系统评价和荟萃分析：疾病前西方饮食模式与炎症性肠病发病风险的关联。

Systematic review and meta-analysis: Association of a pre-illness Western dietary pattern with the risk of developing inflammatory bowel disease.

机构信息

Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.

Department of Gastroenterology and Hepatology, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.

出版信息

J Dig Dis. 2020 Jul;21(7):362-371. doi: 10.1111/1751-2980.12910.

DOI:10.1111/1751-2980.12910

PMID:32463159

Abstract

OBJECTIVE

Previous studies have presented conflicting results on Western diets and the risk of inflammatory bowel disease (IBD). This study aimed to evaluate the role of a pre-illness Western dietary pattern in the development of IBD.

METHODS

The Western dietary pattern was defined as that met at least two of the following, either a high intake of refined grains, red and processed meat, animal protein, animal fats or high-fat dairy products, or with a low consumption of fruit and vegetables. Four medical databases (PubMed, EMBASE, the Cochrane Library and the China National Knowledge Infrastructure) were searched to identify all relevant references. Risk estimate and corresponding 95% confidence interval (CI) were pooled using a random-effects model.

RESULTS

Nine studies (seven case-control studies and two prospective cohorts) were included, with a total of 1491 IBD cases and 53 089 controls. A Western dietary pattern was associated with a risk of all IBD (relative risk [RR] 1.92, 95% CI 1.37-2.68) and separately with Crohn's disease (CD) (RR 1.72, 95% CI 1.01-2.93) and ulcerative colitis (UC) (RR 2.15, 95% CI 1.38-3.34). Subgroup analysis by region showed that a Western dietary pattern was associated with the risk of CD and UC for studies performed in Europe (RR 2.25, 95% CI 1.44-3.50 for CD; RR 2.65, 95% CI 1.61-4.36 for UC). The pooled RR was 2.26 (95% CI 1.42-3.59) in the pediatric CD subgroup.

CONCLUSION

This meta-analysis indicates that a pre-illness Western dietary pattern may increase the risk of developing CD and UC.

摘要

目的

先前的研究对于西方饮食与炎症性肠病（IBD）风险之间的关系得出了相互矛盾的结果。本研究旨在评估疾病发生前的西方饮食模式在 IBD 发展中的作用。

方法

西方饮食模式的定义为符合以下至少两项标准：摄入大量精制谷物、红色和加工肉类、动物蛋白、动物脂肪或高脂肪乳制品，或摄入的水果和蔬菜较少。通过检索四个医学数据库（PubMed、EMBASE、Cochrane 图书馆和中国国家知识基础设施）来确定所有相关参考文献。使用随机效应模型汇总风险估计值和相应的 95%置信区间（CI）。

结果

共纳入 9 项研究（7 项病例对照研究和 2 项前瞻性队列研究），总计 IBD 病例 1491 例，对照组 53089 例。西方饮食模式与所有 IBD（相对风险 [RR] 1.92，95%CI 1.37-2.68）和分别与克罗恩病（RR 1.72，95%CI 1.01-2.93）和溃疡性结肠炎（RR 2.15，95%CI 1.38-3.34）的发病风险相关。按地区进行的亚组分析显示，对于在欧洲进行的研究，西方饮食模式与 CD 和 UC 的发病风险相关（CD：RR 2.25，95%CI 1.44-3.50；UC：RR 2.65，95%CI 1.61-4.36）。在儿童 CD 亚组中，汇总 RR 为 2.26（95%CI 1.42-3.59）。