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Article(id=1322608145139086133, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322608013010120712, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506168, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749744000000, receivedDateStr=2025-06-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793263954671, onlineDateStr=2026-10-29, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793263954671, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793263954671, creator=13701087609, updateTime=1793263954671, updator=13701087609, issue=Issue{id=1322608013010120712, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='21', pageStart='3841', pageEnd='4032', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793263923169, creator='13701087609', updateTime=1793264266929, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609454932149086, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322608013010120712, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609454932149087, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322608013010120712, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3854, endPage=3859, ext={EN=ArticleExt(id=1322608145340412726, articleId=1322608145139086133, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The association between smoking cessation, secondhand smoke exposure,and accelerated biological aging: a study based on the UK Biobank, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the longitudinal association between smoking cessation, secondhand smoke (SHS) exposure, and accelerated biological aging, and to further explore the heterogeneous associations of SHS exposure on biological aging among individuals who have quit smoking.

Methods

This study was based on data from the baseline and the first repeat assessment of the UK Biobank. Phenotypic Age (PA) was constructed using the validated PA algorithm, and PA acceleration was calculated. Multivariable linear regression models were used to perform change analysis to assess the associations between changes in smoking behavior and SHS exposure with changes in PA acceleration. Stratified analyses were conducted to identify potential effect heterogeneity.

Results

A total of 11 189 eligible participants were included. Compared to never smokers, persistent smokers showed significantly greater PA acceleration (β=0.94, 95% CI: 0.22-1.65), whereas long-term quitters were associated with lower PA acceleration (β=0.30, 95% CI: 0.05-0.55). Compared with those consistently unexposed to SHS, individuals with increased SHS exposure exhibited greater PA acceleration(β=0.40, 95% CI: 0.01-0.79). Notably, among long-term quitters, frequent SHS exposure was associated with significantly greater biological aging (β=0.80, 95% CI: 0.02-1.57).

Conclusion

Smoking cessation can partially reverse the adverse effects of smoking on biological aging, although long-term damage may not be fully reversible. Moreover, SHS exposure significantly accelerates biological aging, with more pronounced effects observed among individuals who have quit smoking.

, authors=Ming-lun XIN, Rui CHEN, Yi XIANG, Xiong XIAO, authorsList=Ming-lun XIN, Rui CHEN, Yi XIANG, Xiong XIAO, authorCompany=null, correspAuthors=Xiong XIAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322608146263159613, articleId=1322608145139086133, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=烟草戒断及二手烟暴露与生物衰老加速的关系——基于英国生物银行数据库的研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探究烟草戒断及二手烟暴露与生物衰老加速的纵向关联，进一步探索烟草戒断人群中二手烟暴露与生物衰老的异质性关联。

方法

本研究基于英国生物银行（UK Biobank）的基线调查与首次重复随访数据。运用表型年龄算法构建并计算表型年龄加速值。通过多元线性回归模型开展变化分析（change analysis），探索戒烟行为和二手烟暴露状态的转变与表型年龄加速变化之间的关系。并通过分层分析识别潜在的差异效应。

结果

本研究纳入111 89名符合条件的个体。相较于从不吸烟者，持续吸烟人群表现出更显著的表型年龄加速（β=0.94，95% CI：0.22 ~ 1.65），而长期戒烟会使表型年龄加速降低至（β=0.30，95% CI：0.05 ~ 0.55）。与保持未暴露于二手烟者相比，增加暴露者的表型年龄加速变化为（β=0.40，95% CI：0.01 ~ 0.79），而在长期戒烟者中高频率的二手烟暴露会造成更为显著的衰老加速（β=0.80，95% CI：0.02 ~ 1.57）。

结论

戒烟能够部分逆转吸烟带来的生物衰老损害，但烟草的长期损害难以完全逆转，同时二手烟暴露会显著加速生物衰老，且对戒烟者造成更为显著的危害。

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辛明伦（2003—），男，本科在读，研究方向：预防医学

, correspAuthorsNote=
肖雄，E-mail：
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辛明伦（2003—），男，本科在读，研究方向：预防医学

