Ozone exposure and lung function - Effect modified by obesity and airways hyperresponsiveness in the VA normative aging study
Ozone exposure and lung function - Effect modified by obesity and airways hyperresponsiveness in the VA normative aging study
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DOI：
10.1378/chest.07-1126
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发表时间：
2007-12-01
期刊：
影响因子：
9.6
通讯作者：
Schwartz, Joel
中科院分区：
文献类型：
--
作者：
Alexeeff, Stacey E.;Litonjua, Augusto A.;Schwartz, Joel
背景：臭氧对肺功能具有异质性影响。我们研究了肥胖和气道高反应性 (AHR) 是否会改变臭氧对老年人肺功能的急性影响。方法：我们对来自规范老龄化研究的 904 名老年男性进行了研究，从 1995 年到 2005 年，他们的肺功能（FVC、FEV1）大约每 3 年测量一次。我们将肥胖定义为体重指数至少为 30 kg/m2。使用标准化的乙酰甲胆碱激发试验，我们将 AHR 定义为 FEV，即吸入累积剂量为 0 至 8.58 μmol 的乙酰甲胆碱后下降 20%。连续测量了大波士顿地区的环境臭氧。我们使用混合线性模型估计了影响，并针对已知的混杂因素进行了调整。结果：过去 48 小时内臭氧增加 15 ppb，与非肥胖者 (-0.96%；95% CI，-1.70 至 -0.20%) 相比，肥胖者 (-2.07%；95% 置信区间 [CI]，-3.25 至 -0.89%) 的 FEV1 下降幅度更大。与无 AHR 的患者（-1.32%；95% CI，-2.06 至 -0.57%）相比，相同的暴露也与 AHR 患者的 FEV1 下降幅度更大（-3.07%；95% CI，-4.75 至 -1.36%）相关。三向交互趋势测试证明了这两个风险因素的乘法效应 (p < 0.001)。我们发现 FVC 也有类似的关联。结论：我们的结果表明，肥胖和 AHR 都会改变臭氧对老年人肺功能的急性影响，有证据表明 AHR 和肥胖之间的相互作用会产生大于相加效应。
Background: Ozone has heterogeneous effects on lung function. We investigated whether obesity and airways hyperresponsiveness (AHR) modify the acute effects of ozone on lung function in the elderly. Methods: We studied 904 elderly men from the Normative Aging Study whose lung function (FVC, FEV1) was measured approximately every 3 years from 1995 to 2005. We defined obesity as a body mass index of at least 30 kg/m(2). Using a standardized methacholine challenge test, we defined AHR as a FEV, decline of 20% after inhalation of a cumulative dosage of 0 to 8.58 mu mol of methacholine. Ambient ozone in the Greater Boston area was measured continuously. We estimated effects using mixed linear models, adjusting for known confounders. Results: An increase in ozone of 15 parts per billion during the previous 48 h was associated with a greater decline in FEV1 in the obese (-2.07%; 95% confidence interval [CI], -3.25 to -0.89%) than in the nonobese (-0.96%; 95% CI, -1.70 to - 0.20%). The same exposure was also associated with a greater decline in FEV1 for those with AHR (-3.07%; 95% CI, -4.75 to -1.36%) compared to those without AHR (-1.32%; 95% CI, -2.06 to -0.57%). A three-way interaction trend test demonstrated a multiplicative effect of those two risk factors (p < 0.001). We found similar associations for FVC. Conclusions: Our results indicate that both obesity and AHR modify the acute effect of ozone on lung function in the elderly, with evidence of interaction between AHR and obesity that causes a greater than additive effect.