Summary Background Understanding epidemiological trends of the cardiovascular risk factors is integral in designing effective countermeasures in tackling cardiovascular diseases (CVD) in the Asia–Pacific. The study aims to examine the cardiovascular risk factor burden in the Asia–Pacific from 1990 to 2023, stratified by geographic subregion, sociodemographic index, and age-sex strata, to identify the region-specific risk factor targets for CVD prevention. Methods Estimates from the Global Burden of Disease Study 2023 were used to quantify cardiovascular mortality and disability-adjusted life years (DALYs) attributable to environmental/occupational, behavioural, and metabolic risk factors across 39 Asia–Pacific countries. Findings In 2023, cardiovascular risk factors contributed to 197.1 million DALYs, with an age-standardised DALY rate of 4463.7 per 100,000 population in the Asia–Pacific, which is 16.4% higher than the global estimate. Between 1990 and 2023, age-standardised DALYs declined by 34.9%, yet crude risk-attributable DALYs rose by 61.5%, as the demographic forces of population ageing (87.3%) and growth (45.3%) overwhelmed the gains from risk exposure reduction (−71.1%). Among risk factor categories, metabolic risk factors contributed to the fastest rise in CVD morbidity (74.3%), followed by behavioural (49.5%), and environmental/occupational risk factors (44.6%). The leading risk factors were high systolic blood pressure, dietary risks, air pollution and high LDL cholesterol. Interpretation The improvements in cardiovascular risk factor exposure in the Asia–Pacific have been offset by population growth and ageing. The metabolic-centric pattern in risk factors demands for strategies in tackling the region's high priority metabolic risk factor targets. Funding SingHealth Duke-National University of Singapore Cardiovascular Sciences Academic Clinical Programme, the National Medical Research Council of Singapore, and the Stafford Fox Foundation.
Nicholas W. S. Chew, Yiming Chen, F. Cader et al.· The Lancet Regional Health -...· 0 citations
Environmental factors such as air pollution, ambient temperature, and socioeconomic status are associated with chronic obstructive pulmonary disease (COPD), yet the potential role of proteomic alterations remains unclear. We aim to identify circulating proteomic signatures related to distinct environmental exposures and evaluate their associations with incident COPD. We analyzed 42,445 participants from the UK Biobank with baseline plasma proteomic profiling and 21 environmental exposure assessments. Exposure-associated proteins were identified using multivariable linear regression and further selected using repeated LASSO-based stability selection. Exposure-specific proteomic scores were constructed and evaluated for associations with incident COPD using Cox models. Exploratory mediation analyses under a counterfactual framework assessed the potential mediating role of proteomic scores and individual proteins. Multiple environmental exposures were associated with specific proteomic variation, which were subsequently used to construct exposure-specific scores. Both environmental exposures and their protein scores were related to systemic inflammation, lung function, and the subsequent risk of COPD, with the strongest positive association observed for the Townsend deprivation index-related score (HR = 1.80, 95% CI: 1.71–1.90) and an inverse association observed for the NDVI-related score (HR = 0.72, 95% CI: 0.69–0.76). Protein scores explained 41.1% (95% CI: 25.0–57.2), 33.0% (95% CI: 18.8–47.1), and 50.5% (95% CI: 42.1–58.8) of the SO2–COPD, NO2–COPD, and Townsend deprivation index–COPD associations, respectively. At the separate protein level, CDCP1, REG3A, IL15, TNFSF13B, and IL6 repeatedly ranked among the top estimated contributors across multiple exposures. Circulating proteomic profiles capture the biological imprint of environmental factors and are significantly associated with incident COPD. Both protein scores and specific proteins may partly characterize the proteomic component of the observed associations between exposure and COPD, providing population-based evidence for an environment–proteome–COPD framework.
Yiqun Zhu, Yao Wu, Yan Tan et al.· Environment & Health· 0 citations
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