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Geriatrics & Gerontology International, 2024, 24 Suppl 1 (Suppl 1): 142-149., articleTitle=Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community-dwelling older adults in Japan: Evidence from a 10-year population-based cohort study, refAbstract=null)], funds=[Fund(id=1322608153632551794, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, awardId=82273740, language=CN, fundingSource=国家自然科学基金(82273740), fundOrder=null, country=null), Fund(id=1322608153712243571, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, awardId=2024NSFSC0552, language=CN, fundingSource=四川省自然科学基金(2024NSFSC0552), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322608146506429246, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, xref=null, ext=[AuthorCompanyExt(id=1322608146519012159, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, companyId=1322608146506429246, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1322608146531595072, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, companyId=1322608146506429246, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川大学华西公共卫生学院，四川　成都　610041)])], figs=[ArticleFig(id=1322608149983507293, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Figure 1, caption=Association between changes in smoking cessation status and changes in PA acceleration, figureFileSmall=+WB8Cg8esp8eGMKc8/+yew==, figureFileBig=ht6dRo/hvzU4Z8JCazX4MA==, tableContent=null), ArticleFig(id=1322608150079976286, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=图1, caption=烟草戒断状态变化与表型年龄加速变化的关联结果, figureFileSmall=+WB8Cg8esp8eGMKc8/+yew==, figureFileBig=ht6dRo/hvzU4Z8JCazX4MA==, tableContent=null), ArticleFig(id=1322608150465852256, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Figure 2, caption=Stratified analysis results between short-term and long-term quitters, figureFileSmall=N6fb3zqvMsgQs/8RaqBa0Q==, figureFileBig=xNymkiosMDf3hF+pbYHRkA==, tableContent=null), ArticleFig(id=1322608150587487073, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=图2, caption=短期戒烟者与长期戒烟者分层分析结果

注：图A对长期戒烟者进行分层分析的结果；图B对短期戒烟者进行分层分析的结果。

, figureFileSmall=N6fb3zqvMsgQs/8RaqBa0Q==, figureFileBig=xNymkiosMDf3hF+pbYHRkA==, tableContent=null), ArticleFig(id=1322608150876894050, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Figure 3, caption=Association between changes in secondhand smoke exposure and changes in PA acceleration, figureFileSmall=InMaxarrLc7IpdcRaU9SBQ==, figureFileBig=Cu3mYihm7feqrEDnDoErLQ==, tableContent=null), ArticleFig(id=1322608150948197219, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=图3, caption=二手烟暴露状态变化与表型年龄加速变化的关联结果, figureFileSmall=InMaxarrLc7IpdcRaU9SBQ==, figureFileBig=Cu3mYihm7feqrEDnDoErLQ==, tableContent=null), ArticleFig(id=1322608151308907364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Table 1, caption=

Classification criteria for changes in smoking cessation status

, figureFileSmall=null, figureFileBig=null, tableContent=
基线调查时烟草
戒断状态		首次重复调查时
烟草戒断状态		烟草戒断状态变化
非吸烟者非吸烟者从不吸烟者
烟草戒断者烟草戒断者长期戒烟者
烟草戒断者非吸烟者长期戒烟者
非吸烟者当前吸烟者保持吸烟者
烟草戒断者当前吸烟者保持吸烟者
当前吸烟者当前吸烟者保持吸烟者
当前吸烟者非吸烟者短期戒烟者
当前吸烟者烟草戒断者短期戒烟者
非吸烟者烟草戒断者短期戒烟者
), ArticleFig(id=1322608151376016229, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=表1, caption=

烟草戒断状态的变化分类规则

, figureFileSmall=null, figureFileBig=null, tableContent=
基线调查时烟草
戒断状态		首次重复调查时
烟草戒断状态		烟草戒断状态变化
非吸烟者非吸烟者从不吸烟者
烟草戒断者烟草戒断者长期戒烟者
烟草戒断者非吸烟者长期戒烟者
非吸烟者当前吸烟者保持吸烟者
烟草戒断者当前吸烟者保持吸烟者
当前吸烟者当前吸烟者保持吸烟者
当前吸烟者非吸烟者短期戒烟者
当前吸烟者烟草戒断者短期戒烟者
非吸烟者烟草戒断者短期戒烟者
), ArticleFig(id=1322608151455708006, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Table 2, caption=

Classification criteria for changes in secondhand smoke exposure status

, figureFileSmall=null, figureFileBig=null, tableContent=
基线调查时二手烟
暴露状态		首次重复调查时
二手烟暴露状态		二手烟暴露状态变化
未暴露未暴露保持未暴露者
未暴露暴露增加暴露者
暴露未暴露减少暴露者
暴露暴露保持暴露者
), ArticleFig(id=1322608151531205479, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=表2, caption=

二手烟暴露状态的变化分类规则

, figureFileSmall=null, figureFileBig=null, tableContent=
基线调查时二手烟
暴露状态		首次重复调查时
二手烟暴露状态		二手烟暴露状态变化
未暴露未暴露保持未暴露者
未暴露暴露增加暴露者
暴露未暴露减少暴露者
暴露暴露保持暴露者
), ArticleFig(id=1322608151736726376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Table 3, caption=

