Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States; Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, United States.
Nutrition. 2021 Sep;89:111239. doi: 10.1016/j.nut.2021.111239. Epub 2021 Mar 9.
The aim of this study was to evaluate the interrelationships between dietary, nutritional, and inflammatory factors in predicting all-cause mortality among individuals in hemodialysis (HD) treatment.
Participating in this study were 137 patients undergoing HD (58.4% men, 61.7 ± 15.4 y of age) from the NUtrition and GEnetics on HemoDialysis outcomes (NUGE-HD study) cohort. Sociodemographic, anthropometric, and clinical data were collected. Dietary inflammatory index scores were calculated from a quantitative food frequency questionnaire. Plasma C-reactive protein was used as an inflammatory marker. Data were analyzed by path analysis.
During the 2-y follow-up, 27 patients (19.7%) died. Compared with survivors, non-survivors were older (P = 0.01) and had lower body mass index (P = 0.04). In relation to direct (unmediated) associations, dietary inflammatory index (P = 0.049) and C-reactive protein (P = 0.016) were positively associated, whereas body mass index was negatively associated with mortality (P = 0.012). There were no indirect (mediated) associations of the variables evaluated with mortality.
More proinflammatory diet and systemic inflammation have a direct association with mortality among patients undergoing HD therapy. Additionally, more proinflammatory diet is associated with unhealthy dietary pattern.
本研究旨在评估饮食、营养和炎症因素之间的相互关系，以预测接受血液透析（HD）治疗的个体的全因死亡率。
本研究纳入了来自 NUtrition 和 GEnetics on HemoDialysis outcomes（NUGE-HD）研究队列的 137 名接受 HD 治疗的患者（58.4%为男性，61.7±15.4 岁）。收集了社会人口统计学、人体测量学和临床数据。通过定量食物频率问卷计算膳食炎症指数评分。使用血浆 C 反应蛋白作为炎症标志物。通过路径分析进行数据分析。
在 2 年的随访期间，27 名患者（19.7%）死亡。与幸存者相比，非幸存者年龄更大（P=0.01），体重指数更低（P=0.04）。在直接（无中介）关联方面，膳食炎症指数（P=0.049）和 C 反应蛋白（P=0.016）与死亡率呈正相关，而体重指数与死亡率呈负相关（P=0.012）。评估的变量与死亡率之间没有间接（中介）关联。
在接受 HD 治疗的患者中，促炎饮食和全身炎症与死亡率有直接关联。此外，促炎饮食与不健康的饮食模式有关。
