尽管慢性阻塞性肺疾病(COPD)或缺血性心脏病(IHD)与生活方式因素或空气污染因素(下文称为LAFs)之间的关联已确立,目前尚不清楚LAFs对IHD和COPD多发病轨迹的影响(下文称为ICM).因此,这项研究调查了LAFs对ICM从健康到IHD或COPD的轨迹的影响,ICM,全因死亡。
■一组339,213名来自英国生物银行的37-73岁无IHD和COPD的参与者被纳入。多状态模型用于分析高危因素的影响,包括当前吸烟或因疾病或医生建议而戒烟,目前过度饮酒,缺乏身体活动,不健康的体形,以及ICM轨迹上空气动力学直径≤2.5μm(PM2.5)的颗粒物污染过多。
■在13.74年的中位随访期间,46,398名参与者患有IHD或COPD(以下称为IOC),3949开发的ICM,35,691人死于任何原因。所有五个高风险因素在这些转变中起着至关重要但不同的作用。每个单因素增加的风险比(95%置信区间)为1.29(1.27-1.3),1.38(1.33-1.44),和1.69(1.56-1.84)从基线过渡到国际奥委会,从国际奥委会到ICM,从基线到ICM和1.19(1.17-1.21),1.18(1.15-1.21),从基线到全因死亡的死亡风险为1.12(1.05-1.19),从国际奥委会到全因死亡,从ICM到全因死亡,分别。
■我们的研究表明,与发病结果相比,LAFs对发病结果的影响更大。这些发现为制定管理ICM轨迹的策略提供了证据。
UNASSIGNED: Although associations between chronic obstructive pulmonary disease (COPD) or ischaemic heart disease (IHD) and lifestyle factors or air pollution factors (referred as LAFs below) are well-established, it is unclear the influences of LAFs on the trajectory of IHD and COPD multimorbidity (referred as ICM below). Therefore, this study investigated the influences of LAFs on the trajectory of ICM from healthy to IHD or COPD, to ICM, and to all-cause death.
UNASSIGNED: A cohort of 339,213 participants from the UK Biobank aged 37-73 who were free of IHD and COPD were included. A multi-state model was used to analyse the influences of high-risk factors including current smoking or quitting due to illness or physician\'s advice, current excessive alcohol drinking, physical inactivity, unhealthy body shape, and excessive air pollution with particulates matter with an aerodynamic diameter ≤2.5 μm (PM2.5) on ICM trajectory.
UNASSIGNED: During a median follow-up of 13.74 years, 46,398 participants developed IHD or COPD (referred as IOC below), 3949 developed ICM, and 35,691 died from any cause. All five high-risk factors played crucial but different roles in these transitions. The hazard ratios (95 % confidence intervals) per one-factor increase were 1.29 (1.27-1.3), 1.38 (1.33-1.44), and 1.69 (1.56-1.84) for transitions from baseline to IOC, from IOC to ICM, and from baseline to ICM and 1.19 (1.17-1.21), 1.18 (1.15-1.21), and 1.12 (1.05-1.19) for mortality risk from baseline to all-cause death, from IOC to all-cause death, and from ICM to all-cause death, respectively.
UNASSIGNED: Our study revealed that LAFs have a stronger impact on morbidity outcomes than on morbidity outcomes. These findings provide evidence to develop strategies for managing the trajectory of ICM.