Baseline characteristics of study participants［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
基线特征全人群n=(11 189)从不吸烟者n=(4 296)保持吸烟者n=(490)短期戒烟者n=(638)长期戒烟者n=(5 765)
表型年龄加速（岁）-5.70 (-8.52, -2.66)-5.95 (-8.64, -3.00)-2.95 (-6.13, 0.14)-5.15 (-8.36, -2.03)-5.80 (-8.60, -2.80)
年龄（岁）59.17 (52.75, 63.42)58.25 (51.75, 62.92)56.79 (49.58, 61.92)58.00 (49.83, 62.00)60.00 (54.25, 63.83)
性别
男5 837 (52.2)1 947 (45.3)314 (64.1)354 (55.5)3 222 (55.9)
女5 352 (47.8)2 349 (54.7)176 (35.9)284 (44.5)2 543 (44.1)
种族
白人10 974 (98.1)4 190 (97.5)479 (97.8)628 (98.4)5 677 (98.5)
混血34 (0.3)9 (0.2)4 (0.8)5 (0.8)16 (0.3)
其他181 (1.6)97 (2.3)7 (1.4)5 (0.8)72 (1.2)
剥夺指数-2.78 (-4.00, -0.88)-2.89 (-4.05, -1.23)-1.70 (-3.46, 1.64)-2.67 (-3.92, -0.17)-2.76 (-4.00, -0.86)
受教育程度
初中及以下953 (8.5)307 (7.1)67 (13.7)56 (8.8)523 (9.1)
高中5 323 (47.6)2 033 (47.3)255 (52.0)292 (45.8)2 743 (47.6)
大学及以上4 913 (43.9)1 956 (45.5)168 (34.3)290 (45.5)2 499 (43.3)
膳食得分4.00 (3.00, 5.00)4.00 (3.00, 5.00)3.00 (2.00, 4.00)4.00 (2.00, 5.00)4.00 (3.00, 5.00)
睡眠时长（h/d）7.00 (7.00, 8.00)7.00 (7.00, 8.00)7.00 (6.00, 8.00)7.00 (7.00, 8.00)7.00 (7.00, 8.00)
BMI（kg/m2)26.29 (23.90, 29.14)26.06 (23.66, 28.96)26.75 (23.84, 29.21)26.49 (23.99, 28.93)26.39 (24.10, 29.27)
饮酒
不饮酒297 (2.7)236 (5.5)5 (1.0)5 (0.8)51 (0.9)
现在饮酒280 (2.5)94 (2.2)15 (3.1)13 (2.0)158 (2.7)
曾经饮酒10 612 (94.8)3 966 (92.3)470 (95.9)620 (97.2)5 556 (96.4)
饮茶
不饮茶1 606 (14.4)650 (15.1)88 (18.0)96 (15.0)772 (13.4)
现在饮茶9 583 (85.6)3 646 (84.9)402 (82.0)542 (85.0)4 993 (86.6)
抑郁
否10 805 (96.6)4 153 (96.7)465 (94.9)607 (95.1)5 580 (96.8)
是384 (3.4)143 (3.3)25 (5.1)31 (4.9)185 (3.2)
焦虑
否10 857 (97.0)4 161 (96.9)466 (95.1)614 (96.2)5 616 (97.4)
是332 (3.0)135 (3.1)24 (4.9)24 (3.8)149 (2.6)
心血管疾病
否8 247 (73.7)3 233 (75.3)363 (74.1)506 (79.3)4 145 (71.9)
是2 942 (26.3)1 063 (24.7)127 (25.9)132 (20.7)1 620 (28.1)
自报糖尿病
否10 743 (96.0)4 143 (96.4)465 (94.9)613 (96.1)5 522 (95.8)
是446 (4.0)153 (3.6)25 (5.1)25 (3.9)243 (4.2)
慢性肺阻塞
否11 086 (99.1)4 270 (99.4)481 (98.2)627 (98.3)5 708 (99.0)
是103 (0.9)26 (0.6)9 (1.8)11 (1.7)57 (1.0)
癌症
否10 476 (93.6)4 032 (93.9)465 (94.9)599 (93.9)5 380 (93.3)
是713 (6.4)264 (6.1)25 (5.1)39 (6.1)385 (6.7)
二手烟暴露
否8 658 (77.4)3 546 (82.5)96 (19.6)373 (58.5)4 643 (80.5)
是1 989 (17.8)721 (16.8)57 (11.6)107 (16.8)1 104 (19.2)
), ArticleFig(id=1322608153334756206, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=表3, caption=

