Associations of risk factor burden and genetic predisposition with the 10-year risk of atrial fibrillation: observations from a large prospective study of 348,904 participants

BackgroundUnderstanding the effects of risk factor burden and genetic predisposition on the long-term risk of atrial fibrillation (AF) is important to improve public health initiatives. However, the 10-year risk of AF considering risk factor burden and genetic predisposition is unknown.MethodsA total of 348,904 genetically unrelated participants without AF at baseline from the UK were categorized into three groups: index ages 45 years (n = 84,206), 55 years (n=117,520), and 65 years (n=147,178). Optimal, borderline, or elevated risk factor burden was determined by body mass index, blood pressure, diabetes mellitus, alcohol consumption, smoking status, and history of myocardial infarction or heart failure. Genetic predisposition was estimated using the polygenic risk score (PRS), constructed using 165 predefined genetic risk variants. The combined effects of risk factor burden and PRS on the risk of incident AF in 10 years were estimated for each index age. Fine and Gray models were developed to predict the 10-year risk of AF.ResultsThe overall 10-year risk of AF was 0.67% (95% CI: 0.61-0.73%) for index age 45 years, 2.05% (95% CI: 1.96-2.13%) for index age 55 years, and 6.34% (95% CI: 6.21-6.46%) for index age 65 years, respectively. An optimal risk factor burden was associated with later AF onset regardless of genetic predisposition and sex (P ConclusionsRisk factor burden together with a genetic predisposition is associated with the 10-year risk of AF. Our results may be helpful in selecting high-risk individuals for primary prevention of AF and facilitating subsequent health interventions

Interaction effects of polyfluoroalkyl substances and sex steroid hormones on asthma among children

To evaluate the interactions between polyfluoroalkyl substances (PFASs) and reproductive hormones and associated asthma, a total of 231 asthmatic and 225 non-asthmatic adolescents were selected from northern Taiwan in the Genetic and Biomarkers study for Childhood Asthma from 2009-2010. The interaction between PFASs and reproductive hormones on asthma was analyzed with a two-level binary logistic regression model. The results showed that, among asthmatics, PFASs were positively associated with estradiol levels and negatively associated with testosterone levels. However, only significant association was identified for PFNA and estradiol in control group. After controlling for hormone levels, associations between PFAS exposure and asthma were consistently stronger among children with higher than lower estradiol, with odds ratios (OR) for asthma ranging from 1.25 for PFOS (95% Confidence Interval [CI]: 0.90, 1.72) to 4.01 for PFDA (95% CI: 1.46, 11.06) among boys and 1.25 for PFOS (95% CI: 0.84, 1.86) to 4.16 for PFNA (95% CI: 1.36, 12.73) among girls. Notably, the interactions between estradiol and PFASs were significant for PFOS (p = 0.026) and PFNA (p = 0.043) among girls. However, testosterone significantly attenuated the association between PFOS and asthma across sex. In conclusions, our findings suggested that reproductive hormones amplify the association between PFASs and asthma among adolescents

Potential gains in life expectancy by attaining daily ambient fine particulate matter pollution standards in mainland China: A modeling study based on nationwide data.

