Fine Particulate Matter Exposure, Genetic Susceptibility, and the Risk of Incident Stroke: A Prospective Cohort Study-Reference-Cited by-同舟云学术

Fine Particulate Matter Exposure, Genetic Susceptibility, and the Risk of Incident Stroke: A Prospective Cohort Study

Published:2024-01 Issue:1 Volume:55 Page:92-100
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Huang Keyong¹²,Jia Jiajing¹²,Liang Fengchao³^ORCID,Li Jianxin¹²^ORCID,Niu Xiaoge¹²⁴,Yang Xueli⁵,Chen Shufeng¹²^ORCID,Cao Jie¹²,Shen Chong⁶⁷,Liu Xiaoqing⁸,Yu Ling⁹,Lu Fanghong¹⁰,Wu Xianping¹¹,Zhao Liancheng¹²,Li Ying¹²,Hu Dongsheng¹¹²¹³,Huang Jianfeng¹²,Liu Yang¹⁴^ORCID,Gu Dongfeng²¹⁵^ORCID,Liu Fangchao¹²^ORCID,Lu Xiangfeng¹²^ORCID

Affiliation:

1. Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (K.H., J.J., J.L., X.N., S.C., J.C., L.Z., Y. Li, J.H., D.G., F. Liu, X. Lu).

2. Key Laboratory of Cardiovascular Epidemiology (K.H., J.J., J.L., S.C., J.C., L.Z., Y. Li, J.H., D.G., F. Liu, X. Lu), Chinese Academy of Medical Sciences, Beijing, China.

3. School of Public Health and Emergency Management (F. Liang), Southern University of Science and Technology, Shenzhen, China.

4. Department of Nephrology, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Provincial People’s Hospital and People’s Hospital of Zhengzhou University, China (X.N.).

5. Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, China (X.Y.).

6. Research Units of Cohort Study on Cardiovascular Diseases and Cancers (C.S.), Chinese Academy of Medical Sciences, Beijing, China.

7. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, China (C.S.).

8. Division of Epidemiology, Guangdong Provincial People’s Hospital and Cardiovascular Institute, Guangzhou, China (X. Liu).

9. Department of Cardiology, Fujian Provincial People’s Hospital, Fuzhou, China (L.Y.).

10. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China (F. Lu).

11. Sichuan Center for Disease Control and Prevention, Chengdu, China (X.W.).

12. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, China (D.H.).

13. Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, China (D.H.).

14. Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA (Y. Liu).

15. School of Medicine (D.G), Southern University of Science and Technology, Shenzhen, China.

Abstract

BACKGROUND: Both genetic factors and environmental air pollution contribute to the risk of stroke. However, it is unknown whether the association between air pollution and stroke risk is influenced by the genetic susceptibilities of stroke and its risk factors. METHODS: This prospective cohort study included 40 827 Chinese adults without stroke history. Satellite-based monthly fine particulate matter (PM 2.5 ) estimation at 1-km resolution was used for exposure assessment. Based on 534 identified genetic variants from genome-wide association studies in East Asians, we constructed 6 polygenic risk scores for stroke and its risk factors, including atrial fibrillation, blood pressure, type 2 diabetes, body mass index, and triglyceride. The Cox proportional hazards model was applied to evaluate the hazard ratios and 95% CIs for the associations of PM 2.5 and polygenic risk score with incident stroke and the potential effect modifications. RESULTS: Over a median follow-up of 12.06 years, 3147 incident stroke cases were documented. Compared with the lowest quartile of PM 2.5 exposure, the hazard ratio (95% CI) for stroke in the highest quartile group was 2.72 (2.42–3.06). Among individuals at high genetic risk, the relative risk of stroke was 57% (1.57; 1.40–1.76) higher than those at low genetic risk. Although no statistically significant interaction was found, participants with both the highest PM 2.5 and high genetic risk showed the highest risk of stroke, with ≈4× that of the lowest PM 2.5 and low genetic risk group (hazard ratio, 3.55 [95% CI, 2.84–4.44]). Similar upward gradients were observed in the risk of stroke when assessing the joint effects of PM 2.5 and genetic risks of blood pressure, type 2 diabetes, body mass index, atrial fibrillation, and triglyceride. CONCLUSIONS: Long-term exposure to PM 2.5 was associated with a higher risk of incident stroke across different genetic susceptibilities. Our findings highlighted the great importance of comprehensive assessment of air pollution and genetic risk in the prevention of stroke.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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