研究对象的基线特征［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
基线特征全人群n=(11 189)从不吸烟者n=(4 296)保持吸烟者n=(490)短期戒烟者n=(638)长期戒烟者n=(5 765)
表型年龄加速（岁）-5.70 (-8.52, -2.66)-5.95 (-8.64, -3.00)-2.95 (-6.13, 0.14)-5.15 (-8.36, -2.03)-5.80 (-8.60, -2.80)
年龄（岁）59.17 (52.75, 63.42)58.25 (51.75, 62.92)56.79 (49.58, 61.92)58.00 (49.83, 62.00)60.00 (54.25, 63.83)
性别
男5 837 (52.2)1 947 (45.3)314 (64.1)354 (55.5)3 222 (55.9)
女5 352 (47.8)2 349 (54.7)176 (35.9)284 (44.5)2 543 (44.1)
种族
白人10 974 (98.1)4 190 (97.5)479 (97.8)628 (98.4)5 677 (98.5)
混血34 (0.3)9 (0.2)4 (0.8)5 (0.8)16 (0.3)
其他181 (1.6)97 (2.3)7 (1.4)5 (0.8)72 (1.2)
剥夺指数-2.78 (-4.00, -0.88)-2.89 (-4.05, -1.23)-1.70 (-3.46, 1.64)-2.67 (-3.92, -0.17)-2.76 (-4.00, -0.86)
受教育程度
初中及以下953 (8.5)307 (7.1)67 (13.7)56 (8.8)523 (9.1)
高中5 323 (47.6)2 033 (47.3)255 (52.0)292 (45.8)2 743 (47.6)
大学及以上4 913 (43.9)1 956 (45.5)168 (34.3)290 (45.5)2 499 (43.3)
膳食得分4.00 (3.00, 5.00)4.00 (3.00, 5.00)3.00 (2.00, 4.00)4.00 (2.00, 5.00)4.00 (3.00, 5.00)
睡眠时长（h/d）7.00 (7.00, 8.00)7.00 (7.00, 8.00)7.00 (6.00, 8.00)7.00 (7.00, 8.00)7.00 (7.00, 8.00)
BMI（kg/m2)26.29 (23.90, 29.14)26.06 (23.66, 28.96)26.75 (23.84, 29.21)26.49 (23.99, 28.93)26.39 (24.10, 29.27)
饮酒
不饮酒297 (2.7)236 (5.5)5 (1.0)5 (0.8)51 (0.9)
现在饮酒280 (2.5)94 (2.2)15 (3.1)13 (2.0)158 (2.7)
曾经饮酒10 612 (94.8)3 966 (92.3)470 (95.9)620 (97.2)5 556 (96.4)
饮茶
不饮茶1 606 (14.4)650 (15.1)88 (18.0)96 (15.0)772 (13.4)
现在饮茶9 583 (85.6)3 646 (84.9)402 (82.0)542 (85.0)4 993 (86.6)
抑郁
否10 805 (96.6)4 153 (96.7)465 (94.9)607 (95.1)5 580 (96.8)
是384 (3.4)143 (3.3)25 (5.1)31 (4.9)185 (3.2)
焦虑
否10 857 (97.0)4 161 (96.9)466 (95.1)614 (96.2)5 616 (97.4)
是332 (3.0)135 (3.1)24 (4.9)24 (3.8)149 (2.6)
心血管疾病
否8 247 (73.7)3 233 (75.3)363 (74.1)506 (79.3)4 145 (71.9)
是2 942 (26.3)1 063 (24.7)127 (25.9)132 (20.7)1 620 (28.1)
自报糖尿病
否10 743 (96.0)4 143 (96.4)465 (94.9)613 (96.1)5 522 (95.8)
是446 (4.0)153 (3.6)25 (5.1)25 (3.9)243 (4.2)
慢性肺阻塞
否11 086 (99.1)4 270 (99.4)481 (98.2)627 (98.3)5 708 (99.0)
是103 (0.9)26 (0.6)9 (1.8)11 (1.7)57 (1.0)
癌症
否10 476 (93.6)4 032 (93.9)465 (94.9)599 (93.9)5 380 (93.3)
是713 (6.4)264 (6.1)25 (5.1)39 (6.1)385 (6.7)
二手烟暴露
否8 658 (77.4)3 546 (82.5)96 (19.6)373 (58.5)4 643 (80.5)
是1 989 (17.8)721 (16.8)57 (11.6)107 (16.8)1 104 (19.2)
), ArticleFig(id=1322608153422836591, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=EN, label=Table 4, caption=

