，95%CI：1.11，1.15（PM））。患有糖尿病和血脂异常会增加全人群、城市和农村地区 PM 引起的中风风险。具体而言，居住在农村地区的人更容易受到 PM 引起中风的影响。居住在农村地区的年轻和老年人群因 PMs 导致中风的风险呈统计学增加。总之，长期暴露于 PMs 会增加中风的风险，这种关联在收入水平较低的农村地区人群中更为明显。糖尿病和血脂异常似乎加强了 PMs 与中风之间的关联。
