地中海饮食可降低吸烟者腹主动脉瘤的发病风险：两项前瞻性队列研究的结果。
Mediterranean Diet is Associated with Reduced Risk of Abdominal Aortic Aneurysm in Smokers: Results of Two Prospective Cohort Studies.
机构信息
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland.
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Section of Vascular Surgery, Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden.
出版信息
Eur J Vasc Endovasc Surg. 2021 Aug;62(2):284-293. doi: 10.1016/j.ejvs.2021.04.017. Epub 2021 Jun 16.
OBJECTIVE
Smoking is a strong risk factor for the development of abdominal aortic aneurysm (AAA). It was hypothesised that a Mediterranean diet via its anti-oxidative properties would decrease the risk of AAA, particularly among smokers.
METHODS
The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 632 women), aged 45 - 83 years at baseline. A modified Mediterranean Diet (mMED) score, including eight food groups, was calculated based on a food frequency questionnaire. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS
During 17.5 years of follow up (1 427 841 person-years), 1 781 AAA cases (1 496 in men, 285 in women; 1 497 non-ruptured, 284 ruptured) were ascertained via Swedish registers. The mMED score was inversely associated with AAA incidence in men (per each one point increment in mMED score HR 0.96, 95% CI 0.93 - 1.00) and in women (HR 0.83, 95% CI 0.77 - 0.90), for non-ruptured (HR 0.95, 95% CI 0.92 - 0.99; in men with infrarenal aortic diameter ≥ 30 mm HR 0.90, 95% CI 0.81 - 1.00) and for ruptured AAA (HR 0.81, 95% CI 0.70 - 0.93). In current and ex-smokers with low (< 20) and moderate (20 - 39.9) pack-years of smoking, a statistically significant inverse association was observed. HRs for each one point increment in the mMED score in current smokers were 0.83 (95% CI 0.75 - 0.91) and 0.90 (95% CI 0.84 - 0.97), respectively; in ex-smokers 0.89 (95% CI 0.81 - 0.97) and 0.93 (95% CI 0.85 - 1.01), respectively. No association was observed among current or ex-smokers with ≥ 40 pack-years; HRs 1.02 (95% CI 0.91 - 1.13) and 0.95 (95% CI 0.83 - 1.10), respectively.
CONCLUSION
Adherence to the Mediterranean diet was associated with a reduced AAA risk in current and ex-smokers with low pack-years of smoking.
目的
吸烟是腹主动脉瘤（AAA）发展的一个强烈危险因素。据推测，地中海饮食通过其抗氧化特性会降低 AAA 的风险，尤其是在吸烟者中。
方法
研究人群包括瑞典男性队列（45072 名男性）和瑞典乳腺 X 线摄影队列（36632 名女性），基线时年龄为 45-83 岁。根据食物频率问卷计算改良地中海饮食（mMED）评分，包括 8 种食物组。使用 Cox 比例风险模型估计危险比（HR）及其 95%置信区间（CI）。
结果
在 17.5 年的随访期间（1427841 人年），通过瑞典登记处确定了 1781 例 AAA 病例（男性 1496 例，女性 285 例；非破裂 1497 例，破裂 284 例）。mMED 评分与男性（每增加一个 mMED 评分点 HR 0.96，95%CI 0.93-1.00）和女性（HR 0.83，95%CI 0.77-0.90）的 AAA 发生率呈负相关，对于非破裂（HR 0.95，95%CI 0.92-0.99；在肾下主动脉直径≥30mm 的男性中 HR 0.90，95%CI 0.81-1.00）和破裂的 AAA（HR 0.81，95%CI 0.70-0.93）。在当前吸烟者和曾经吸烟者中，低（<20）和中度（20-39.9）吸烟包年的吸烟者中，观察到统计学上显著的负相关。当前吸烟者中每增加一个 mMED 评分点的 HR 分别为 0.83（95%CI 0.75-0.91）和 0.90（95%CI 0.84-0.97）；在曾经吸烟者中，HR 分别为 0.89（95%CI 0.81-0.97）和 0.93（95%CI 0.85-1.01）。在吸烟≥40 包年的当前吸烟者或曾经吸烟者中，未观察到相关性；HR 分别为 1.02（95%CI 0.91-1.13）和 0.95（95%CI 0.83-1.10）。
结论
地中海饮食的依从性与低吸烟包年的当前吸烟者和曾经吸烟者的 AAA 风险降低相关。
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