Association between secondhand smoke exposure and PA among individuals who quit smoking [β (95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
二手烟
暴露频率		长期戒烟者短期戒烟者
β (95% CI)sP值β (95% CI)sP值
未暴露0 (Ref.)——0 (Ref.)——
低频暴露0.33（-0.06 ~ 0.73）0.200.10-0.34（-1.73 ~ 1.02）0.700.62
中频暴露0.34（-0.40 ~ 0.87）0.270.220.67（-1.16 ~ 2.50）0.930.47
高频暴露0.80（0.02 ~ 1.57）0.400.043.46（0.36 ~ 6.56）1.580.03
), ArticleFig(id=1322608153515111281, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608145139086133, language=CN, label=表4, caption=

烟草戒断人群的二手烟暴露与表型年龄之间的关联结果 [β (95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
二手烟
暴露频率		长期戒烟者短期戒烟者
β (95% CI)sP值β (95% CI)sP值
未暴露0 (Ref.)——0 (Ref.)——
低频暴露0.33（-0.06 ~ 0.73）0.200.10-0.34（-1.73 ~ 1.02）0.700.62
中频暴露0.34（-0.40 ~ 0.87）0.270.220.67（-1.16 ~ 2.50）0.930.47
高频暴露0.80（0.02 ~ 1.57）0.400.043.46（0.36 ~ 6.56）1.580.03
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烟草戒断及二手烟暴露与生物衰老加速的关系——基于英国生物银行数据库的研究
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辛明伦 , 陈睿 , 向毅 , 肖雄
现代预防医学 | 流行病与统计方法 2025,52(21): 3854-3859
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现代预防医学 |流行病与统计方法 2025 , 52 (21) : 3854 -3859
烟草戒断及二手烟暴露与生物衰老加速的关系——基于英国生物银行数据库的研究
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辛明伦, 陈睿, 向毅, 肖雄
作者信息
  • 四川大学华西公共卫生学院，四川　成都　610041
通讯作者:
肖雄，E-mail：
作者简介:

辛明伦（2003—），男，本科在读，研究方向：预防医学

The association between smoking cessation, secondhand smoke exposure,and accelerated biological aging: a study based on the UK Biobank
Ming-lun XIN, Rui CHEN, Yi XIANG, Xiong XIAO
Affiliations
  • West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2025-11-10 doi: 10.20043/j.cnki.MPM.202506168
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摘要
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目的

探究烟草戒断及二手烟暴露与生物衰老加速的纵向关联，进一步探索烟草戒断人群中二手烟暴露与生物衰老的异质性关联。

方法

本研究基于英国生物银行（UK Biobank）的基线调查与首次重复随访数据。运用表型年龄算法构建并计算表型年龄加速值。通过多元线性回归模型开展变化分析（change analysis），探索戒烟行为和二手烟暴露状态的转变与表型年龄加速变化之间的关系。并通过分层分析识别潜在的差异效应。

结果

本研究纳入111 89名符合条件的个体。相较于从不吸烟者，持续吸烟人群表现出更显著的表型年龄加速（β=0.94，95% CI：0.22 ~ 1.65），而长期戒烟会使表型年龄加速降低至（β=0.30，95% CI：0.05 ~ 0.55）。与保持未暴露于二手烟者相比，增加暴露者的表型年龄加速变化为（β=0.40，95% CI：0.01 ~ 0.79），而在长期戒烟者中高频率的二手烟暴露会造成更为显著的衰老加速（β=0.80，95% CI：0.02 ~ 1.57）。

结论

戒烟能够部分逆转吸烟带来的生物衰老损害，但烟草的长期损害难以完全逆转，同时二手烟暴露会显著加速生物衰老，且对戒烟者造成更为显著的危害。

生物衰老  /  烟草戒断  /  二手烟暴露  /  变化分析
Objective

To investigate the longitudinal association between smoking cessation, secondhand smoke (SHS) exposure, and accelerated biological aging, and to further explore the heterogeneous associations of SHS exposure on biological aging among individuals who have quit smoking.

Methods

This study was based on data from the baseline and the first repeat assessment of the UK Biobank. Phenotypic Age (PA) was constructed using the validated PA algorithm, and PA acceleration was calculated. Multivariable linear regression models were used to perform change analysis to assess the associations between changes in smoking behavior and SHS exposure with changes in PA acceleration. Stratified analyses were conducted to identify potential effect heterogeneity.

Results

A total of 11 189 eligible participants were included. Compared to never smokers, persistent smokers showed significantly greater PA acceleration (β=0.94, 95% CI: 0.22-1.65), whereas long-term quitters were associated with lower PA acceleration (β=0.30, 95% CI: 0.05-0.55). Compared with those consistently unexposed to SHS, individuals with increased SHS exposure exhibited greater PA acceleration(β=0.40, 95% CI: 0.01-0.79). Notably, among long-term quitters, frequent SHS exposure was associated with significantly greater biological aging (β=0.80, 95% CI: 0.02-1.57).

