Lander Eric M, Wertheim Betsy C, Koch Stephanie M, Chen Zhao, Hsu Chiu-Hsieh, Thomson Cynthia A
University of Arizona College of Medicine-Tucson, 1501 N. Campbell Avenue, Tucson, AZ 85724, United States.
University of Arizona Cancer Center, 1501 N. Campbell Avenue, PO Box 245017, Tucson, AZ 85724, United States.
Prev Med. 2016 Jul;88:20-6. doi: 10.1016/j.ypmed.2016.03.016. Epub 2016 Mar 20.
This study aimed to measure associations between gallbladder disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women.
Analyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of gallbladder disease prior to baseline. Cox proportional hazards regression models, adjusted for gallbladder disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and gallbladder disease.
In this study sample, 8.1% of postmenopausal women self-reported incident gallbladder disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (>24.0g/d) had a lower risk of gallbladder disease (HR, 0.87; 95% CI, 0.81-0.93) as compared to women in the lowest quintile (<16.3g/d) (Ptrend<0.001). Total protein intake was modestly protective against gallbladder disease (Ptrend<0.021). Animal protein intake was not associated with gallbladder disease risk. The protective effect of vegetable protein held stable only for women without history of diabetes (HR, 0.86; 95% CI, 0.80-0.92) and without recent weight loss (HR, 0.88; 95% CI, 0.80-0.97).
Vegetable protein intake is inversely associated with gallbladder disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for gallbladder disease.
本研究旨在测量绝经后女性胆囊疾病与蛋白质摄入模式之间的关联,按数量和类型(植物性与动物性)进行区分。
分析基于1993年至1998年在美国40个临床中心纳入女性健康倡议临床试验和观察性研究的130,859名绝经后女性。如果女性在基线前报告有胆囊疾病史,则将其排除。使用经胆囊疾病风险因素调整的Cox比例风险回归模型来估计能量调整后的蛋白质摄入量与胆囊疾病之间关联的风险比(HR)和95%置信区间(CI)。
在本研究样本中,8.1%的绝经后女性自我报告患有新发胆囊疾病。在多变量分析中,能量调整后的植物性蛋白质摄入量最高五分位数组(>24.0g/天)的女性患胆囊疾病的风险低于最低五分位数组(<16.3g/天)的女性(HR,0.87;95%CI,0.81 - 0.93)(P趋势<0.001)。总蛋白质摄入量对胆囊疾病有适度的保护作用(P趋势<0.021)。动物性蛋白质摄入量与胆囊疾病风险无关。植物性蛋白质的保护作用仅在无糖尿病史的女性(HR,0.86;95%CI,0.80 - 0.92)和近期无体重减轻的女性(HR,0.88;95%CI,0.80 - 0.97)中保持稳定。
在我们的绝经后女性样本中,植物性蛋白质摄入量与胆囊疾病风险呈负相关。除了体重管理外,医疗保健提供者可以强调植物性蛋白质作为一种额外的饮食方式,以降低胆囊疾病风险。