Ultraviolet Radiation Exposure and the Risk of Herpes Zoster in Three Prospective Cohort Studies
Ultraviolet Radiation Exposure and the Risk of Herpes Zoster in Three Prospective Cohort Studies
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DOI：
10.1016/j.mayocp.2019.08.022
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发表时间：
2020-02-01
影响因子：
8.9
通讯作者：
Curhan, Gary C.
中科院分区：
文献类型：
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作者：
Kawai, Kosuke;Trang VoPham;Curhan, Gary C.
目的：在3个前瞻性队列中研究紫外线照射与带状疱疹(HZ)风险的关系。患者和方法：205,756名参与者来自卫生专业人员跟踪研究(HPFS；1986-2008)、护士健康研究(NHS；1996-2012)和护士健康研究II(NHS II；1991-2013)。环境紫外线照射是基于与高分辨率时空紫外线模型相关联的更新的地理编码地址历史。HZ事件病例由临床医生自行诊断确定。使用两年一次的调查问卷评估晒伤病史以及医疗、生活方式和饮食因素。结果：3,626,131人年共发生HZ病例24,201例。暴露在环境中的UVR与男性患HZ的风险更高(HPFS：多变量调整后的风险比[MVHR]，最高与最低五分位数比较，1.14；95%CI，1.02-1.29；P=.03为趋势)，但与女性无关(NHS：MVHR，0.99；95%CI，0.93-1.05；NHS II：MVHR，0.96；95%CI，0.90-1.03)。在所有队列中，一生中严重晒伤的次数越多，患HZ的风险就越高(HPFS：MVHR；=10次晒伤与无晒伤，1.08；95%CI，0.96-1.20；P=0.02；NHS：MVHR，1.14；95%CI，1.05-1.22；P=0.01；NHS II：MVHR，1.13；95%CI，1.00-1.28；P
Objective: To examine the association between ultraviolet radiation (UVR) exposure and the risk of herpes zoster (HZ) in 3 prospective cohorts.Patients and Methods: We included 205,756 participants from the Health Professionals Follow-up Study (HPFS; 1986-2008), Nurses' Health Study (NHS; 1996-2012), and Nurses' Health Study II (NHS II; 1991-2013). Ambient UVR exposure was based on updated geocoded address histories linked with a high-resolution spatiotemporal ultraviolet model. Incident HZ cases were identified by self-reported clinician diagnosis. Sunburn history and medical, lifestyle, and dietary factors were assessed using biennial questionnaires. Multivariable Cox proportional hazards models were used.Results: A total of 24,201 cases of HZ occurred during 3,626,131 person-years. Ambient UVR exposure was associated with a higher risk of HZ in men (HPFS: multivariable-adjusted hazard ratio [MVHR] comparing highest vs lowest quintiles, 1.14; 95% CI, 1.02-1.29; P=.03 for trend) but not in women (NHS: MVHR, 0.99; 95% CI, 0.93-1.05; NHS II: MVHR, 0.96; 95% CI, 0.90-1.03). A higher lifetime number of severe sunburns was associated with a higher risk of HZ in all cohorts (HPFS: MVHR for >= 10 sunburns vs none, 1.08; 95% CI, 0.96-1.20; P=.02 for trend; NHS: MVHR, 1.14; 95% CI, 1.05-1.22; P=.01 for trend; NHS II: MVHR, 1.13; 95% CI, 1.00-1.28; P