Conclusion

Smoking cessation can partially reverse the adverse effects of smoking on biological aging, although long-term damage may not be fully reversible. Moreover, SHS exposure significantly accelerates biological aging, with more pronounced effects observed among individuals who have quit smoking.

Biological aging  /  Smoking cessation  /  Secondhand smoke exposure  /  Change analysis
辛明伦, 陈睿, 向毅, 肖雄. 烟草戒断及二手烟暴露与生物衰老加速的关系——基于英国生物银行数据库的研究. 现代预防医学, 2025 , 52 (21) : 3854 -3859 . DOI: 10.20043/j.cnki.MPM.202506168
Ming-lun XIN, Rui CHEN, Yi XIANG, Xiong XIAO. The association between smoking cessation, secondhand smoke exposure,and accelerated biological aging: a study based on the UK Biobank[J]. Modern Preventive Medicine, 2025 , 52 (21) : 3854 -3859 . DOI: 10.20043/j.cnki.MPM.202506168
正文
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烟草使用是全球主要死亡风险因素[1-2]。截至2020年，全球约22.3%人口使用烟草，每年导致超800万人死亡，含约130万二手烟暴露非吸烟者[3]。研究表明，戒烟显著降低呼吸系统疾病[4]、心血管疾病[5]、慢性肾病和癌症风险[6-9]。生物衰老为年龄相关疾病早期起点，生活方式改善可延缓生物衰老、降低疾病风险[10]。戒烟和二手烟暴露作为可干预因素备受关注。研究发现二手烟暴露与端粒长度及KDM生物年龄相关[11-13]。而戒烟相关研究有限，部分显示戒烟与端粒长度缩短相关[14-15]，端粒长度能够反映细胞水平的衰老状况[16]。相比之下，表型年龄（phenotypic age）作为一种复合生物年龄指标，在预测与衰老相关的健康结局方面优于分子层面的指标[17]。
目前关于戒烟与二手烟暴露对衰老影响的研究多为横断面设计，缺乏纵向证据，难以评估个体行为改变对生物衰老的作用。本研究从个体行为变化出发，分析不同行为转变下戒烟和二手烟暴露对衰老的长期影响。并且以往研究主要关注儿童、孕妇或从未吸烟者等易感人群，对于戒烟者由于其本身的社会环境因素，被动暴露于二手烟对生物衰老的影响尚未得到充分研究。
本研究基于英国生物银行（UK Biobank，UKB）两期生化数据构建表型年龄，旨在探讨烟草戒断状态变化与生物年龄（biological age）变化的纵向关系，并分析二手烟暴露在戒烟者与非吸烟者中的差异性影响，为控烟政策与健康老龄化策略提供依据。
1　对象与方法
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1.1　研究对象
本研究对象来源于UKB，该项大型人群前瞻性队列于2006—2010年招募了37～73岁超过50万名参与者。通过触屏问卷收集人口统计、生活方式及既往病史等信息，并完成体测和生物样本采集。研究设计和方法见既往文献[18]。所有参与者签署电子知情同意书，获得英国西北多中心伦理委员会批准。由于临床生化数据的可及性，本研究最终选择纳入UKB的基线和首次重复调查数据。
本研究排除以下个体：（1）未参加首次重复调查者（n=482 051）；（2）缺失表型年龄生物标志物数据者（n=7 859）；（3）缺失烟草戒断状态者（n=61）；（4）协变量资料不全者（n=1 234）。最终纳入分析者共11 189名。
1.2　研究方法
1.2.1　暴露测量
烟草戒断状态由触屏问卷测量，基于“您现在抽烟吗？”和“您过去抽烟频率？”两个问题，将参与者分为非吸烟者（从未吸烟）、戒断者（曾吸烟但现不吸烟）和当前吸烟者。根据两次调查结果，戒断状态变化被归为四组：从未吸烟、短期戒烟（由吸烟转为不吸烟）、长期戒烟（持续戒烟）和持续吸烟。见表1。
二手烟暴露通过问卷收集家庭内外每周暴露小时数，合并计算总暴露时长。基于总时长分为未暴露（0 h/周）与暴露（>0 h/周），进一步细分为未暴露、低频（1 h/周）、中度（2～6 h/周）和高频（>6 h/周）四组。结合两次调查回答，二手烟暴露状态变化分为从未暴露、增加暴露、减少暴露和保持暴露。见表2。
