Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Clin Gastroenterol Hepatol. 2022 Feb;20(2):303-313.e6. doi: 10.1016/j.cgh.2021.03.029. Epub 2021 Mar 26.
BACKGROUND & AIMS: Diet is thought to play a role in the development of inflammatory bowel disease (IBD), though it is unknown whether gluten intake confers risk of IBD. The aim of this study was to determine the relationship between gluten intake and risk of incident Crohn's disease (CD) and ulcerative colitis (UC).
We performed a prospective cohort study of 208,280 US participants from the Nurses' Health Study (1986-2016), Nurses' Health Study II (1991-2017), and the Health Professionals Follow-up Study (1986-2016) who did not have IBD at baseline or celiac disease, and who completed semiquantitative food frequency questionnaires. We used Cox proportional hazards modeling to estimate the risk of IBD according to quintiles of cumulative average energy-adjusted dietary gluten intake over the follow-up period.
We documented 337 CD cases and 447 UC cases over 5,115,265 person-years of follow-up evaluation. Dietary gluten intake was not associated with risk of IBD. Compared with participants in the lowest quintile of gluten intake, the adjusted hazard ratios and 95% CIs for participants in the highest quintile of gluten intake were 1.16 (95% CI, 0.82-1.64; P = .41) for CD and 1.04 (95% CI, 0.75-1.44; P = .64) for UC. Adjusting for primary sources of gluten intake did not materially change our estimates.
In 3 large adult US prospective cohorts, gluten intake was not associated with risk of CD or UC. Our findings are reassuring at a time when consumption of gluten has been increasingly perceived as a trigger for chronic gastrointestinal diseases.
饮食被认为在炎症性肠病（IBD）的发展中起作用，但尚不清楚摄入麸质是否会增加 IBD 的风险。本研究的目的是确定麸质摄入与克罗恩病（CD）和溃疡性结肠炎（UC）发病风险之间的关系。
我们对来自美国护士健康研究（1986-2016 年）、护士健康研究 II（1991-2017 年）和健康专业人员随访研究（1986-2016 年）的 208280 名参与者进行了前瞻性队列研究，这些参与者在基线或乳糜泻时没有 IBD，并且完成了半定量食物频率问卷。我们使用 Cox 比例风险模型根据随访期间累积平均能量调整后的饮食麸质摄入量的五分位数来估计 IBD 的风险。
在 5115265 人年的随访评估中，我们记录了 337 例 CD 病例和 447 例 UC 病例。饮食麸质摄入与 IBD 风险无关。与摄入麸质最低五分位的参与者相比，摄入麸质最高五分位的参与者的调整后风险比和 95%CI 为 CD 为 1.16（95%CI，0.82-1.64；P=0.41），UC 为 1.04（95%CI，0.75-1.44；P=0.64）。调整主要的麸质摄入来源并未实质性改变我们的估计值。
在 3 个大型美国成年前瞻性队列中，麸质摄入与 CD 或 UC 风险无关。在越来越多的人认为麸质摄入是慢性胃肠道疾病的诱因的时代，我们的发现令人安心。
