膳食纤维摄入量与慢性阻塞性肺疾病风险：一项针对男性的前瞻性队列研究。
Dietary Fiber Intake and Risk of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study of Men.
出版信息
Epidemiology. 2018 Mar;29(2):254-260. doi: 10.1097/EDE.0000000000000750.
BACKGROUND
The limited literature suggests that dietary fiber intake from whole grains, fruits, and vegetables is negatively associated with chronic obstructive pulmonary disease (COPD) via fiber's anti-inflammatory properties. Therefore, we investigated the association between total fiber and fiber sources and risk of COPD in the population-based prospective Cohort of Swedish Men (45,058 men, ages 45-79 years) with no history of COPD at baseline.
METHODS
Dietary fiber intake was assessed with a self-administered questionnaire in 1997 and was energy adjusted using the residual method. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) adjusted for potential confounders.
RESULTS
During a mean follow-up of 13.1 years (1998-2012), 1,982 incident cases of COPD were ascertained via linkage to the Swedish health registers. A strong inverse association between total fiber intake (≥36.8 vs. <23.7 g/day) and COPD was observed in current smokers (hazard ratio [HR] = 0.54; 95% confidence interval [CI] = 0.43, 0.67) and ex-smokers (HR = 0.62; 95% CI = 0.50, 0.78) but not in never smokers (HR = 0.93; 95% CI = 0.60, 1.45; P interaction = 0.04). For cereal fiber, HRs for highest versus lowest quintile were 0.62 (95% CI = 0.51, 0.77; P trend < 0.001) in current smokers and 0.66 (95% CI = 0.52, 0.82; P trend < 0.001) in ex-smokers; for fruit fiber, the HR was 0.65 (95% CI = 0.52, 0.81; P trend < 0.001) in current smokers and 0.77 (95% CI = 0.61, 0.98; P trend = 0.17) in ex-smokers; and for vegetable fiber, it was 0.71 (95% CI = 0.57, 0.88; P trend = 0.003) in current smokers and 0.92 (95% CI = 0.71, 1.19; P trend = 0.48) in ex-smokers.
CONCLUSIONS
Our findings indicate that high fiber intake was inversely associated with COPD incidence in men who are current or ex-smokers.
背景
有限的文献表明，全谷物、水果和蔬菜中的膳食纤维摄入通过纤维的抗炎特性与慢性阻塞性肺疾病（COPD）呈负相关。因此，我们在基于人群的瑞典男性前瞻性队列研究（45058 名年龄在 45-79 岁之间、无 COPD 病史的男性）中，调查了膳食纤维和纤维来源与 COPD 风险之间的关系。
方法
1997 年采用自我管理问卷评估膳食纤维摄入量，并采用残差法进行能量调整。使用 Cox 比例风险回归模型估计风险比（HR）及其 95%置信区间（95%CI），并调整潜在混杂因素。
结果
在平均 13.1 年（1998-2012 年）的随访期间，通过与瑞典健康登记处的链接确定了 1982 例 COPD 新发病例。在当前吸烟者（HR=0.54；95%CI=0.43，0.67）和前吸烟者（HR=0.62；95%CI=0.50，0.78）中，总膳食纤维摄入量（≥36.8 vs. <23.7 g/天）与 COPD 呈强负相关，但在从不吸烟者中则无此相关性（HR=0.93；95%CI=0.60，1.45；P 交互=0.04）。对于谷物纤维，最高五分位数与最低五分位数相比，当前吸烟者的 HR 为 0.62（95%CI=0.51，0.77；P 趋势<0.001），前吸烟者为 0.66（95%CI=0.52，0.82；P 趋势<0.001）；对于水果纤维，当前吸烟者的 HR 为 0.65（95%CI=0.52，0.81；P 趋势<0.001），前吸烟者的 HR 为 0.77（95%CI=0.61，0.98；P 趋势=0.17）；对于蔬菜纤维，当前吸烟者的 HR 为 0.71（95%CI=0.57，0.88；P 趋势=0.003），前吸烟者的 HR 为 0.92（95%CI=0.71，1.19；P 趋势=0.48）。
结论
我们的研究结果表明，高纤维摄入量与男性中当前吸烟者或前吸烟者的 COPD 发病率呈负相关。
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