1.2.2　结局测量
本研究采用经验证的表型年龄算法构建表型年龄指标，用于评估生物衰老。表型年龄基于实际年龄及九项生物标志物（白蛋白、肌酐、血糖、对数CRP、淋巴细胞百分比、平均红细胞体积、红细胞分布宽度、碱性磷酸酶、白细胞计数），通过目标为预测死亡风险的10折交叉验证的Cox比例风险弹性网模型筛选得到。
由于表型年龄受实际年龄影响，不能完全反映个体生物衰老差异，因此计算表型年龄加速（表型年龄减去实际年龄），以更准确反映衰老状态。表型年龄加速>0表示衰老加速，<0则提示衰老减缓。
1.3　统计分析方法
本研究根据烟草戒断状态变化进行分组，描述基线特征。连续变量以中位数（P25，P75）表示，分类变量用频数和比例描述。
为了探讨烟草戒断状态变化及二手烟暴露状态变化与表型年龄加速之间的关系，采用多元线性回归模型进行变化分析。该方法控制个体内非时变混杂因素[19]。协变量的选择基于所构建的有向无环图，涵盖年龄、种族、教育水平及汤森剥夺指数（Townsend deprivation index, TDI）、就业状态、睡眠时长、焦虑、抑郁、膳食评分、饮茶、饮酒、身体质量指数(body mass index，BMI)、慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）、心血管疾病（cardiovascular disease,CVD）、糖尿病和癌症[20-21]。其次，本研究为探索效应的异质性，进一步将年龄、性别等作为分层因素来进行分层分析。最后，本研究以烟草戒断状态为分层因素深入分析了二手烟暴露在烟草戒断人群的异质性效应。
为验证本研究结果的稳健性，开展了多项敏感性分析。首先，采用残差法重新定义表型年龄加速重复分析。其次，对协变量缺失采用多重插补链式方程填补。最后，我们计算了E值，用以评估未测量混杂因素对研究结果潜在影响的程度[22]。统计分析用R 4.4.3，双侧检验，检验水准α=0.05。
2　结果
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2.1　研究对象特征描述
研究对象的基线特征见表3。相比从不吸烟者中男性（45.3%）和二手烟暴露比例（16.8%），保持吸烟者的男性（64.1%）及二手烟暴露率（80.4%）比例显著更高，长期戒烟者中男性比例亦偏高（55.9%）。并且保持吸烟者的膳食得分为3.00（2.00，4.00），低于其他组；饮酒比例近 99%；COPD 患病率最高，为1.8%；而短期戒烟者的 CVD 患病率最低，为20.7%。
2.2　烟草戒断状态变化与表型年龄加速变化的关系
烟草戒断状态变动与表型年龄加速变动的关联如图1所示，以从不吸烟者为参照组，保持吸烟者的表型年龄加速变化最高（β=0.94，95% CI: 0.22 ~1.65），短期戒烟者和长期戒烟者的表型年龄加速变化相对较低（β=0.22，95% CI: -0.26 ~ 0.70；β=0.30，95% CI: 0.05 ~ 0.55），较保持吸烟者明显降低，提示戒烟可能逆转吸烟对加速生物年龄部分效应。
2.3　分层分析结果
图2展示戒烟人群的分层分析结果。结果显示≥60岁长期戒烟者表型年龄加速为（β=0.23，95% CI: -0.15 ~ 0.62），略低于<60岁人群（β=0.34，95% CI: 0.01 ~ 0.66）。女性长期戒烟者表型年龄加速高于男性，社会经济地位较高者表型年龄加速更明显，但均未达统计学显著性。总体来看短期与长期戒烟者在各亚组中仍旧保持表型年龄加速大于0的趋势。
2.4　烟草戒断人群的二手烟暴露与表型年龄之间的关联
表4显示在戒烟者中，二手烟暴露频率与表型年龄加速呈正相关。长期戒烟者中，高频暴露组的表型年龄加速显著升高（β=0.80，95% CI: 0.02 ~1.57）。短期戒烟者中该关联更强（β=3.46，95% CI:0.36 ~ 6.56），但置信区间较宽，可能受样本量或异质性影响。
2.5　二手烟暴露状态变化与表型年龄加速变化的关系
二手烟暴露状态变化与表型年龄加速变化的关系如图3所示，以保持未暴露者为参照组，增加暴露者的表型年龄加速变化最高（β=0.40，95% CI: 0.01 ~0.79），保持暴露者的表型年龄加速变化相对较低（β=0.26，95% CI: -0.09 ~ 0.61；β=0.05，95% CI: -0.24 ~0.33），提示二手烟暴露增加会显著引起生物衰老加速。
2.6　敏感性分析结果
采用残差法计算表型年龄加速的重复分析结果一致。对协变量缺失数据进行多重插补后，结果与主分析相似，部分显著性略有提升。长期戒烟与二手烟暴露增加对应的E值分别为2.20和2.23，提示未测量混杂影响较小，具有一定的稳健性。
3　讨论
