■先前的观察性研究表明,心血管疾病(CVD)的患病率与颗粒物(PM)有关。然而,鉴于传统观测研究的方法论局限性,很难确定因果关系。探讨PM对心血管疾病和心血管生物标志物的因果关系,我们进行了孟德尔随机化(MR)分析.
■在这项研究中,我们获得了心血管疾病和心血管生物标志物的汇总数据,包括心房颤动(AF),心力衰竭(HF),心肌梗死(MI),缺血性卒中(IS),中风亚型,体重指数(BMI),脂质性状,空腹血糖,空腹胰岛素,和血压来自几个大型全基因组关联研究(GWAS)。然后我们使用双样本MR来评估PM对CVD和心血管生物标志物的因果关系,从UKBiobank参与者获得了PM2.5的16个单核苷酸多态性(SNP)和PM10的6个SNP。固定效应模型下的逆方差加权(IVW)分析被用作计算MR估计值的主要分析方法,然后进行多重敏感性分析,以确认结果的稳健性。
■我们的研究表明,PM2.5浓度的增加与更高的MI风险显着相关(优势比(OR),2.578;95%置信区间(CI),1.611-4.127;p=7.920×10-5)。在PM10浓度和HF(OR,2.015;95%CI,1.082-3.753;p=0.027)和IS(OR,2.279;95%CI,1.099-4.723;p=0.027)。没有证据表明PM浓度对其他CVD有影响。此外,PM2.5浓度升高与甘油三酯(TG)升高显著相关(OR,1.426;95%CI,1.133-1.795;p=2.469×10-3),高密度脂蛋白胆固醇(HDL-C)降低(OR,0.779;95%CI,0.615-0.986;p=0.038)。PM10浓度的增加也与HDL-C的降低密切相关(OR,0.563;95%CI,0.366-0.865;p=8.756×10-3)。我们没有观察到PM对其他心血管生物标志物的因果效应。
■在遗传水平上,我们的研究表明PM2.5对MI的因果关系,TG,以及HDL-C,并揭示了PM10对HF的因果关系,IS,和HDL-C我们的研究结果表明,有必要继续改善减少空气污染以预防CVD。
Previous observational studies have shown that the prevalence of cardiovascular diseases (CVDs) is related to particulate matter (PM). However, given the methodological limitations of conventional observational research, it is difficult to identify causality conclusively. To explore the causality of PM on CVDs and cardiovascular biomarkers, we conducted a Mendelian randomization (MR) analysis.
In this study, we obtained summary-level data for CVDs and cardiovascular biomarkers including atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), stroke subtypes, body mass index (BMI), lipid traits, fasting glucose, fasting insulin, and blood pressure from several large genome-wide association studies (GWASs). Then we used two-sample MR to assess the causality of PM on CVDs and cardiovascular biomarkers, 16 single nucleotide polymorphisms (SNPs) for PM2.5 and 6 SNPs for PM10 were obtained from UK Biobank participants. Inverse variance weighting (IVW) analyses under the fixed effects model were used as the main analytical method to calculate MR Estimates, followed by multiple sensitivity analyses to confirm the robustness of the results.
Our study revealed increases in PM2.5 concentration were significantly related to a higher risk of MI (odds ratio (OR), 2.578; 95% confidence interval (CI), 1.611-4.127; p = 7.920 × 10-5). Suggestive evidence was found between PM10 concentration and HF (OR, 2.015; 95% CI, 1.082-3.753; p = 0.027) and IS (OR, 2.279; 95% CI,1.099-4.723; p = 0.027). There was no evidence for an effect of PM concentration on other CVDs. Furthermore, PM2.5 concentration increases were significantly associated with increases in triglyceride (TG) (OR, 1.426; 95% CI, 1.133-1.795; p = 2.469 × 10-3) and decreases in high-density lipoprotein cholesterol (HDL-C) (OR, 0.779; 95% CI, 0.615-0.986; p = 0.038). The PM10 concentration increases were also closely related to the decreases in HDL-C (OR, 0.563; 95% CI, 0.366-0.865; p = 8.756 × 10-3). We observed no causal effect of PM on other cardiovascular biomarkers.
At the genetic level, our study suggested the causality of PM2.5 on MI, TG, as well HDL-C, and revealed the causality of PM10 on HF, IS, and HDL-C. Our findings indicated the need for continued improvements in air pollution abatement for CVDs prevention.