大气臭氧暴露与动脉粥样硬化性心血管疾病关联的meta分析

Meta-analysis of association between atmospheric ozone exposure and atherosclerotic cardiovascular disease

  • 摘要:
    背景 动脉粥样硬化性心血管疾病(ASCVD)是心血管疾病负担的重要组成,大气臭氧暴露与ASCVD风险的meta分析证据相对不足。
    目的 探索大气臭氧暴露与ASCVD流行病学的关联,从环境危险因素控制的角度为ASCVD的防控提供部分科学依据。
    方法 检索PubMed、Web of Science、Embase、Cochrane图书馆、中国知网、万方数据库、中国生物医学文献数据库和维普网中公开发表的关于大气臭氧暴露与ASCVD关系的流行病学研究文献,检索时间为2007年1月至2023年12月。对纳入文献进行质量评估和数据提取,并采用meta分析方法探讨大气臭氧短期暴露、长期暴露对不同ASCVD结局的影响,包括缺血性心脏病(IHD)、缺血性脑卒中(IS)的死亡和发病风险。
    结果 根据纳入排除标准,最终纳入24篇文献。meta分析结果显示,大气臭氧短期暴露与ASCVD死亡和发病风险升高相关。包括大气臭氧短期暴露与IHD的死亡风险升高显著相关(RR合并=1.011,95%CI:1.008~1.015,P<0.05),大气臭氧短期暴露与IS的死亡风险升高(RR合并=1.005,95%CI:1.003~1.008)、发病风险升高(RR合并=1.015,95%CI:1.003~1.027)均显著相关(P<0.05)。
    结论 大气臭氧短期暴露显著增加动脉粥样硬化心血管疾病急性风险,但其长期暴露与动脉粥样硬化心血管疾病之间的流行病学关联仍不明确,将来有待于开展高质量的队列研究进一步探讨大气臭氧暴露对心血管健康的慢性风险。

     

    Abstract:
    Background Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to the global burden of cardiovascular diseases. However, evidence from meta-analyses on the association between ambient ozone exposure and ASCVD risk remains relatively insufficient.
    Objective To explore the epidemiological association between ambient ozone exposure and ASCVD, providing scientific evidence for ASCVD prevention and control from the perspective of environmental risk factor management.
    Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, CNKI, Wanfang Database, CBM, and VIP for published epidemiological studies on the relationship between ambient ozone exposure and ASCVD from January 2007 to December 2023. We performed quality assessment and data extraction of the included studies, and utilized meta-analysis to evaluate the effects of short-term and long-term ozone exposure on different ASCVD outcomes, including mortality and incidence of ischemic heart disease (IHD) and ischemic stroke (IS).
    Results A total of 24 studies were included based on a set of predetermined eligibility criteria. The meta-analysis results indicated that short-term ozone exposure was associated with an increased risk of ASCVD mortality and incidence. Specifically, short-term ozone exposure was significantly associated with an elevated risk of IHD mortality (combined RR=1.011, 95%CI: 1.008, 1.015; P < 0.05). Additionally, short-term ozone exposure was significantly linked to increased IS mortality (combined RR=1.005, 95%CI: 1.003, 1.008; P < 0.05) and incidence (combined RR=1.015, 95%CI: 1.003, 1.027; P < 0.05).
    Conclusion Short-term exposure to ambient ozone significantly elevates acute cardiovascular disease risk. However, the epidemiological association between long-term ozone exposure and ASCVD remains inconclusive. Future high-quality cohort studies with refined exposure assessment methods are warranted to elucidate the chronic cardiovascular effects of ozone exposure.

     

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