METHODS: A prospective population-based study of 976 stroke-free and non-demented individuals living in Barcelona, Spain, was conducted during 2010-2016. A land use regression model was used to estimate the exposure of each participant to AP: NOx, NO2, PM2.5, PM10, PMcoarse and PM2.5 absorbance. Cognitive function and cCVD were assessed at baseline (n = 976) and 4 years after (n = 317). Multivariate-adjusted models were developed.
RESULTS: At baseline, 99 participants (10.1%) had covert brain infarcts and 91 (9.3%) had extensive periventricular white matter hyperintensities (WMHs). Marked subcortical WMH progression was seen in 19.7%; the incidence of other covert cerebrovascular lessons ranged between 5% and 6% each. PM2.5 was related to higher odds of having a covert brain infarct (odds ratio [OR] 2.21; 95% confidence interval [CI] 1.06-4.60). PM2.5 absorbance was related to higher odds of having extensive subcortical WMHs (OR 1.72; 95% CI 1.13-2.60), whereas NO2 was related to higher odds of having extensive subcortical (OR 1.66; 95% CI 1.17-2.35) or periventricular (OR 1.96; 95% CI 1.10-3.50) WMHs and to higher odds of developing marked subcortical WMH progression (OR 1.40; 95% CI 1.05-1.90). NOx was related to incident cerebral microbleeds (OR 1.36; 95% CI 1.04-1.79). There was no association between AP and cognition.
CONCLUSIONS: Air pollutant predicts the presence and accumulation of cCVD. Its impact on cognitive impairment remains to be determined.
方法:一项针对居住在巴塞罗那的976名无卒中和非痴呆个体的前瞻性人群研究,西班牙,在2010-2016年期间进行。土地利用回归模型用于估计每个参与者对AP:NOx的暴露,NO2、PM2.5、PM10、PM粗粒和PM2.5的吸光度。在基线(n=976)和4年后(n=317)评估认知功能和cCVD。建立了多变量调整模型。
结果:在基线时,99名参与者(10.1%)患有隐性脑梗塞,91名(9.3%)患有广泛的脑室周围白质高信号(WMHs)。19.7%的皮质下WMH明显进展;其他隐性脑血管课程的发生率分别在5%至6%之间。PM2.5与隐性脑梗塞的几率较高相关(比值比[OR]2.21;95%置信区间[CI]1.06-4.60)。PM2.5吸光度与具有广泛皮质下WMHs的较高几率相关(OR1.72;95%CI1.13-2.60),而NO2与出现广泛皮质下(OR1.66;95%CI1.17-2.35)或脑室周围(OR1.96;95%CI1.10-3.50)WMHs的几率较高,并且与出现明显皮质下WMH进展的几率较高(OR1.40;95%CI1.05-1.90)相关.NOx与脑微出血相关(OR1.36;95%CI1.04-1.79)。AP与认知之间无关联。
结论:空气污染物可预测cCVD的存在和积累。其对认知障碍的影响尚待确定。