饮食炎症指数、遗传易感性与新发痴呆症风险：来自英国生物库的前瞻性队列研究。
Dietary inflammatory index, genetic susceptibility and risk of incident dementia: a prospective cohort study from UK biobank.
机构信息
Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China.
出版信息
J Neurol. 2024 Mar;271(3):1286-1296. doi: 10.1007/s00415-023-12065-7. Epub 2023 Nov 20.
BACKGROUND
Genetic factors, diet and inflammation are associated with the development of dementia. In this study, we aimed at evaluating the impact of the dietary inflammatory index (DII) scores and genetic susceptibility on the development of dementia.
METHODS
This prospective study involved 207,301 participants aged between 39 and 72 years from UK biobank. A web-based 24-h dietary questionnaire was collected at least once from participants between 2006 and 2012. The DII was calculated based on inflammatory effect score of nutrients. Individual AD-GRS (Alzheimer's disease genetic risk score) was calculated. Incident dementia was ascertained through hospital or death records.
RESULTS
Of all 207,301 participants, 468 incident cases of all-cause dementia (165 AD, 91 VD and 26 FTD) were reported during a follow-up period of 11.4 years. The participants in the highest quintile (Q) of DII scores reported a higher risk for all-cause dementia (Q5 vs. Q3, hazard ratio (HR) = 1.702; 95% CI: 1.285-2.255) and VD (Q5 vs. Q3, HR = 2.266, 95% CI: 1.133-4.531) compared to participants in the Q3. Besides, when compared with the Q1, there was a higher risk for AD in the subjects of Q5 (Q5 vs. Q1, HR = 1.590; 95% CI: 1.004-2.519). There was a non-linear relationship between DII score and all-cause incidence (P for non-linear = 0.038) by restricted cubic splines. Subgroup analysis found that the increased risk for all-cause dementia and AD was more pronounced in the elderly, women, and higher educated population. Cox regression models indicated that compared with the participants who had a low AD-GRS risk and in the lowest tertile of DII, participants had a high AD-GRS and the highest tertile of DII were associated with a higher risk of AD (HR = 1.757, 95% CI: 1.082-2.855, P = 0.023).
CONCLUSIONS
The DII scores were independently associated with an augmented risk for all-cause dementia, AD and VD. Additionally, high AD-GRS with higher DII scores was significantly associated with a higher risk of AD.
背景
遗传因素、饮食和炎症与痴呆的发生发展有关。本研究旨在评估饮食炎症指数（DII）评分和遗传易感性对痴呆发生的影响。
方法
这项前瞻性研究纳入了英国生物库中年龄在 39 至 72 岁之间的 207301 名参与者。参与者在 2006 年至 2012 年期间至少通过网络问卷调查了一次 24 小时的饮食情况。根据营养素的炎症效应评分计算 DII。个体 AD-GRS（阿尔茨海默病遗传风险评分）计算。通过医院或死亡记录确定痴呆的发病情况。
结果
在 207301 名参与者中，随访 11.4 年后共报告了 468 例全因痴呆（165 例 AD、91 例 VaD 和 26 例 FTD）病例。DII 评分最高五分位（Q）组报告全因痴呆（Q5 比 Q3，风险比（HR）=1.702；95%CI：1.285-2.255）和 VaD（Q5 比 Q3，HR=2.266，95%CI：1.133-4.531）的风险更高，与 Q3 组相比。此外，与 Q1 相比，Q5 组发生 AD 的风险更高（Q5 比 Q1，HR=1.590；95%CI：1.004-2.519）。通过限制立方样条的非线性检验发现，DII 评分与全因发病率之间存在非线性关系（P 非线性=0.038）。亚组分析发现，在老年人、女性和受教育程度较高的人群中，全因痴呆和 AD 风险增加更为明显。Cox 回归模型表明，与低 AD-GRS 风险和 DII 最低三分位的参与者相比，高 AD-GRS 和 DII 最高三分位的参与者发生 AD 的风险更高（HR=1.757，95%CI：1.082-2.855，P=0.023）。
结论
DII 评分与全因痴呆、AD 和 VaD 的发病风险增加独立相关。此外，高 AD-GRS 伴高 DII 评分与 AD 风险显著增加相关。
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