母亲孕期吸烟及子代遗传风险与全肿瘤死亡风险的队列研究  

A cohort study of maternal smoking during pregnancy,offspring genetic risk,and overall cancer mortality

作　　者：庞官连 马志敏 诸铭轩 葛文静 牟园淋 王国庆 朱兆鹏 李樵 朱猛 Pang Guanlian;Ma Zhimin;Zhu Mingxuan;Ge Wenjing;Mou Yuanlin;Wang Guoqing;Zhu Zhaopeng;Li Qiao;Zhu Meng(Department of Epidemiology,School of Public Health,Nanjing Medical University,Nanjing 211166,China;Collaborative Innovation Center for Cancer Personalized Medicine,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学公共卫生学院流行病学系,南京211166 [2]南京医科大学省部共建肿瘤个体化医学协同创新中心,南京211166

出　　处：《中华流行病学杂志》2024年第8期1045-1051,共7页Chinese Journal of Epidemiology

基　　金：江苏省优秀青年基金(BK20220100)。

摘　　要：目的探讨母亲孕期吸烟和子代遗传易感性对全肿瘤死亡风险的独立和综合影响。方法基于英国生物银行(n=419228)数据,使用Cox比例风险回归模型估计母亲孕期吸烟对子代全肿瘤(包括男性16种和女性18种恶性肿瘤)死亡风险的影响,并分析母亲孕期吸烟与子代遗传因素的联合效应和交互作用。结果母亲孕期吸烟与子代全肿瘤死亡风险的增加显著相关,其中男性增加13%[风险比(HR)=1.13,95%CI:1.06~1.20],女性增加19%(HR=1.19,95%CI:1.11~1.27)。与低遗传风险者相比,高遗传风险者的全肿瘤死亡风险最高(男性:HR=1.42,95%CI:1.30~1.55;女性:HR=1.38,95%CI:1.25~1.52)。与母亲孕期未吸烟、低遗传风险的参与者相比,母亲孕期吸烟且高遗传风险的男性全肿瘤死亡风险增加56%(HR=1.56,95%CI:1.37~1.77),女性增加59%(HR=1.59,95%CI:1.39~1.83)。结论母亲孕期吸烟可能会增加子代的全肿瘤死亡风险,且在高遗传风险的个体中母亲孕期吸烟的危害更严重。Objective To investigate the independent and combined effects of maternal smoking during pregnancy and offspring genetic susceptibility on overall cancer mortality.Methods Based on the United Kingdom Biobank(n=419228)data,the Cox proportional hazard regression model was used to estimate the effect of maternal smoking during pregnancy on offspring overall cancer(including 16 cancers in men and 18 in women)mortality and its combined effect and interaction with offspring genetic factors.Results Maternal smoking during pregnancy was significantly associated with a 13%increased risk of overall cancer mortality in men[hazard ratio(HR)=1.13,95%CI:1.06-1.20]and 19%increased risk in women(HR=1.19,95%CI:1.11-1.27).Participants with high genetic risk had the highest overall cancer mortality than those with low genetic risk(men:HR=1.42,95%CI:1.30-1.55;women:HR=1.38,95%CI:1.25-1.52).Compared with participants without maternal smoking during pregnancy and low genetic risk,those with maternal smoking during pregnancy and high genetic risk were associated with a 56%increased risk of overall cancer mortality in men(HR=1.56,95%CI:1.37-1.77)and 59%in women(HR=1.59,95%CI:1.39-1.83).Conclusion Maternal smoking during pregnancy may increase offspring overall cancer mortality and more severe harm in individuals with high genetic risk.

关 键 词：母亲孕期吸烟 多基因风险评分 全肿瘤死亡风险 前瞻性队列研究 

分 类 号：R715.3[医药卫生—妇产科学]