Association between per- and polyfluoroalkyl substances exposure and prevalence of chronic obstructive pulmonary disease: The mediating role of serum albumin

Wang, Yan; Zhang, Jingwen; Zhang, Jiaxian; Hou, Miao; Kong, Lingkun; Lin, Xiong; Xu, Jinxin; Yan, Chun; Lin, Fan; Ke, Sunkui

doi:10.1016/j.scitotenv.2024.171742

Cited by 4 publications

(1 citation statement)

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“…We formed the non-ACO group by combining participants from the asthma-only, COPD-only, and non-asthma/COPD groups. In this study, smoking was not considered as a condition to identify COPD [ 38 , 39 ], mainly because while it has been regarded as the best-known and most important risk factor for irreversible airflow obstruction, non-smokers can also develop COPD [ 40 ]. Figure 1 is the flow chart of identifying study population and grouping.…”

Section: Methodsmentioning

confidence: 99%

Epidemiological characteristics of asthma-COPD overlap, its association with all-cause mortality, and the mediating role of depressive symptoms: evidence from NHANES 2005–2018

Zhu,

Chen

2024

BMC Public Health

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Background Asthma-COPD overlap (ACO) is a distinct and intricate respiratory condition that requires specific attention and management. The objective of this cohort study was to examine the epidemiological characteristics of ACO, explore the association between ACO and all-cause mortality, and investigate the potential mediating role of depressive symptoms in this association. Methods This retrospective cohort study used data from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 and National Death Index (NDI) 2019. A total of 22,745 participants were included: 705 with ACO, 2352 with asthma-only, 853 with COPD-only, and 18,835 without asthma or COPD. The non-ACO group (N = 22,040) referred to the individuals without ACO. Statistical tests were employed to assess differences in some characteristics between the ACO group and the other groups. Cox proportional hazards models were applied to evaluate the relationship between ACO and all-cause mortality, estimating hazard ratios (HR) with 95% confidence intervals. Mediation analysis was conducted to investigate the potential mediating effects of depressive symptoms on the association of ACO with all-cause mortality. Results The prevalence of ACO was 3.10% in our study population. Compared to the non-ACO participants, the ACO participants exhibited significantly different characteristics, including higher age, a lower family income-to-poverty ratio, a higher body mass index, higher rates of comorbidities i.e., hypertension, diabetes, hyperlipidemia, cardiovascular disease, and cancer, poorer dietary habits, and a higher rate of depressive disorders. Compared to the participants without ACO, the participants with ACO exhibited a significant increase in all-cause mortality (HR = 1.908, 95%CI 1.578–1.307, p < 0.001). The proportions mediated by depressive symptoms for ACO -associated all-cause mortality were 8.13% (CI: 4.22%-14.00%, p < 0.001). Conclusions This study revealed a strong relationship between ACO and all-cause mortality and uncovered a potential psychological mechanism underlying this relationship. Our study indicates the possible necessity of offering comprehensive care to ACO patients, encompassing early detection, lifestyle guidance, and mental health support. Nevertheless, due to the limitations in the study design and the dataset, the results should be interpreted with caution.

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Section: Methodsmentioning

confidence: 99%