欧洲的饮食模式与炎症性肠病风险：EPIC研究结果
Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study.
作者信息
Racine Antoine, Carbonnel Franck, Chan Simon S M, Hart Andrew R, Bueno-de-Mesquita H Bas, Oldenburg Bas, van Schaik Fiona D M, Tjønneland Anne, Olsen Anja, Dahm Christina C, Key Timothy, Luben Robert, Khaw Kay-Tee, Riboli Elio, Grip Olof, Lindgren Stefan, Hallmans Göran, Karling Pontus, Clavel-Chapelon Françoise, Bergman Manuela M, Boeing Heiner, Kaaks Rudolf, Katzke Verena A, Palli Domenico, Masala G, Jantchou Prevost, Boutron-Ruault Marie-Christine
机构信息
1INSERM, Centre for Research in Epidemiology and Population, Health, UMR1018, Institut Gustave Roussy, Université Paris Sud, Villejuif, France; 2Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Le Kremlin Bicêtre, France; 3Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom; 4Department of Gastroenterology, Norfolk and Norwich University Hospital NHS Trust, Norwich, United Kingdom; 5Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; 6Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands; 7Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; 8Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 9Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; 10Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark; 11Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; 12Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; 13Division of Epidemiology, Imperial College London, London, United Kingdom; 14Department of Gastroenterology and Hepatology, University Hospital Malmö, Malmö, Sweden; 15Department of Public Health and Clinical Medicine, Nutritional Research, Umea University, Umea, Sweden; 16Department of Public Health and Clinical Medicine, GI unit, Umea University, Umea, Sweden; 17Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany; 18Division of Clinical Epidemiology, DKFZ-German Cancer Research Centre Heidelberg, Heidelberg, Germany; 19Molecular and Nutritional Epidemio
出版信息
Inflamm Bowel Dis. 2016 Feb;22(2):345-54. doi: 10.1097/MIB.0000000000000638.
BACKGROUND
Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks.
METHODS
Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case-control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis.
RESULTS
No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a "high sugar and soft drinks" pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00-2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes.
CONCLUSIONS
A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.
背景
特定营养素或食物与溃疡性结肠炎（UC）或克罗恩病（CD）风险之间的关联并不一致。因此，我们研究了整体饮食（即饮食模式）与UC和CD风险之间的关联。
方法
在EPIC（欧洲癌症前瞻性调查）前瞻性研究中，我们在366,351名有炎症性肠病数据的参与者中开展了一项巢式匹配病例对照研究，其中包括256例UC新发病例和117例CD新发病例，每个病例匹配4名对照。通过经验证的食物频率问卷在基线时记录饮食摄入量。针对地中海饮食评分的五分位数以及通过因子分析得出的事后饮食模式，计算发生UC和CD的发病率比。
结果
没有饮食模式与UC或CD风险相关。然而，在排除饮食评估后前2年内发生的病例后，“高糖和软饮料”模式与UC风险之间存在正相关（第五分位数与第一分位数的发病率比为1.68 [1.00 - 2.82]；P趋势 = 0.02）。在考虑与该模式最相关的食物时，只有当糖和软饮料的高摄入量者蔬菜摄入量低时，他们患UC的风险才更高。
结论
高糖和软饮料高摄入量且蔬菜低摄入量的饮食失衡与UC风险相关。需要进一步研究以调查微生物群改变或其他机制是否介导了这种关联。
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