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本研究基于UKB，系统分析烟草戒断及二手烟暴露变化与生物衰老加速的关系。结果表明，长期戒烟者生物衰老加速显著低于持续吸烟者，支持戒烟对当前吸烟者延缓衰老进程的积极作用。但戒烟者衰老水平仍高于未吸烟者，提示戒烟虽有益，无法完全消除吸烟长期影响，强调避免初始吸烟行为的重要性。同时二手烟暴露增加会加速衰老，高频二手烟暴露对戒烟者伤害更显著。
与既往研究相比，目前尚无研究系统性探讨烟草戒断与二手烟暴露对表型年龄的影响。已有的文献多聚焦于吸烟及二手烟暴露与端粒长度之间的关联，普遍发现吸烟及暴露于二手烟与端粒变短密切相关[13-14,16]。端粒缩短被认为与多种疾病风险升高存在联系[23]，但在预测与年龄相关的健康结局方面效果有限。表型年龄融合了多个系统的生理和生化指标，更全面反映机体衰老状态，在预测死亡和衰老相关风险方面优势更明显[16]。
研究发现戒烟可延缓吸烟人群的生物衰老，但其加速水平仍高于从未吸烟者，提示吸烟造成的损伤难以完全逆转[24]。这与部分研究认为戒烟后健康指标可恢复接近未吸烟者的观点存在差异，强调预防首次吸烟行为的重要性[25-26]。此外本研究首次揭示二手烟对戒烟者的持续伤害，发现高频暴露者的生物衰老显著加速，而过往研究主要聚焦非吸烟人群[13-14]。本研究发现，戒烟者若高频率暴露于二手烟环境中，会显著加速其生物衰老速度。提示戒烟行为本身虽为积极的干预措施，但若未配合改善所处暴露环境，可能难以实现预期健康获益。这一发现对当前控烟政策提出更高要求，不仅应鼓励个体戒烟，也应营造无烟环境，避免被动吸烟对已戒烟人群造成进一步伤害[27]。
大量机制研究为本研究结果提供生物学支持。烟草烟雾中的尼古丁、多环芳烃、重金属等毒物可诱导活性氧生成、炎症反应及内皮功能障碍，进而引起代谢异常[24,28-29]。吸烟通过氧化应激、慢性炎症、DNA甲基化异常及线粒体功能障碍等机制加速衰老。尽管戒烟有助于缓解上述机制，但部分炎症、表观遗传和组织损伤可能具有持续效应，解释了戒烟者虽优于持续吸烟者，但仍不及从未吸烟者。二手烟也会引发类似主动吸烟的病理过程，特别是在戒烟者中，既往烟草暴露可能增强其对后续暴露的敏感性，加剧生物学脆弱性，使高频暴露的损害更显著[30]。本研究发现二手烟对戒烟者的影响进一步强化了烟草暴露累积损伤对加速衰老的可能路径。
本研究具多重优势。一方面，据我们所知，这是为首篇探讨烟草戒断与二手烟暴露对生物年龄加速纵向影响的研究。另一方面，生物年龄指标基于大样本两期血生化与体检数据，证据强度较高。并通过多项敏感性分析验证结果稳健性。但亦有局限，一是烟草使用与二手烟暴露依赖自报，可能受回忆偏倚影响，且无法确定戒烟具体时间；二是重复调查数据限制，部分亚组样本量小，影响统计效能；三是尽管控制多项协变量，反向因果与未测混杂仍可能存在；四是样本主要来自欧洲人群，结果外部适用性有限，未来需纳入多样化人群验证。
综上，长期戒烟可部分逆转吸烟引发的生物衰老损害，支持其作为延缓衰老的有效干预。但烟草的持久损害难以完全消除，凸显戒烟益处的同时，也强调早期预防吸烟的重要性。同时二手烟显著加速衰老，且对戒烟者危害更大，提示控烟策略应同时重视无烟环境建设，以最大程度降低健康风险，为优化控烟与衰老干预提供科学支持。
基金
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  • 国家自然科学基金(82273740)
  • 四川省自然科学基金(2024NSFSC0552)
文献
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参考文献 引证文献
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doi: 10.20043/j.cnki.MPM.202506168
  • 接收时间：2025-06-13
  • 首发时间：2026-10-29
  • 出版时间：2025-11-10
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  • 收稿日期：2025-06-13
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国家自然科学基金(82273740)
四川省自然科学基金(2024NSFSC0552)
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    四川大学华西公共卫生学院，四川　成都　610041

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肖雄，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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