Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Division of Medical Oncology, Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, Ohio; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Clin Gastroenterol Hepatol. 2020 Sep;18(10):2279-2286.e3. doi: 10.1016/j.cgh.2019.11.011. Epub 2019 Nov 8.
BACKGROUND & AIMS: Lifestyle and dietary risk factors for diverticulitis also have been associated with chronic inflammation. We performed a prospective study of associations among the inflammatory potential of diets, circulating markers of inflammation, and the incidence of diverticulitis.
We followed 46,418 men, initially free of diverticulitis, from 1986 through 2014 in the Health Professionals Follow-Up Study. We collected data on empiric dietary inflammatory pattern scores, which indicate the inflammatory potential of diets, and determined their association with the risk of incident diverticulitis using Cox proportional hazards regression. We used blood samples provided by 18,225 participants from 1993 through 1995 to conduct a nested case-control study; we used conditional logistic regression to evaluate prediagnostic plasma levels of markers of inflammation, including C-reactive protein (CRP), interleukin 6 (IL6), and tumor necrosis factor-receptor superfamily member 1B, in 310 diverticulitis cases and 310 matched diverticulitis-free individuals (controls).
We documented 1110 cases of incident diverticulitis over 992,589 person-years of follow-up. Compared with participants in the lowest quintile of empiric dietary inflammatory pattern scores, men in the highest quintile had a multivariable-adjusted hazard ratio for diverticulitis of 1.31 (95% CI, 1.07-1.60; P = .01). The association did not differ significantly by strata of body mass index or vigorous activity (P for interaction > .05 for each). In the nested case-control study, plasma levels of CRP and IL6 were associated with risk of diverticulitis. When we compared extreme quintiles, the multivariable-adjusted relative risk for diverticulitis was 1.85 for CRP (95% CI, 1.04-3.30) and 2.04 for IL6 (95% CI, 1.09-3.84).
In a large prospective cohort of men, we found that the inflammatory potential of diet and prediagnostic plasma levels of markers of inflammation were associated with incident diverticulitis.
与憩室炎相关的生活方式和饮食风险因素也与慢性炎症有关。我们进行了一项前瞻性研究，探讨饮食的炎症潜能、循环炎症标志物与憩室炎发病之间的关系。
我们对 1986 年至 2014 年间最初无憩室炎的 46418 名男性进行了随访。我们收集了经验性饮食炎症模式评分的数据，这些评分表明了饮食的炎症潜能，并使用 Cox 比例风险回归分析确定了它们与新发憩室炎风险的关系。我们利用 1993 年至 1995 年期间 18225 名参与者提供的血液样本进行了一项巢式病例对照研究；我们使用条件逻辑回归分析评估了 310 例憩室炎病例和 310 例匹配的无憩室炎对照者的炎症标志物（包括 C 反应蛋白[CRP]、白细胞介素 6[IL6]和肿瘤坏死因子受体超家族成员 1B）的预诊断血浆水平。
在 992589 人年的随访中，我们记录了 1110 例新发憩室炎病例。与经验性饮食炎症模式评分最低五分位数的参与者相比，评分最高五分位数的男性发生憩室炎的多变量校正风险比为 1.31（95%CI，1.07-1.60；P=0.01）。这种关联在体重指数或剧烈活动的分层中没有显著差异（对于每个因素的交互作用 P >0.05）。在巢式病例对照研究中，CRP 和 IL6 的血浆水平与憩室炎风险相关。当我们比较极端五分位数时，憩室炎的多变量校正相对风险为 CRP 1.85（95%CI，1.04-3.30）和 IL6 2.04（95%CI，1.09-3.84）。
在一项大型前瞻性男性队列中，我们发现饮食的炎症潜能和预诊断炎症标志物的血浆水平与新发憩室炎相关。
