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Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study

BACKGROUND: Previous studies indicated that air pollution plausibly increases the risk of adverse outcomes in inflammatory bowel disease (IBD) via proinflammatory mechanisms. However, there is scant epidemiological data and insufficient prospective evidence assessing associations between ambient air...

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Autores principales: Chen, Jie, Dan, Lintao, Sun, Yuhao, Yuan, Shuai, Liu, Weilin, Chen, Xuejie, Jiang, Fangyuan, Fu, Tian, Zhang, Han, Deng, Minzi, Wang, Xiaoyan, Li, Xue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Environmental Health Perspectives 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10379095/
https://www.ncbi.nlm.nih.gov/pubmed/37505744
http://dx.doi.org/10.1289/EHP12215
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author Chen, Jie
Dan, Lintao
Sun, Yuhao
Yuan, Shuai
Liu, Weilin
Chen, Xuejie
Jiang, Fangyuan
Fu, Tian
Zhang, Han
Deng, Minzi
Wang, Xiaoyan
Li, Xue
author_facet Chen, Jie
Dan, Lintao
Sun, Yuhao
Yuan, Shuai
Liu, Weilin
Chen, Xuejie
Jiang, Fangyuan
Fu, Tian
Zhang, Han
Deng, Minzi
Wang, Xiaoyan
Li, Xue
author_sort Chen, Jie
collection PubMed
description BACKGROUND: Previous studies indicated that air pollution plausibly increases the risk of adverse outcomes in inflammatory bowel disease (IBD) via proinflammatory mechanisms. However, there is scant epidemiological data and insufficient prospective evidence assessing associations between ambient air pollution and clinical outcomes of IBD. OBJECTIVES: We aimed to investigate the associations between ambient air pollution and clinical outcomes among individuals with IBD. METHODS: Leveraging data from the UK Biobank, we included 4,708 individuals with IBD recruited in the period 2006–2010 in this study. A land use regression model was used to assess annual mean concentrations of ambient air pollutants nitrogen including oxides ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and particulate matter (PM) with aerodynamic diameter [Formula: see text] ([Formula: see text]) and PM with aerodynamic diameter [Formula: see text] ([Formula: see text]). Individuals with IBD were followed up for incident clinical outcomes of enterotomy, gastrointestinal cancer, and all-cause mortality, ascertained via death registry, inpatient, primary care, and cancer registry data. Cox proportional hazard model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the magnitude of the associations. RESULTS: During a mean follow-up of 12.0 y, 265 enterotomy events, 124 incident gastrointestinal cancer, and 420 death events were documented among individuals with IBD. We found that each interquartile range (IQR) increase in exposure to [Formula: see text] was associated with increased risk of enterotomy ([Formula: see text]; 95% CI: 1.00, 1.34, [Formula: see text]), whereas an IQR increase in exposure to [Formula: see text] ([Formula: see text]; 95% CI: 1.01, 1.20, [Formula: see text]), [Formula: see text] ([Formula: see text]; 95% CI: 1.03, 1.29, [Formula: see text]), [Formula: see text] ([Formula: see text]; 95% CI: 1.03, 1.30, [Formula: see text]), and [Formula: see text] ([Formula: see text]; 95% CI: 1.02, 1.28, [Formula: see text]) was associated with increased risk of all-cause mortality among individuals with IBD. We did not observe any significant associations between air pollutants and gastrointestinal cancer in the primary analyses. Consistent results were observed in subgroup and sensitivity analyses. CONCLUSIONS: Ambient pollution exposure was associated with an increased risk of enterotomy and all-cause mortality among individuals with IBD, highlighting the important role of environmental health in improving the prognosis of IBD. https://doi.org/10.1289/EHP12215
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spelling pubmed-103790952023-07-29 Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study Chen, Jie Dan, Lintao Sun, Yuhao Yuan, Shuai Liu, Weilin Chen, Xuejie Jiang, Fangyuan Fu, Tian Zhang, Han Deng, Minzi Wang, Xiaoyan Li, Xue Environ Health Perspect Research BACKGROUND: Previous studies indicated that air pollution plausibly increases the risk of adverse outcomes in inflammatory bowel disease (IBD) via proinflammatory mechanisms. However, there is scant epidemiological data and insufficient prospective evidence assessing associations between ambient air pollution and clinical outcomes of IBD. OBJECTIVES: We aimed to investigate the associations between ambient air pollution and clinical outcomes among individuals with IBD. METHODS: Leveraging data from the UK Biobank, we included 4,708 individuals with IBD recruited in the period 2006–2010 in this study. A land use regression model was used to assess annual mean concentrations of ambient air pollutants nitrogen including oxides ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and particulate matter (PM) with aerodynamic diameter [Formula: see text] ([Formula: see text]) and PM with aerodynamic diameter [Formula: see text] ([Formula: see text]). Individuals with IBD were followed up for incident clinical outcomes of enterotomy, gastrointestinal cancer, and all-cause mortality, ascertained via death registry, inpatient, primary care, and cancer registry data. Cox proportional hazard model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the magnitude of the associations. RESULTS: During a mean follow-up of 12.0 y, 265 enterotomy events, 124 incident gastrointestinal cancer, and 420 death events were documented among individuals with IBD. We found that each interquartile range (IQR) increase in exposure to [Formula: see text] was associated with increased risk of enterotomy ([Formula: see text]; 95% CI: 1.00, 1.34, [Formula: see text]), whereas an IQR increase in exposure to [Formula: see text] ([Formula: see text]; 95% CI: 1.01, 1.20, [Formula: see text]), [Formula: see text] ([Formula: see text]; 95% CI: 1.03, 1.29, [Formula: see text]), [Formula: see text] ([Formula: see text]; 95% CI: 1.03, 1.30, [Formula: see text]), and [Formula: see text] ([Formula: see text]; 95% CI: 1.02, 1.28, [Formula: see text]) was associated with increased risk of all-cause mortality among individuals with IBD. We did not observe any significant associations between air pollutants and gastrointestinal cancer in the primary analyses. Consistent results were observed in subgroup and sensitivity analyses. CONCLUSIONS: Ambient pollution exposure was associated with an increased risk of enterotomy and all-cause mortality among individuals with IBD, highlighting the important role of environmental health in improving the prognosis of IBD. https://doi.org/10.1289/EHP12215 Environmental Health Perspectives 2023-07-28 /pmc/articles/PMC10379095/ /pubmed/37505744 http://dx.doi.org/10.1289/EHP12215 Text en https://ehp.niehs.nih.gov/about-ehp/licenseEHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.
spellingShingle Research
Chen, Jie
Dan, Lintao
Sun, Yuhao
Yuan, Shuai
Liu, Weilin
Chen, Xuejie
Jiang, Fangyuan
Fu, Tian
Zhang, Han
Deng, Minzi
Wang, Xiaoyan
Li, Xue
Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title_full Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title_fullStr Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title_full_unstemmed Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title_short Ambient Air Pollution and Risk of Enterotomy, Gastrointestinal Cancer, and All-Cause Mortality among 4,708 Individuals with Inflammatory Bowel Disease: A Prospective Cohort Study
title_sort ambient air pollution and risk of enterotomy, gastrointestinal cancer, and all-cause mortality among 4,708 individuals with inflammatory bowel disease: a prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10379095/
https://www.ncbi.nlm.nih.gov/pubmed/37505744
http://dx.doi.org/10.1289/EHP12215
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