Abstract：
OBJECTIVE: Although air pollution (AP) has been associated with stroke and dementia, data regarding its relationship with covert cerebrovascular disease (cCVD) and cognition over time are sparse. The aim of this study was to explore these relationships.
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.
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.
摘要：
目标：尽管空气污染（AP）与中风和痴呆有关，随着时间的推移，关于其与隐性脑血管疾病（cCVD）和认知的关系的数据很少。这项研究的目的是探索这些关系。
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。
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。
