Ambient particulate matter air pollution and venous thromboembolism in the Women's Health Initiative Hormone Therapy trials.
Ambient particulate matter air pollution and venous thromboembolism in the Women's Health Initiative Hormone Therapy trials.
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DOI：
10.1289/ehp.1002256
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发表时间：
2011-03
影响因子：
10.4
通讯作者：
Whitsel EA
中科院分区：
文献类型：
--
作者：
Shih RA;Griffin BA;Salkowski N;Jewell A;Eibner C;Bird CE;Liao D;Cushman M;Margolis HG;Eaton CB;Whitsel EA
绝经后激素治疗对颗粒物（PM）空气污染和静脉血栓栓塞症（VTE）之间的关联的假定影响尚未在激素治疗的随机试验中进行评估，尽管其在绝经后妇女中广泛使用。在这项研究中，我们检查了激素治疗是否改变了PM与VTE风险的关联。年龄在50-79岁之间的绝经后妇女（n = 26，450），没有VTE病史，也没有服用抗凝剂，在美国40个地理位置不同的临床中心参加了妇女健康倡议激素治疗试验。这些妇女被随机分为雌激素组和安慰剂组（E试验），或雌激素加雷公藤红素组和安慰剂组（E + P试验）。我们使用年龄分层的考克斯比例风险模型来检查事件发生时间、中心裁定的VTE和参与者地理编码地址空间内插的每日平均PM浓度之间的关联，并在1、7、30和365天内取平均值。在随访期间（平均7.7年），508名参与者（2.0%）发生了VTE，发生率为2.6起事件/1,000人-年。未校正和协变量校正的VTE风险与空气动力学直径< 2.5 μm（PM2.5）或< 10 μm（PM10）的PM浓度无关，PM ×活性治疗相互作用无统计学显著性（p > 0.05），无论PM平均期如何，在合并两项试验的数据之前或之后[例如，PM2.5和PM10年平均值每增加10 μg/m3，合并试验调整的风险比（95%置信区间）分别为0.93（0.54-1.60）和1.05（0.72-1.53）。结果对其他暴露指标、结局定义、时间尺度、分析方法和删失日期不敏感。与先前的研究相反，我们的研究结果几乎没有提供证据表明短期或长期PM暴露与VTE之间存在关联，或绝经后妇女随机暴露于外源性雌激素引起临床重要改变。
The putative effects of postmenopausal hormone therapy on the association between particulate matter (PM) air pollution and venous thromboembolism (VTE) have not been assessed in a randomized trial of hormone therapy, despite its widespread use among postmenopausal women. In this study, we examined whether hormone therapy modifies the association of PM with VTE risk. Postmenopausal women 50–79 years of age (n = 26,450) who did not have a history of VTE and who were not taking anticoagulants were enrolled in the Women’s Health Initiative Hormone Therapy trials at 40 geographically diverse U.S. clinical centers. The women were randomized to treatment with estrogen versus placebo (E trial) or to estrogen plus progestin versus placebo (E + P trial). We used age-stratified Cox proportional hazard models to examine the association between time to incident, centrally adjudicated VTE, and daily mean PM concentrations spatially interpolated at geocoded addresses of the participants and averaged over 1, 7, 30, and 365 days. During the follow-up period (mean, 7.7 years), 508 participants (2.0%) had VTEs at a rate of 2.6 events per 1,000 person-years. Unadjusted and covariate-adjusted VTE risk was not associated with concentrations of PM < 2.5 μm (PM2.5) or < 10 μm (PM10)] in aerodynamic diameter and PM × active treatment interactions were not statistically significant (p > 0.05) regardless of PM averaging period, either before or after combining data from both trials [e.g., combined trial-adjusted hazard ratios (95% confidence intervals) per 10 μg/m3 increase in annual mean PM2.5 and PM10, were 0.93 (0.54–1.60) and 1.05 (0.72–1.53), respectively]. Findings were insensitive to alternative exposure metrics, outcome definitions, time scales, analytic methods, and censoring dates. In contrast to prior research, our findings provide little evidence of an association between short-term or long-term PM exposure and VTE, or clinically important modification by randomized exposure to exogenous estrogens among postmenopausal women.
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影响因子：
10.4
作者：
Dales, R. E.;Cakmak, S.;Vidal, C. B.
通讯作者：
Vidal, C. B.
影响因子：
5
作者：
Giugliano, M;Lonati, G;Grosso, M
通讯作者：
Grosso, M
DOI：
10.1097/ede.0b013e31819644cc
发表时间：
2009-03
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Allen RW;Criqui MH;Diez Roux AV;Allison M;Shea S;Detrano R;Sheppard L;Wong ND;Stukovsky KH;Kaufman JD
通讯作者：
Kaufman JD
影响因子：
10.4
作者：
Liao D;Peuquet DJ;Duan Y;Whitsel EA;Dou J;Smith RL;Lin HM;Chen JC;Heiss G
通讯作者：
Heiss G
DOI：
10.1038/sj.jea.7500408
发表时间：
2005-07-01
期刊：
JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY
影响因子：
--
作者：
Liao, DP;Heiss, G;Salomaa, V
通讯作者：
Salomaa, V