BACKGROUND:Ambient fine particulate matter pollution (PM2.5) is one leading cause of disease burden, but no study has quantified the association between daily PM2.5 exposure and life expectancy. We aimed to assess the potential benefits in life expectancy by attaining the daily PM2.5 standards in 72 cities of China during 2013-2016. METHODS AND FINDINGS:We applied a two-stage approach for the analysis. At the first stage, we used a generalized additive model (GAM) with a Gaussian link to examine the city-specific short-term association between daily PM2.5 and years of life lost (YLL); at the second stage, a random-effects meta-analysis was used to generate the regional and national estimations. We further estimated the potential gains in life expectancy (PGLE) by assuming that ambient PM2.5 has met the Chinese National Ambient Air Quality Standard (NAAQS, 75 μg/m3) or the ambient air quality guideline (AQG) of the World Health Organization (WHO) (25 μg/m3). We also calculated the attributable fraction (AF), which denoted the proportion of YLL attributable to a higher-than-standards daily mean PM2.5 concentration. During the period from January 18, 2013 to December 31, 2016, we recorded 1,226,849 nonaccidental deaths in the study area. We observed significant associations between daily PM2.5 and YLL: each 10 μg/m3 increase in three-day-averaged (lag02) PM2.5 concentrations corresponded to an increment of 0.43 years of life lost (95% CI: 0.29-0.57). We estimated that 168,065.18 (95% CI: 114,144.91-221,985.45) and 68,684.95 (95% CI: 46,648.79-90,721.11) years of life lost can be avoided by achieving WHO's AQG and Chinese NAAQS in the study area, which corresponded to 0.14 (95% CI: 0.09-0.18) and 0.06 (95% CI: 0.04-0.07) years of gain in life expectancy for each death in these cities. We observed differential regional estimates across the 7 regions, with the highest gains in the Northwest region (0.28 years of gain [95% CI: 0.06-0.49]) and the lowest in the North region (0.08 [95% CI: 0.02-0.15]). Furthermore, using WHO's AQG and Chinese NAAQS as the references, we estimated that 1.00% (95% CI: 0.68%-1.32%) and 0.41% (95% CI: 0.28%-0.54%) of YLL could be attributable to the PM2.5 exposure at the national level. Findings from this study were mainly limited by the unavailability of data on individual PM2.5 exposure. CONCLUSIONS:This study indicates that significantly longer life expectancy could be achieved by a reduction in the ambient PM2.5 concentrations. It also highlights the need to formulate a stricter ambient PM2.5 standard at both national and regional levels of China to protect the population's health

Housing characteristics, home environmental factors, and pulmonary function deficit in Chinese children: Results from the Seven Northeast Cities (SNEC) Study

To assess the effects of housing characteristics and home environmental factors on lung function of Chinese children, 6740 children (aged 6–16 years) were recruited from seven cities in Northeast China in 2012. Performance of lung function was determined by comparison of forced vital capacity (FVC), forced expiratory volume (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF). Multivariate regression models were used to evaluate the associations with lung function deficit. The results showed that housing conditions were associated with lung function deficit in children. The adjusted odds ratios were 0.47 (95% CI: 0.26–0.83) for FVC for “ping-fang” housing compared with “dan-yuan-lou-fang” housing and 2.90 (95% CI: 2.43–3.47) for FEV1 with home renovations completed within two years compared with counterparts. The linear regression models consistently showed a significant association of housing conditions and home environmental factors with lung function measurements across subjects. A residence taller than seven stories was negatively associated with FEV1 (β = −55; 95% CI: −97 to −13). In conclusion, housing conditions and home environmental factors are particularly important to the development of lung function and respiratory health in children. These factors are concerning and action should be taken to improve them

The associations of glycosylated hemoglobin with grey matter volume and depression: Investigating mediating role of grey matter volume

Background: Depression has caused enormous health burden to human worldwide. Glycemia has been found as one important risk factor of depression. However, the biological mechanism underlying this relationship remained largely unknown. Methods: This analysis was derived from a cohort of 33,151 participants in the UK Biobank who provided brain magnetic resonance imaging data from 2014 to 2020. Participants were classified into diabetic, prediabetic and non-diabetic groups, as well as groups aged ≥60 years and <60 years. We assessed the associations between glycosylated hemoglobin (HbA1c), grey matter volume (GMV) in 117 brain regions, and depression based on the multivariable linear and logistic regression. We further investigated the mediation effect of GMV on the relationship between HbA1c and depression. Results: Higher HbA1c was found to be associated with reduced GMV and depression. Lower GMV was observed associated with depression. Moreover, the association was strongest in prediabetes compared to prediabetic and non-diabetic, and the association was greater in those aged ≥60 years. We further observed a significant mediation effect of GMV on the association between HbA1c and depression, and the proportions of the effect mediated by HbA1c-depression signatured regions was 7.29% (95% CI: 1.43%, 34.38%). Conclusions: This study suggests that HbA1c is associated with cerebral grey matter abnormality especially in participants aged ≥60 years. In the context of global aging, the unhealthy blood sugar can contribute to more severe brain damage for the population and effective control of blood sugar levels among the elderly can have a positive impact on brain health and potentially reduce the risk of developing depression

