长期空气污染暴露对体力活动与慢性阻塞性肺病住院之间关系的影响：一项50万中国成年人的前瞻性队列研究

IF 8.1 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-09-01 DOI:10.1016/j.lanwpc.2025.101676

Xi Xia , Cong Liu , Yue Niu , Xia Meng , Neil Wright , Christiana Kartsonaki , Yiping Chen , Ling Yang , Huaidong Du , Canqing Yu , Dianjianyi Sun , Jun Lv , Junshi Chen , Liming Li , Maxim Barnard , Kai Kang , Shaowei Wu , Ka Hung Chan , Kin Bong Hubert Lam , Haidong Kan , Zhengming Chen

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引用次数: 0

摘要

关于长期暴露在环境空气污染中如何改变身体活动对慢性阻塞性肺疾病（COPD）的潜在益处，我们知之甚少。我们的目的是研究环境空气污染和体力活动之间的相互作用与COPD住院风险的关系。方法在一项前瞻性队列研究中，我们从中国10个地区招募了467,944名成年人，在2004-2008年基线时没有肺量测定定义的气流阻塞，我们研究了总身体活动水平（代谢当量任务小时/天；MET-h/d）与COPD住院的暴露-反应关系，分别以长期暴露于环境PM2.5（中位数：58.7 μg/m3）、NO2 （33.3 μg/m3）和O3 （87.8 μg/m3）为分层，使用多变量Cox回归。在467,944名成年人（平均[SD]年龄= 51.8[10.6]岁；280,590名女性，187,354名男性）中，在590万人-年的随访中记录了14,688例COPD事件。在低空气污染环境中，体力活动与COPD呈负相关，而在高空气污染环境中，体力活动与COPD呈弱相关或无相关（均p交互作用<； 0.001）。比较体力活动最高（≥29.8 MET-h/d）和最低四分位数（<10.7 MET-h/d）的参与者，低空气污染暴露者的风险有统计学意义上的18-23%降低，但高空气污染暴露者（PM2.5和NO2）的风险略有显著升高。当以较高的空气污染暴露临界值对参与者进行分层时，效果修正增强。在中国成年人中，长期暴露于环境空气污染与身体活动对慢性阻塞性肺病的潜在益处衰减有关。资助项目：中英奖学金信托基金、中国国家重点研发计划、嘉道理慈善基金会、惠康基金会、非传染性慢性病国家科技重大专项、中国国家自然科学基金、英国医学研究理事会、英国癌症研究所、英国心脏基金会。

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Effect modification of long-term air pollution exposure on the association of physical activity with COPD hospitalization: a prospective cohort study of 0.5 million Chinese adults

Background

Little is known about how long-term ambient air pollution exposure modifies the potential benefits of physical activity against chronic obstructive pulmonary disease (COPD). We aimed to examine the interaction between ambient air pollution and physical activity in relation to risk of COPD hospitalization.

Methods

In a prospective cohort study of 467,944 adults recruited from 10 areas of China and without spirometry-defined airflow obstruction at baseline in 2004–2008, we examined the exposure-response relationships of total physical activity levels (metabolic-equivalent of task-hour/day; MET-h/d) with COPD hospitalization, stratified by long-term exposure to ambient PM_2.5 (median: 58.7 μg/m³), NO₂ (33.3 μg/m³), and O₃ (87.8 μg/m³), respectively, using multivariable Cox regression.

Findings

In 467,944 adults (mean [SD] age = 51.8 [10.6] years; 280,590 females, 187,354 males), 14,688 incidents of COPD were recorded during 5.9 million person-years of follow-up. Physical activity was inversely associated with COPD in participants exposed to low air pollution but showed weak or no association in those exposed to high air pollution (all p-interaction < 0.001). Comparing participants at the highest (≥29.8 MET-h/d) versus lowest quartile (<10.7 MET-h/d) of physical activity, there were 18–23% statistically significant lower risks among those with low air pollution exposure, but marginally significant elevated risks among those with high air pollution exposure (for PM_2.5 and NO₂). The effect modification strengthened when stratifying participants by higher cut-offs of air pollution exposure.

Interpretation

Long-term exposure to ambient air pollution is associated with attenuation of the potential benefits of physical activity against COPD in Chinese adults.

Funding

Sino-British Fellowship Trust, National Key Research and Development Program of China, Kadoorie Charitable Foundation, Wellcome, Noncommunicable Chronic Diseases-National Science and Technology Major Project, National Natural Science Foundation of China, UK Medical Research Council, Cancer Research UK, British Heart Foundation.

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.