Institute for Biomedical Research and Innovation (IRIB), National Research Council, Palermo, Italy.
Division of Pediatric Pulmonary Medicine, University of Pittsburgh and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Pediatr Allergy Immunol. 2022 Jan;33(1):e13667. doi: 10.1111/pai.13667. Epub 2021 Sep 27.
Unbalanced dietary intake has been increasingly recognized as an important modifiable risk factor for asthma. In this study, we assessed whether a pro-inflammatory diet is associated with higher asthma burden in three steps: (1) identification of asthma latent classes (LC) based on symptoms, indoor exposures, and pulmonary function; (2) identification of risk factors associated with LC membership; and (3) estimation of the probabilities of LC membership with variation in DII.
A cross-sectional study on 415 children aged 5-14 years (266 with persistent asthma and 149 controls). LC analysis was performed in asthmatic children. The DII was calculated based on a semiquantitative food frequency questionnaire. Elastic net logistic regression was used to investigate whether increasing DII was associated with worse asthma burden.
Two LCs were identified. Children in Class 1, "high burden," had higher symptom burden and worse lung function. Children in Class 2, "low burden," had lower symptom burden and less impaired lung function but were more subject to indoor exposures. DII was the only risk factor significantly associated with Class 1 membership. As the DII increased (from -4.0 to +4.0), the probability of Class 1 membership increased from 32% to 65% when compared with control group, whereas it increased from 41% to 72% when compared with Class 2.
We identified two phenotypes of persistent asthma associated with different disease burden linked to indoor exposures. An increasing DII was associated with high-burden asthma, providing further evidence about the role of a pro-inflammatory diet in asthma morbidity.
越来越多的人认识到，不均衡的饮食摄入是哮喘的一个重要可改变的危险因素。在这项研究中，我们通过三个步骤评估了促炎饮食是否与更高的哮喘负担有关：（1）基于症状、室内暴露和肺功能确定哮喘潜在类别（LC）；（2）确定与 LC 成员身份相关的危险因素；（3）通过 DII 变化估计 LC 成员身份的概率。
一项横断面研究纳入了 415 名 5-14 岁儿童（266 名持续性哮喘患儿和 149 名对照）。对哮喘患儿进行 LC 分析。根据半定量食物频率问卷计算 DII。使用弹性网络逻辑回归来研究 DII 增加是否与更严重的哮喘负担有关。
确定了两个 LC。“高负担”类别的儿童具有更高的症状负担和更差的肺功能。“低负担”类别的儿童具有较低的症状负担和受损较轻的肺功能，但更易受到室内暴露的影响。DII 是唯一与 Class 1 成员身份显著相关的危险因素。随着 DII 的增加（从-4.0 到+4.0），与对照组相比，Class 1 成员的概率从 32%增加到 65%，而与 Class 2 相比，该概率从 41%增加到 72%。
我们确定了两种与室内暴露相关的不同疾病负担相关的持续性哮喘表型。DII 增加与高负担哮喘有关，为促炎饮食在哮喘发病机制中的作用提供了进一步的证据。
