Occupational and environmental exposures in the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study.
Occupational and environmental exposures in the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study.
复制标题
Alpha-1 抗胰蛋白酶缺乏症和结节病基因组研究 (GRADS) 研究中的职业和环境暴露。
DOI：
10.1016/j.rmed.2022.106923
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发表时间：
2022
影响因子：
4.3
通讯作者：
Gulati,Mridu
中科院分区：
文献类型：
--
作者：
Ryan,SarahM;Mroz,MargaretM;Herzog,EricaL;Ryu,Changwan;Fingerlin,TashaE;Maier,LisaA;Gulati,Mridu
简介结节病是一种肉芽肿性疾病，被认为是由遗传易感个体的暴露引起的。本研究调查了特定暴露是否与不同的结节病表型相关。方法对参加 NHLBI 基因组研究 Alpha-1 抗胰蛋白酶缺乏和结节病 (GRADS) 研究的受试者进行了广泛的人口、职业和环境暴露数据进行分析。结果在结节病患者中，与非心脏结节病相比，辐射暴露与心脏结节病风险增加显着相关。没有暴露与仅肺部疾病与伴或不伴肺部受累的肺外疾病、Scadding II/III/IV 期与 Scadding 0/I 期、急性或缓解性疾病与非急性或非缓解性疾病、慢性与非慢性疾病显着相关。尽管在调整多重比较后未达到统计学显着性，但存在许多与特定疾病表型相关的暴露，包括以前描述过的与结节病关系的暴露，例如农村暴露和农药暴露。结论辐射暴露可能是心脏结节病的危险因素。其他暴露也可能与特定表型相关，应进一步探讨。该研究受到小群体暴露受试者的个体暴露和多重比较的限制。需要开发新颖和创新的暴露评估工具。
IntroductionSarcoidosis is a granulomatous disorder thought to be caused by exposures in genetically susceptible individuals. This study investigated whether specific exposures were associated with different sarcoidosis phenotypes.MethodsExtensive demographic, occupational and environmental exposure data was analyzed from subjects enrolled in the NHLBI Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study.ResultsIn patients with sarcoidosis, radiation exposure was significantly associated with an increased risk of cardiac sarcoidosis versus non-cardiac sarcoidosis. No exposures were significantly associated with pulmonary only disease versus extrapulmonary disease with or without pulmonary involvement, Scadding Stage II/III/IV versus Scadding Stage 0/I, acute or remitting disease versus non-acute or non-remitting disease, nor chronic versus non-chronic disease. Although not reaching statistically significance after adjustment for multiple comparisons, there were a number of exposures associated with specific disease phenotypes, including exposures where relationships to sarcoidosis have previously been described such as rural exposures and pesticide exposures.ConclusionsRadiation exposure may be a risk factor for cardiac sarcoidosis. Other exposures may also be associated with specific phenotypes and should be further explored. The study was limited by small groups of exposed subjects for individual exposures and multiple comparisons. The development of novel and innovative exposure assessment tools is needed.