子宫内、童年和青少年时期的烟草烟雾暴露、体力活动和成年后的慢性肾病发病率：一项大型前瞻性队列研究的证据。

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2024-11-11 DOI:10.1186/s12916-024-03745-w

Bingxin Shang, Yuxin Yao, Haoyu Yin, Yujia Xie, Shiyu Yang, Xiaojie You, Haoxiang Liu, Miao Wang, Jixuan Ma

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引用次数: 0

摘要

背景：早期烟草烟雾暴露对慢性肾脏病（CKD）风险的不利影响仍不清楚。本研究旨在调查早年烟草烟雾暴露与成年后慢性肾脏病发病率的关系，并进一步探讨体育锻炼（PA）的调节作用：方法：英国生物库共纳入了352883名参与者。方法：英国生物库共纳入了 352,883 名参与者，通过采用子宫内烟草烟雾暴露和开始吸烟的年龄来评估早期烟草烟雾暴露的信息。计算了每个人每周的中强度体力活动（MVPA）。采用 Cox 比例危险回归法估算 CKD 风险的危险比 (HR) 和 95% 置信区间 (CI)，并研究 MVPA 的调节作用：结果：子宫内有烟草烟雾暴露的参与者的慢性肾脏病发病率明显增加（HR：1.08，95% CI：1.04，1.12）。与从不吸烟者相比，我们发现随着成年期（HR：1.21，95% CI：1.16，1.27）、青春期（HR：1.29，95% CI：1.24，1.35）和儿童期（HR：1.34，95% CI：1.25，1.43）开始吸烟，患慢性肾脏病的风险呈单调上升趋势（P 趋势结论：早期烟草烟雾暴露可能导致慢性肾脏病的发病率增加：早年的烟草烟雾暴露可能会导致成年后的慢性肾脏病发病率，所观察到的关联可能会因 MVPA 而改变。这些发现提供了在受试者早期生活中预防慢性肾脏病的重要信息，同时敦促在怀孕夫妇、儿童和青少年中更迅速、更有力地开展烟草控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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In utero, childhood, and adolescence tobacco smoke exposure, physical activity, and chronic kidney disease incidence in adulthood: evidence from a large prospective cohort study.

Background: The adverse effects of early-life tobacco smoke exposure on chronic kidney disease (CKD) risk remain unclear. This study aimed to investigate the associations of early-life tobacco smoke exposure with CKD incidence in adulthood, and further explore the modification effects of physical activity (PA).

Methods: A total of 352,883 participants were included from the UK Biobank. The information on early-life tobacco smoke exposure was assessed by employing in utero tobacco smoke exposure and age of smoking initiation. Weekly moderate-to-vigorous physical activity (MVPA) was calculated for each individual. Cox proportional hazard regression was fitted to estimate the hazard ratio (HR) and 95% confidence interval (CI) of CKD risk, and to investigate the modification effects of MVPA.

Results: CKD incidence significantly increased in participants with in utero tobacco smoke exposure (HR: 1.08, 95% CI: 1.04, 1.12). Compared with never-smokers, we found a monotonic increase in the risk of CKD with smoking initiation across adulthood (HR: 1.21, 95% CI: 1.16, 1.27), adolescence (HR: 1.29, 95% CI: 1.24, 1.35), and childhood (HR: 1.34, 95% CI: 1.25, 1.43) (P trend < 0.001). Additionally, we identified joint cumulative effects of MVPA and early-life tobacco smoke exposure on incident CKD. Compared with never-smokers with recommended MVPA, prenatal or childhood tobacco smokers without recommended MVPA had the highest CKD risk, and the HRs (95% CIs) were 1.17 (1.10, 1.24) and 1.51 (1.36, 1.68), respectively.

Conclusions: Early-life tobacco smoke exposure may contribute to CKD incidence in adulthood, and the observed associations could be modified by MVPA. These findings provide important information on CKD prevention in the participant's early life while urging a more rapid and powerful need for tobacco control among pregnant couples, children, and adolescents.

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.