Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC, 29203, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Eur J Nutr. 2017 Apr;56(3):1085-1093. doi: 10.1007/s00394-016-1158-4. Epub 2016 Jan 29.
Chronic inflammation is associated with increased risk of cancer, cardiovascular disease (CVD), and diabetes. The role of pro-inflammatory diet in the risk of cancer mortality and CVD mortality in prediabetics is unclear. We examined the relationship between diet-associated inflammation, as measured by dietary inflammatory index (DII) score, and mortality, with special focus on prediabetics.
This prospective cohort study used data from the Third National Health and Nutrition Examination Survey (NHANES III). We categorized 13,280 eligible participants, ages 20-90 years, according to glycosylated hemoglobin (HgbA1c) level and identified 2681 with prediabetes, defined as a glycosylated hemoglobin percentage of 5.7-6.4. Computation of DII scores and all statistical analyses were conducted in 2015. The DII was computed based on baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Over follow-up ranging between 135 and 168 person-months, a total of 3016 deaths were identified, including 676 cancer, 192 lung cancer, 176 digestive-tract cancer, and 1328 CVD deaths. Cox proportional hazard regression was used to estimate hazard ratios.
The prevalence of prediabetes was 20.19 %. After controlling for age, sex, race, HgbA1c, current smoking, physical activity, BMI, and systolic blood pressure, DII scores in tertile III (vs tertile I) was significantly associated with mortality from all causes (HR 1.39, 95 % CI 1.13, 1.72), CVD (HR 1.44, 95 % CI 1.02, 2.04), all cancers (HR 2.02, 95 % CI 1.27, 3.21), and digestive-tract cancer (HR 2.89, 95 % CI 1.08, 7.71). Findings for lung cancer (HR 2.01, 95 % CI 0.93, 4.34) suggested a likely effect. These results were moderately enhanced after additional adjustment for serum low-density lipoprotein and triglyceride and following eliminating deaths during the first year.
A pro-inflammatory diet, as indicated by higher DII scores, is associated with an increased risk of all-cause, CVD, all-cancer, and digestive-tract cancer mortality among prediabetic subjects.
慢性炎症与癌症、心血管疾病（CVD）和糖尿病风险增加有关。在糖尿病前期患者中，促炎饮食与癌症死亡率和 CVD 死亡率风险之间的关系尚不清楚。我们研究了饮食相关炎症与死亡率之间的关系，炎症程度通过饮食炎症指数（DII）评分来衡量，尤其关注糖尿病前期患者。
本前瞻性队列研究使用了第三次全国健康和营养调查（NHANES III）的数据。我们根据糖化血红蛋白（HgbA1c）水平对 13280 名年龄在 20-90 岁之间的合格参与者进行分类，并确定了 2681 名糖尿病前期患者，定义为糖化血红蛋白百分比为 5.7-6.4。DII 评分的计算和所有统计分析均于 2015 年进行。DII 基于使用 24 小时膳食回顾（1988-1994 年）评估的基线饮食摄入进行计算。通过国家死亡指数记录确定死亡率，截至 2006 年。在随访期间为 135-168 人月，共确定了 3016 例死亡，包括 676 例癌症、192 例肺癌、176 例消化道癌和 1328 例 CVD 死亡。使用 Cox 比例风险回归估计风险比。
糖尿病前期的患病率为 20.19%。在控制年龄、性别、种族、HgbA1c、当前吸烟状况、身体活动、BMI 和收缩压后，DII 评分处于第三三分位数（与第一三分位数相比）与所有原因（HR 1.39，95%CI 1.13，1.72）、CVD（HR 1.44，95%CI 1.02，2.04）、所有癌症（HR 2.02，95%CI 1.27，3.21）和消化道癌（HR 2.89，95%CI 1.08，7.71）的死亡率显著相关。肺癌（HR 2.01，95%CI 0.93，4.34）的结果表明可能存在影响。在进一步调整血清低密度脂蛋白和甘油三酯并排除第一年死亡后，这些结果得到了适度增强。
在糖尿病前期患者中，较高的 DII 评分表明促炎饮食与全因、CVD、所有癌症和消化道癌死亡率风险增加有关。
