背景:心血管,呼吸,神经系统疾病的发病率和死亡率都很高,但是空气污染和这些疾病之间的因果关系仍然存在争议。
方法:我们使用孟德尔随机化(MR)进行了大规模的全基因组关联(GWAS)研究,以调查诸如二氧化氮(NO2)之类的空气污染之间的关联。氮氧化物(NOX),直径<2.5μm的颗粒物(PM2.5),直径<10μm的颗粒物(PM10)和心血管,呼吸,神经系统疾病,包括急性心肌梗塞,心力衰竭,哮喘,慢性阻塞性肺疾病(COPD),肺炎,中风和帕金森病。这项研究包括337199例急性心肌梗死患者,178,726例心力衰竭患者,463,010名哮喘患者,462,933例COPD患者,486,484例肺炎患者,484,598例中风患者,和482,730名帕金森病患者。所有的遗传工具都是从GWAS鉴定的。使用MR分析研究了环境污染与这些疾病的关联效应,具有异质性的敏感性分析,多效性测试,和离开一次测试。
结果:我们的MR分析显示NOX与COPD和卒中的发展之间存在关联(赔率比(OR)=1.010,95%置信区间(CI):1.000〜1.020,P=0.046;OR=1.017,95CI:1.003-1.031,P=0.019),PM2.5与哮喘发病之间的关系,COPD与卒中(OR=1.013,95CI:1.003~1.024,P=0.011;OR=1.010,95CI:1.000~1.019,P=0.035;OR=1.019,95CI:1.004~1.033,P=0.012)。在其他空气污染暴露与疾病之间没有发现显着关联。留一法敏感性分析显示结果稳定。
结论:这项研究阐明了空气污染与心血管疾病之间的关系,呼吸,神经系统疾病,为环境污染防治和人口健康监测提供有价值的证据,并为后续调查空气污染与疾病之间的关联提供了明确的方向和证据。
BACKGROUND: Cardiovascular, respiratory, and nervous system diseases have high morbidity and mortality rates, but the causal relationship between air pollution and these diseases remains controversial.
METHODS: We conducted a large-scale genome-wide association (GWAS) study using Mendelian randomization (MR) to investigate the association between air pollution like Nitrogen dioxide (NO2), Nitrogen oxides (NOX), Particulate matter with diameter<2.5μm (PM2.5), Particulate matter with diameter<10μm (PM10) and cardiovascular, respiratory, and nervous system diseases, including acute myocardial infarction, heart failure, asthma, chronic obstructive pulmonary disease (COPD), pneumonia, stroke and Parkinson\'s disease. This study included 337,199 patients with acute myocardial infarction, 178,726 patients with heart failure, 463,010 patients with asthma, 462,933 patients with COPD, 486,484 patients with pneumonia, 484,598 patients with stroke, and 482,730 patients with Parkinson\'s disease. All genetic tools were identified from GWAS. The association effects of environmental pollution and these diseases were investigated using MR analysis, sensitivity analysis with heterogeneity, pleiotropy test, and leave-one-out test.
RESULTS: Our MR analysis showed the association between NOX and the development of COPD and stroke (Odds ratio (OR)=1.010, 95 % Confidence interval (CI): 1.000~1.020, P=0.046; OR=1.017, 95 %CI:1.003-1.031, P=0.019), the association between PM2.5 and the development of asthma, COPD and stroke (OR=1.013, 95 %CI:1.003-1.024, P=0.011; OR=1.010, 95 %CI:1.000-1.019, P=0.035; OR=1.019, 95 %CI:1.004-1.033, P=0.012). No significant associations were found between the rest of the air pollution exposures and diseases. Leave-one-out sensitivity analysis showed stable results.
CONCLUSIONS: The study clarifies the relationship between air pollution and cardiovascular, respiratory, and nervous system diseases, providing valuable evidence for environmental pollution prevention and population health monitoring, and provides a clear direction and evidence for the subsequent investigation of the association between air pollution and diseases.