Ma Qiye, Chen Lin, Xu Hao, Weng Yiru
Department of Emergency, Ningbo Ninth Hospital, Ningbo 315000, China.
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Toxics. 2024 Dec 28;13(1):21. doi: 10.3390/toxics13010021.
Cardiovascular disease continues to be a major contributor to global morbidity and mortality, with environmental and occupational factors such as air pollution, noise, and shift work increasingly recognized as potential contributors. Using a two-sample Mendelian randomization (MR) approach, this study investigates the causal relationships of these risk factors with the risks of unstable angina (UA) and myocardial infarction (MI). Leveraging single nucleotide polymorphisms (SNPs) as genetic instruments, a comprehensive MR study was used to assess the causal influence of four major air pollutants (PM, PM, NO, and NO), noise, and shift work on unstable angina and myocardial infarction. Summary statistics were derived from large genome-wide association studies (GWASs) from the UK Biobank and the FinnGen consortium (Helsinki, Finland), with replication using an independent GWAS data source for myocardial infarction. The inverse-variance weighted (IVW) approach demonstrated a significant positive correlation between shift work and the increased risk of both unstable angina (OR with 95% CI: 1.62 [1.12-2.33], = 0.010) and myocardial infarction (OR with 95% CI: 1.46 [1.00-2.14], = 0.052). MR-PRESSO analysis identified outliers, and after correction, the association between shift work and myocardial infarction strengthened (OR with 95% CI: 1.58 [1.11-2.27], = 0.017). No notable causal associations were identified for air pollution or noise with either outcome. The replication of myocardial infarction findings using independent data supported a possible causal link between shift work and myocardial infarction (OR with 95% CI: 1.41 [1.08-1.84], = 0.012). These results provide novel evidence supporting shift work as a likely causal risk factor for unstable angina and myocardial infarction, underscoring the need for targeted public health strategies to mitigate its cardiovascular impact. However, further investigation is necessary to elucidate the role of air pollution and noise in cardiovascular outcomes.
心血管疾病仍然是全球发病和死亡的主要原因，空气污染、噪音和轮班工作等环境和职业因素越来越被认为是潜在的致病因素。本研究采用双样本孟德尔随机化（MR）方法，调查这些危险因素与不稳定型心绞痛（UA）和心肌梗死（MI）风险之间的因果关系。利用单核苷酸多态性（SNP）作为基因工具，一项全面的MR研究被用于评估四种主要空气污染物（PM、PM、NO和NO）、噪音和轮班工作对不稳定型心绞痛和心肌梗死的因果影响。汇总统计数据来自英国生物银行和芬兰芬基因联盟（芬兰赫尔辛基）的大型全基因组关联研究（GWAS），并使用独立的GWAS数据源对心肌梗死进行重复验证。逆方差加权（IVW）方法显示，轮班工作与不稳定型心绞痛风险增加之间存在显著正相关（OR值及95%置信区间：1.62 [1.12 - 2.33]，P = 0.010）以及与心肌梗死风险增加之间存在显著正相关（OR值及95%置信区间：1.46 [1.00 - 2.14]，P = 0.052）。MR - PRESSO分析识别出了异常值，校正后，轮班工作与心肌梗死之间的关联得到加强（OR值及95%置信区间：1.58 [1.11 - 2.27]，P = 0.017）。未发现空气污染或噪音与任何一种结果之间存在显著的因果关联。使用独立数据对心肌梗死研究结果进行重复验证，支持了轮班工作与心肌梗死之间可能存在因果联系（OR值及95%置信区间：1.41 [1.08 - 1.84]，P = 0.012）。这些结果提供了新的证据，支持轮班工作可能是不稳定型心绞痛和心肌梗死的因果风险因素，强调了需要有针对性的公共卫生策略来减轻其对心血管系统的影响。然而，需要进一步研究以阐明空气污染和噪音在心血管疾病结局中的作用。
