英国生物银行中的心脑血管健康、遗传易感性与自身免疫性疾病发病风险:一项前瞻性队列研究
Cardiovascular Health, Genetic Susceptibility, and the Risk of Incident Autoimmune Disorders in the UK Biobank: A Prospective Cohort Study.
作者信息
Lin Lijin, Shan Yuanjun, Lei Fang, Zhang Jianqing, Zhang Li, Zhang Xiao-Jing, Yao Wenlin, She Zhi-Gang, Li Hongliang
机构信息
Department of Cardiology Renmin Hospital of Wuhan University Wuhan China.
Department of Central Laboratory Renmin Hospital of Wuhan University Wuhan China.
出版信息
J Am Heart Assoc. 2025 May 20;14(10):e039451. doi: 10.1161/JAHA.124.039451. Epub 2025 May 15.
BACKGROUND
Autoimmune diseases are closely linked to cardiovascular diseases. This study aimed to assess the relationship between cardiovascular health (CVH) defined by Life's Essential 8 (LE8), genetic predisposition, and the risk of 19 autoimmune disorders.
METHODS AND RESULTS
A total of 247 660 participants without prior autoimmune diseases from the UK Biobank were included. CVH was assessed using LE8 scores, categorized into low, moderate, and high. Cox proportional hazards models estimated the association between CVH, genetic susceptibility, and autoimmune disorder risk. Over 13.2 years of follow-up, 11 422 incident autoimmune disorders occurred. Higher CVH levels were associated with reduced risks of overall autoimmune disorders (hazard ratio, 0.68 [95% CI, 0.62-0.74]) and specific conditions, including Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes. Dose-response analyses revealed a linear negative relationship between continuous LE8 scores and the risks of Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes (>0.05). Genetic predisposition to autoimmune disorders (including ankylosing spondylitis, celiac disease, Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, Sjögren syndrome, systemic lupus erythematosus, systemic sclerosis, and type 1 diabetes) significantly modified these associations (<0.05), with protective effects more pronounced in women, participants aged <65 years, and those with low genetic risk.
CONCLUSIONS
LE8 scores inversely and linearly predicted autoimmune disease incidence. Prioritizing CVH optimization through LE8 adherence may reduce the global autoimmune disease burden.
背景
自身免疫性疾病与心血管疾病密切相关。本研究旨在评估由生命八大要素(LE8)定义的心血管健康、遗传易感性与19种自身免疫性疾病风险之间的关系。
方法与结果
纳入了英国生物银行中247660名无既往自身免疫性疾病的参与者。使用LE8评分评估心血管健康,分为低、中、高三个等级。Cox比例风险模型估计心血管健康、遗传易感性与自身免疫性疾病风险之间的关联。在超过13.2年的随访中,发生了11422例新发自身免疫性疾病。较高的心血管健康水平与总体自身免疫性疾病风险降低相关(风险比,0.68[95%CI,0.62 - 0.74]),以及与特定疾病相关,包括格雷夫斯病、炎症性肠病、风湿性多肌痛、银屑病、类风湿关节炎和1型糖尿病。剂量反应分析显示,连续的LE8评分与格雷夫斯病、炎症性肠病、风湿性多肌痛、银屑病、类风湿关节炎和1型糖尿病的风险之间存在线性负相关(P>0.05)。自身免疫性疾病的遗传易感性(包括强直性脊柱炎、乳糜泻、格雷夫斯病、炎症性肠病、风湿性多肌痛、银屑病、类风湿关节炎、干燥综合征、系统性红斑狼疮、系统性硬化症和1型糖尿病)显著改变了这些关联(P<0.05),在女性、年龄<65岁的参与者以及遗传风险低的人群中保护作用更为明显。
结论
LE8评分呈线性反比预测自身免疫性疾病的发病率。通过遵循LE8来优化心血管健康可能会减轻全球自身免疫性疾病负担。