Fine Particulate Matter Exposure, Genetic Susceptibility, and the Risk of Incident Stroke: A Prospective Cohort Study

被引:4
作者
Huang, Keyong [3 ,4 ]
Jia, Jiajing [3 ,4 ]
Liang, Fengchao [6 ]
Li, Jianxin [3 ,4 ]
Niu, Xiaoge [3 ,8 ,9 ]
Yang, Xueli [10 ]
Chen, Shufeng [3 ,4 ]
Cao, Jie [3 ,4 ]
Shen, Chong [5 ,11 ]
Liu, Xiaoqing [12 ,13 ]
Yu, Ling [14 ]
Lu, Fanghong [15 ]
Wu, Xianping [16 ]
Zhao, Liancheng [3 ,4 ]
Li, Ying [3 ,4 ]
Hu, Dongsheng [17 ,18 ]
Huang, Jianfeng [3 ,4 ]
Liu, Yang [19 ]
Gu, Dongfeng [3 ,4 ,7 ]
Liu, Fangchao [1 ,2 ,3 ,4 ]
Lu, Xiangfeng [1 ,2 ,3 ,4 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Key Lab Cardiovasc Epidemiol, Beijing 100037, Peoples R China
[2] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Dept Epidemiol, Beijing 100037, Peoples R China
[3] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Dept Epidemiol, Beijing, Peoples R China
[4] Chinese Acad Med Sci, Key Lab Cardiovasc Epidemiol, Beijing, Peoples R China
[5] Chinese Acad Med Sci, Res Units Cohort Study Cardiovasc Dis & Canc, Beijing, Peoples R China
[6] Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, Shenzhen, Peoples R China
[7] Southern Univ Sci & Technol, Sch Med, Shenzhen, Peoples R China
[8] Zhengzhou Univ, Henan Prov Peoples Hosp, Henan Prov Clin Res Ctr Kidney Dis, Dept Nephrol,Henan Prov Key Lab Kidney Dis & Immu, Zhengzhou, Peoples R China
[9] Zhengzhou Univ, Peoples Hosp, Zhengzhou, Peoples R China
[10] Tianjin Med Univ, Sch Publ Hlth, Dept Occupat & Environm Hlth, Tianjin Key Lab Environm, Tianjin, Peoples R China
[11] Nanjing Med Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Nanjing, Peoples R China
[12] Guangdong Prov Peoples Hosp, Div Epidemiol, Guangzhou, Peoples R China
[13] Cardiovasc Inst, Guangzhou, Peoples R China
[14] Fujian Prov Peoples Hosp, Dept Cardiol, Fuzhou, Peoples R China
[15] Shandong Acad Med Sci, Inst Basic Med, Cardiocerebrovasc Control & Res Ctr, Jinan, Peoples R China
[16] Sichuan Ctr Dis Control & Prevent, Chengdu, Peoples R China
[17] Zhengzhou Univ, Coll Publ Hlth, Dept Epidemiol & Hlth Stat, Zhengzhou, Peoples R China
[18] Shenzhen Univ, Sch Publ Hlth, Dept Biostat & Epidemiol, Hlth Sci Ctr, Shenzhen, Peoples R China
[19] Emory Univ, Rollins Sch Publ Hlth, Gangarosa Dept Environm Hlth, Atlanta, GA USA
基金
美国国家卫生研究院; 中国国家自然科学基金;
关键词
air pollution; genetic association studies; particulate matter; stroke; AMBIENT AIR-POLLUTION; EPIDEMIOLOGY; CHINESE;
D O I
10.1161/STROKEAHA.123.043812
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND:Both genetic factors and environmental air pollution contribute to the risk of stroke. However, it is unknown whether the association between air pollution and stroke risk is influenced by the genetic susceptibilities of stroke and its risk factors.METHODS:This prospective cohort study included 40 827 Chinese adults without stroke history. Satellite-based monthly fine particulate matter (PM2.5) estimation at 1-km resolution was used for exposure assessment. Based on 534 identified genetic variants from genome-wide association studies in East Asians, we constructed 6 polygenic risk scores for stroke and its risk factors, including atrial fibrillation, blood pressure, type 2 diabetes, body mass index, and triglyceride. The Cox proportional hazards model was applied to evaluate the hazard ratios and 95% CIs for the associations of PM2.5 and polygenic risk score with incident stroke and the potential effect modifications.RESULTS:Over a median follow-up of 12.06 years, 3147 incident stroke cases were documented. Compared with the lowest quartile of PM2.5 exposure, the hazard ratio (95% CI) for stroke in the highest quartile group was 2.72 (2.42-3.06). Among individuals at high genetic risk, the relative risk of stroke was 57% (1.57; 1.40-1.76) higher than those at low genetic risk. Although no statistically significant interaction was found, participants with both the highest PM2.5 and high genetic risk showed the highest risk of stroke, with approximate to 4x that of the lowest PM2.5 and low genetic risk group (hazard ratio, 3.55 [95% CI, 2.84-4.44]). Similar upward gradients were observed in the risk of stroke when assessing the joint effects of PM2.5 and genetic risks of blood pressure, type 2 diabetes, body mass index, atrial fibrillation, and triglyceride.CONCLUSIONS:Long-term exposure to PM2.5 was associated with a higher risk of incident stroke across different genetic susceptibilities. Our findings highlighted the great importance of comprehensive assessment of air pollution and genetic risk in the prevention of stroke.
引用
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页码:92 / 100
页数:9
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