The Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China.
Department of Orthopaedics, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
J Health Popul Nutr. 2023 Oct 3;42(1):106. doi: 10.1186/s41043-023-00447-6.
This study aimed to explore the association of adherence to the Mediterranean diet (MD), osteopenia and the risk of all-cause mortality in general population.
This retrospective cohort study included 5452 participants ≥ 50 years from the National Health and Nutrition Examination Survey (NHANES). The associations of osteopenia and adherence to the MD with all-cause mortality, as well as the interaction and moderating effects between the osteopenia and adherence to the MD on the all-cause mortality, were explored via univariate and multivariable Cox proportional hazards models.
The follow-up was from October 1, 2006, to December 31, 2019. The median survival time of patients was 81 months. In total, 4724 people were survived and 728 were dead. Osteopenia was associated with increased risk of all-cause mortality in people [hazards ratio (HR) = 1.57, 95% confidence interval (CI) 1.23-1.99]. No significant risk of all-cause mortality was found in people with high adherence to the MD compared with those with low adherence to the MD (P > 0.05). Compared to subjects with no osteopenia who had high adherence to the MD, osteopenia people who had high adherence to the MD (HR = 1.52, 95% CI 1.17-1.98) or low adherence to the MD (HR = 1.81, 95% CI 1.23-2.66) were at increased risk of all-cause mortality after adjusting for confounding factors. The relationship between osteopenia and the risk of all-cause mortality was decreased in those with high adherence to the MD (HR = 1.57, 95% CI 1.17-2.11) compared with those with low adherence to the MD (HR = 1.62, 95% CI 1.08-2.41) after adjusting for confounding factors.
The adherence to the MD regulated the association between osteopenia and the risk of all-cause mortality, which suggested the importance of adherence to the MD in those with osteopenia, and the MD could be advocated in general people.
本研究旨在探讨普通人群中地中海饮食（MD）依从性、骨量减少与全因死亡率的关系。
本回顾性队列研究纳入了来自国家健康和营养检查调查（NHANES）的 5452 名≥50 岁的参与者。通过单变量和多变量 Cox 比例风险模型探讨了骨量减少与 MD 依从性与全因死亡率的关系，以及骨量减少与 MD 依从性对全因死亡率的交互作用和调节作用。
随访时间为 2006 年 10 月 1 日至 2019 年 12 月 31 日。患者的中位生存时间为 81 个月。共有 4724 人存活，728 人死亡。骨量减少与全因死亡率的增加相关[风险比（HR）=1.57，95%置信区间（CI）1.23-1.99]。与 MD 低依从性相比，MD 高依从性的人群全因死亡率无显著升高（P>0.05）。与 MD 高依从性且无骨量减少的受试者相比，MD 高依从性（HR=1.52，95%CI 1.17-1.98）或 MD 低依从性（HR=1.81，95%CI 1.23-2.66）的骨量减少患者全因死亡率风险增加。调整混杂因素后，与 MD 低依从性相比，MD 高依从性的患者骨量减少与全因死亡率之间的关系减弱（HR=1.57，95%CI 1.17-2.11）。
MD 依从性调节了骨量减少与全因死亡率之间的关系，这表明 MD 依从性对骨量减少患者的重要性，并且可以在一般人群中提倡 MD。
