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心血管健康指标、遗传易感性与慢性阻塞性肺疾病的发病:一项前瞻性队列分析

Cardiovascular Health Metrics, Genetic Susceptibility, and Incident Chronic Obstructive Pulmonary Disease: A Prospective Cohort Analysis.

作者信息

Gao Jing-Wei, You Si, He Wan-Bing, Huang Ze-Gui, Cai Yang-Wei, Wu Yu-Biao, Chen Qian, Wang Jing-Feng, Zhang Hai-Feng, Zhang Shao-Ling, Liu Pin-Ming

机构信息

Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

JACC Adv. 2025 Jul 16;4(8):102003. doi: 10.1016/j.jacadv.2025.102003.


DOI:10.1016/j.jacadv.2025.102003
PMID:40675023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12284668/
Abstract

BACKGROUND: Evidence on the prospective relationship between cardiovascular health (CVH) and chronic obstructive pulmonary disease (COPD) risk is limited, particularly regarding genetic susceptibility as an effect modifier. OBJECTIVES: We aimed to investigate the association between CVH levels and COPD risk and to determine whether genetic susceptibility influences this relationship. METHODS: We included 293,342 participants free of COPD from the UK Biobank cohort. CVH levels were assessed using the Life's Essential 8 (LE8) and the Life's Simple 7 scores. Genetic predisposition to COPD was quantified via the polygenic risk score. Cox proportional hazard models examined the impacts of CVH levels and polygenic risk score on COPD incidence. RESULTS: During a median follow-up of 12.89 (Q1-Q3: 12.22-13.54) years, 9,481 participants developed COPD, with an incidence rate of 2.533 per 1,000 person-years (95% CI: 2.482-2.584). Compared to low CVH levels measured by LE8, the HRs (95% CI) for incident COPD were 0.468 (0.446-0.490) for moderate and 0.201 (0.177-0.227) for high CVH levels. No statistically significant interactions were observed between CVH levels and genetic susceptibility to COPD. LE8 showed better predictive accuracy for COPD incidence than Life's Simple 7, with a higher area under the receiver operating characteristic curve (0.698 [95% CI: 0.693-0.704] vs 0.677 [95% CI: 0.672-0.682], P < 0.001). CONCLUSIONS: High CVH levels are significantly associated with a lower risk of incident COPD, regardless of genetic predisposition. These findings highlight the importance of maintaining optimal CVH in COPD prevention. (Predictors of coronary artery calcification [CAC] progression in the UKB population; 91090).

摘要

背景:心血管健康(CVH)与慢性阻塞性肺疾病(COPD)风险之间前瞻性关系的证据有限,尤其是关于基因易感性作为效应修饰因素方面。 目的:我们旨在研究CVH水平与COPD风险之间的关联,并确定基因易感性是否会影响这种关系。 方法:我们纳入了英国生物银行队列中293,342名无COPD的参与者。使用生命必需的8项指标(LE8)和生命简单7项指标来评估CVH水平。通过多基因风险评分来量化COPD的遗传易感性。Cox比例风险模型检验了CVH水平和多基因风险评分对COPD发病率的影响。 结果:在中位随访12.89年(第一四分位数 - 第三四分位数:12.22 - 13.54年)期间,9481名参与者患上了COPD,发病率为每1000人年2.533例(95%置信区间:2.482 - 2.584)。与通过LE8测量的低CVH水平相比,中度CVH水平的COPD发病风险比(HRs,95%置信区间)为0.468(0.446 - 0.490),高度CVH水平为0.201(0.177 - 0.227)。在CVH水平与COPD的遗传易感性之间未观察到统计学上显著的相互作用。与生命简单7项指标相比,LE8对COPD发病率的预测准确性更高,受试者工作特征曲线下面积更大(0.698 [95%置信区间:0.693 - 0.704] 对比 0.677 [95%置信区间:0.672 - 0.682],P < 0.001)。 结论:无论遗传易感性如何,高CVH水平与较低的COPD发病风险显著相关。这些发现凸显了在COPD预防中维持最佳CVH的重要性。(英国生物银行人群中冠状动脉钙化[CAC]进展的预测因素;91090)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/0dad835b79f7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/0dad835b79f7/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/f680b1d7f318/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/2c116380193b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/0dad835b79f7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/0dad835b79f7/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/f680b1d7f318/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/2c116380193b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6db/12284668/0dad835b79f7/gr3.jpg

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[7]
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[8]
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[10]
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本文引用的文献

[1]
Wearable device-measured bouted and sporadic physical activity patterns and incident COPD: A prospective cohort study from UK Biobank.

Public Health. 2024-12

[2]
Life's Essential 8 and risk of non-communicable chronic diseases: Outcome-wide analyses.

Chin Med J (Engl). 2024-7-5

[3]
Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019.

EClinicalMedicine. 2023-5

[4]
Lung Function Decline in Young Adulthood and Coronary Artery Calcium Progression in Midlife.

Am J Med. 2023-9

[5]
The association between sleep duration, respiratory symptoms, asthma, and COPD in adults.

Front Med (Lausanne). 2023-4-17

[6]
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary.

Eur Respir J. 2023-4

[7]
Exercise adaptations in COPD: the pulmonary perspective.

Am J Physiol Lung Cell Mol Physiol. 2022-12-1

[8]
Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission.

Lancet. 2022-9-17

[9]
The Dietary Inflammatory Index and Early COPD: Results from the National Health and Nutrition Examination Survey.

Nutrients. 2022-7-11

[10]
Cardiovascular disease in chronic obstructive pulmonary disease: a narrative review.

Thorax. 2022-6-30

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