Zheng Lili, Baroom Ghaliah, Naqvi Rida E Z, Heath Alicia K, Berlanga-Taylor Antonio, Hibino Makoto, Aune Dagfinn
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London, W12 0BZ, UK.
Unidad de Medicina de Datos, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Sci Rep. 2025 Sep 1;15(1):32191. doi: 10.1038/s41598-025-18013-x.
Smoking is an established risk factor for aortic aneurysm, however, few studies have investigated the associations with different aortic aneurysm subsites. The aim of this study was to investigate whether different tobacco smoking metrics and smoking cessation was associated with aortic aneurysm and its subsites in the UK Biobank. The analysis included 495,993 participants, aged 37-73 years. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between smoking and aortic aneurysm. After 12.3 years of follow-up, 3,353 incident cases and 184 deaths from aortic aneurysm were identified. The HRs (95% CIs) of aortic aneurysm incidence for current and former vs. never smokers were 4.32 (3.93-4.76) and 1.70 (1.56-1.84), respectively, and for ≥ 20 vs. <10 cigarettes per day was 5.67 (4.93-6.52), and similar results were observed for pack-years and duration of smoking. At ≥ 30 years of smoking cessation vs. current smoking risk was substantially reduced (0.23, 0.20-0.27) and comparable to never smoking (0.22, 0.20-0.25). Strong positive HRs were observed for current vs. never smoking and abdominal (8.90, 7.79-10.16), thoracoabdominal (11.64, 4.20-32.25), and unspecified site (2.06, 1.61-2.65), ruptured (10.47, 6.12-17.90) and non-ruptured (4.19, 3.80-4.62) aortic aneurysms, but no association was observed for thoracic aortic aneurysm (1.13, 0.88-1.44). Smoking was strongly associated with increased risk of aortic aneurysm and most subtypes. Smoking cessation for ≥ 30 years strongly reduced risk to levels comparable of never smokers. These findings support public health policies promoting smoking prevention and cessation.
吸烟是已确定的主动脉瘤风险因素，然而，很少有研究调查其与不同主动脉瘤亚部位的关联。本研究的目的是在英国生物银行中调查不同的吸烟指标及戒烟情况是否与主动脉瘤及其亚部位相关。分析纳入了495,993名年龄在37至73岁之间的参与者。采用Cox比例风险模型来估计吸烟与主动脉瘤之间关联的多变量调整风险比（HR）和95%置信区间（CI）。经过12.3年的随访，共识别出3353例主动脉瘤发病病例和184例因主动脉瘤死亡的病例。当前吸烟者和既往吸烟者与从不吸烟者相比，主动脉瘤发病的HR（95%CI）分别为4.32（3.93 - 4.76）和1.70（1.56 - 1.84），每天吸≥20支与<10支香烟者相比为5.67（4.93 - 6.52），吸烟包年数和吸烟持续时间也观察到类似结果。戒烟≥30年与当前吸烟相比，风险大幅降低（0.23，0.20 - 0.27），且与从不吸烟相当（0.22，0.20 - 0.25）。当前吸烟者与从不吸烟者相比，腹主动脉瘤（8.90，7.79 - 10.16）、胸腹主动脉瘤（11.64，4.20 - 32.25）、部位未明确的主动脉瘤（2.06，1.61 - 2.65）、破裂性主动脉瘤（10.47，6.12 - 17.90）和非破裂性主动脉瘤（4.19，3.80 - 4.62）的HR均呈强阳性，但未观察到与胸主动脉瘤的关联（1.13，0.88 - 1.44）。吸烟与主动脉瘤及大多数亚型的风险增加密切相关。戒烟≥30年可将风险大幅降低至与从不吸烟者相当的水平。这些发现支持促进吸烟预防和戒烟的公共卫生政策。
