膳食炎症指数与肥胖成年人全因死亡率的关系。

Association between the Dietary Inflammatory Index and All-Cause Mortality in Adults with Obesity.

机构信息

Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.

出版信息

Ann Nutr Metab. 2023;79(5):434-447. doi: 10.1159/000533380. Epub 2023 Sep 8.

DOI:10.1159/000533380

PMID:37690445

Abstract

INTRODUCTION

The dietary inflammatory index (DII) is associated with numerous chronic noncommunicable diseases. Previous studies have shown that the pro-inflammatory DII categories are associated with abdominal and simple obesity. However, the association between DII and mortality in patients with abdominal obesity and simple overweight or obesity remains unclear.

METHODS

We used data from the US National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A DII >0 (positive DII) was defined as a pro-inflammatory diet. A restricted cubic spline curve was used to describe the trend between DII and all-cause mortality. We then examined the association between DII and all-cause mortality in different body types using a Cox regression analysis and investigated the differences between sexes. Finally, the mediating effects of systemic inflammation were explored.

RESULTS

A pro-inflammatory diet increased all-cause mortality in adults with abdominal obesity (aHR: 1.31, 95% confidence interval [CI]: 1.11-1.54; p < 0.001) and with simple overweight or obesity (aHR: 1.30, 95% CI: 1.11-1.53; p < 0.001). In addition, the most pro-inflammatory DII increased the risk of mortality by 43% (hazard ratio [HR]: Q4 vs. Q1 = 1.43, 95% CI = 1.14-1.79; p = 0.002; p for trend = 0.003) and 39% (HR: Q4 vs. Q1 = 1.39, 95% CI = 1.13-1.74; p = 0.003; p for trend = 0.009) in participants with abdominal obesity and with simple overweight or obesity, respectively. However, this association was not present in normal-sized participants. Compared with men, women resisted the effects of a pro-inflammatory diet. Mediation analysis showed that white blood cell and neutrophil were mediators of the association between DII and all-cause mortality (p < 0.001).

CONCLUSION

A pro-inflammatory diet is associated with all-cause mortality in adults with abdominal obesity and simple overweight or obesity, and this effect differs between men and women. Systemic inflammation may mediate the association between DII and all-cause mortality.

摘要

简介

饮食炎症指数（DII）与许多慢性非传染性疾病有关。先前的研究表明，促炎 DII 类别与腹部和单纯性肥胖有关。然而，DII 与腹部肥胖和单纯超重或肥胖患者的死亡率之间的关系尚不清楚。

方法

我们使用了 2007 年至 2018 年美国国家健康和营养检查调查（NHANES）的数据。DII >0（阳性 DII）被定义为促炎饮食。使用限制立方样条曲线描述 DII 与全因死亡率之间的趋势。然后，我们使用 Cox 回归分析检查了不同体型的 DII 与全因死亡率之间的关系，并探讨了性别差异。最后，探讨了系统性炎症的中介作用。

结果

促炎饮食会增加腹部肥胖成年人（aHR：1.31，95%置信区间[CI]：1.11-1.54；p < 0.001）和单纯超重或肥胖成年人（aHR：1.30，95%CI：1.11-1.53；p < 0.001）的全因死亡率。此外，最促炎的 DII 使死亡率增加了 43%（危险比[HR]：Q4 与 Q1=1.43，95%CI=1.14-1.79；p=0.002；p 趋势=0.003）和 39%（HR：Q4 与 Q1=1.39，95%CI=1.13-1.74；p=0.003；p 趋势=0.009）在腹部肥胖和单纯超重或肥胖的参与者中。然而，这种关联在正常体型的参与者中并不存在。与男性相比，女性对促炎饮食的影响有抵抗力。中介分析表明，白细胞和中性粒细胞是 DII 与全因死亡率之间关联的中介（p < 0.001）。