环境臭氧暴露与冠心病的严重程度:天冬氨酸氨基转移酶的预测作用

Ambient ozone exposure and the severity of coronary heart disease:A predicting role of aspartate aminotransferase

目的:探讨臭氧暴露与冠心病严重程度的关系以及天冬氨酸氨基转移酶(AST)的中介作用。方法:回顾性分析武汉大学中南医院2016—2021年行冠状动脉造影的2537例冠心病患者。根据SYNTAX评分将其分为低分组(0~22)和高分组(≥23)。采用Logistic回归用于评估臭氧暴露与冠心病严重程度的关系,线性回归探讨臭氧暴露与AST的关系,中介效应分析评估血清AST在臭氧暴露与冠心病严重程度之间的预测作用。结果:臭氧浓度增加,罹患更严重的冠心病的风险增加(OR=1.072,P<0.05)。老年患者中AST(β=3.622,P<0.05)与臭氧暴露呈正相关。同时AST在臭氧暴露和冠心病严重程度中起中介作用,中介效应量为13.1%。结论:长期臭氧暴露与冠心病的严重程度有关,并且AST可作为臭氧暴露下冠心病严重程度的预测指标。

Objective:To explore the relationship between ambient ozone exposure and the severity of coronary heart disease(CHD)and the potential role of aspartate aminotransferase(AST).Methods:We included 2537 CHD patients who had undergone coronary angiography from 2016 to 2021 at the Zhongnan Hospital of Wuhan University.According to the SYNTAX score,they were categorized into low(0-22)or high(≥23)SYNTAX score groups.The logistic regression was used to fit the association between ozone exposure and the severity of CHD.Linear regression was performed to explore the relationship between ozone exposure and biochemical indicators.Mediation analysis was performed to examine the potential effect of AST in the association between ozone exposure and CHD severity.Results:As the ozone concentration increased,the risk of suffering from more severe CHD increased(OR=1.072,P<0.05).AST(β=3.622,P<0.05)was positively correlated with ozone exposure in elderly patients.Mediation analysis showed that AST mediated 13.1%(P=0.045)of the ozoneSYNTAX score association.Conclusion:This study indicated that long-term ozone exposure was associated with the severity of CHD,and serum AST might be used as a predictor of the severity of CHD.