Association of perfluoroalkyl substances exposure with reproductive hormone levels in adolescents: By sex status

Polyfluoroalkyl substances (PFASs) are a group of common\ud chemicals that ubiquitously exist in wildlife and humans. However, few studies have researched the effect of PFASs on reproductive hormones in adolescents. To provide information in this regard, we recruited 225 Taiwanese adolescents aged 13-15 years from 2009 to 2010 to investigate the relationship between serum PFASs (PFOS, PFOA, PFBS, PFDA, PFDoA, PFHxA, PFHxS, PFNA and PFTA) and reproductive hormone concentrations using a cross-sectional study design. Results showed PFOS and PFTA levels were highest among the PFASs, with a median concentrations of 29.9 (interquartile range: 13.0-43.8) ng/mL and 6.0 (0.6-25.9) ng/mL in males, and a median concentrations of 28.8 (14.8-42.6) ng/mL and 4.5 (0.3-18.4) ng/mL in \ud females. After adjustment for confounding factors, nonsignificant associations between PFASs and reproductive hormone were found except for PFNA with ln(estradiol) (β=0.2060, 95%CI: 0.0016, 0.4105). When stratified by sex, more significant associations were found in males than in females. Among males, PFASs were negatively associated with ln(testosterone) level for PFOS (β=-0.0029, 95%CI: -0.0055, - 0.0003), PFDA (β=-0.2565, 95%CI: -0.4135,-0.0994), PFHxA (β=-0.3095, 95%CI: -0.5942,-0.0248), and PFNA (β=-0.4233, 95%CI:-0.6998, -0.1467).\ud Furthermore, male participant ln(estradiol) levels were positively associated with PFOA (β=0.0921, 95%CI: 0.0186, 0.1656), and PFHxS (β=0.0462, 95%CI: 0.0020, 0.0905). Among females, a significant relationship was found only for PFDoA with ln(testosterone)(β=-0.0119, 95%CI: -0.0227, -0.0010). In conclusion, this study showed higher levels of PFASs coincide with lower testosterone and higher estradiol levels, and more significant associations of PFASs with reproductive hormone were found in males than in females

Association of Indoor and Outdoor Air Pollution With Hand-Grip Strength Among Adults in Six Low- and Middle-Income Countries

BACKGROUND: Air pollution has been associated with various health outcomes. Its effect on hand-grip strength, a measurement of the construct of muscle strength and health status, remains largely unknown. METHODS: We used the survey data from 31,209 adults ≥ 50 years of age within Wave 1 of the Study on Global AGEing and Adult Health in six low- and middle-income countries. The outdoor concentration of fine particulate matter pollution (PM2.5) was estimated using satellite data. Domestic fuel type and ventilation were used as indicators of indoor air pollution. We used multilevel linear regression models to examine the association between indoor and outdoor air pollution and hand-grip strength, as well as the potential effect modifiers. RESULTS: We found inverse associations between both indoor and outdoor air pollution and hand-grip strength. Each 10 μg/m3 increase in 3 years' averaged concentrations of outdoor PM2.5 corresponded to 0.70 kg (95% CI: -1.26, -0.14) lower hand-grip strength; and compared with electricity/liquid/gas fuel users, those using solid fuels had lower hand-grip strength (β = -1.25, 95% CI: -1.74, -0.75). However, we did not observe a statistically significant association between ventilation and hand-grip strength. We further observed that urban residents and those having a higher education level had a higher association between ambient PM2.5 and hand-grip strength, and men, young participants, smokers, rural participants, and those with lower household income had higher associations between indoor air pollution and hand-grip strength. CONCLUSION: This study suggests that both indoor and outdoor air pollution might be important risk factors of poorer health and functional status as indicated by hand-grip strength

Overweight modifies the association between long-term ambient air pollution and prehypertension in Chinese adults: the 33 Communities Chinese Health Study

Abstract Background Research regarding the interaction of ambient air pollution and overweight on prehypertension is scarce. We aimed to test whether overweight modifies the association between long-term exposure to ambient air pollution and prehypertension in Chinese adults. Methods A total of 16,188 Chinese adults, aged 18–74 years old, from 33 communities in 3 Northeastern Chinese cities were evaluated. Three-year average levels of particles with an aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxides (SO2), nitrogen dioxides (NO2), and ozone (O3) were calculated at monitoring stations. Generalized additive models and 2-level regression analyses were applied. Results We observed significant interactions between air pollutants and overweight on prehypertension and blood pressure. The associations of PM10, SO2, NO2, and O3 with prehypertension were significant among overweight participants (Prevalence Rate Ratios (PRRs) per interquartile range (IQR) of air pollutants: 1.14–1.20), but not among normal weight participants (PRRs: 0.98–1.04). PM10, SO2, and O3 were significantly associated with systolic blood pressure (SBP), and the magnitudes of these associations were higher among overweight adults (increases in SBP per IQR of air pollutants: 1.82–4.53 mmHg) than those among normal weight adults (increases in SBP: 0.42–0.61 mmHg). For diastolic blood pressure (DBP), significant associations were mainly observed in overweight participants (increases in DBP: 0.80–1.63 mmHg). Further stratified analyses showed that all these interactions were stronger in women, the older, and participants living in areas with lower income levels or higher population density. Conclusions Being overweight may enhance the effects of ambient air pollution on prehypertension and blood pressure in Chinese adults

Exposure to ambient particulate matter and hyperuricemia: An eight-year prospective cohort study on male traffic officers in China

Background and objectives: Studies on the effects of airborne particulates of diameter ≤ 1 µm (PM1), airborne particulates of diameter ≤ 2.5 µm (PM2.5) and airborne particulates of diameter ranges from 1 to 2.5 µm (PM1–2.5) on incidence of hyperuricemia are limited. We aimed to investigate the associations between PM1, PM2.5, and PM1–2.5 and hyperuricemia among male traffic officers. Methods: We conducted a prospective cohort study of 1460 traffic officers without hyperuricemia in Guangzhou, China from 2009 to 2016. Exposures of PM1 and PM2.5 were estimated with a spatiotemporal model. PM1–2.5 concentrations were calculated by subtracting PM1 from PM2.5 concentrations. Cox's proportional hazards regressions models were used to examine the association between PM1, PM2.5, and PM1–2.5 and hyperuricemia, adjusted for potential confounders. Associations between PM1, PM2.5, and PM1–2.5 and serum uric acid (SUA) levels were evaluated with multiple linear regression models. Results: Hazard ratios (HRs) and 95% confidence intervals (CIs) of hyperuricemia associated with 10 μg/m3 increment in PM1, PM2.5, and PM1–2.5 were 1.67 (95% CI:1.30–2.36), 1.49 (95% CI: 1.27–1.75), and 2.18 (95% CI: 1.58–3.02), respectively. The SUA concentrations increased by 12.23 μmol/L (95% CI: 5.91–18.56), 6.93 μmol/L (95% CI: 3.02–10.84), and 8.72 μmol/L (95% CI: 0.76–16.68) per 10 μg/m3 increase in PM1, PM2.5, and PM1–2.5, respectively. Stratified analyses indicated the positive associations of PM2.5 and PM1–2.5 with SUA levels were stronger in non-smokers, and PM1, PM2.5, and PM1–2.5 with SUA levels were stronger in non-drinkers. Conclusion: Long-term PM1, PM2.5, and PM1–2.5 exposures may increase the risk of hyperuricemia and elevate SUA levels among male traffic officers, especially in non-smokers and non-drinkers