Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Front Public Health. 2023 Dec 4;11:1297245. doi: 10.3389/fpubh.2023.1297245. eCollection 2023.
It remains unclear how antioxidant intake affects all-cause mortality in osteoarthritis (OA) patients. In this prospective cohort study, we aim to explore the association of the Composite Dietary Antioxidant Index (CDAI) with all-cause mortality and investigate the interaction of physical activity (PA) and CDAI on all-cause mortality in OA populations.
A total of 3,197 adults with OA in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018 were included in this study. Death outcomes were obtained from National Death Index (NDI) records. Multivariable Cox regression analyses with cubic spines were applied to estimate the association of CDAI with all-cause mortality. The interaction between CDAI and PA on all-cause mortality was further assessed in stratified analysis and interaction tests.
The hazard ratios for all-cause mortality were 0.95 (0.77-1.17) for Q2, 0.75 (0.59-0.97) for Q3, and 0.71 (0.55-0.92) for Q4 ( for trend <0.001), compared with the lowest quartile of CDAI. A negative linear association was found between CDAI and all-cause mortality. In the stratified analyses, CDAI was negatively associated with all-cause mortality in the insufficient PA group. While in the low and sufficient PA group, there were nonlinear relationships of CDAI with all-cause mortality.
A negative linear relationship was observed between CDAI and all-cause mortality in OA patients, and this association was significantly modified by PA. Higher intake of dietary antioxidants might be the interventional objective to reduce the risk of all-cause mortality in the US OA population.
目前尚不清楚抗氧化剂的摄入如何影响骨关节炎 (OA) 患者的全因死亡率。在这项前瞻性队列研究中，我们旨在探讨复合饮食抗氧化剂指数 (CDAI) 与全因死亡率的关系，并研究身体活动 (PA) 和 CDAI 对 OA 人群全因死亡率的交互作用。
本研究共纳入了 2001 年至 2018 年全国健康和营养调查 (NHANES) 中 3197 名 OA 成年人。死亡结局来自国家死亡指数 (NDI) 记录。采用带有三次样条的多变量 Cox 回归分析来估计 CDAI 与全因死亡率的关系。进一步在分层分析和交互检验中评估 CDAI 与 PA 对全因死亡率的交互作用。
与 CDAI 最低四分位相比，Q2 组的全因死亡率比为 0.95（0.77-1.17），Q3 组为 0.75（0.59-0.97），Q4 组为 0.71（0.55-0.92）（趋势检验<0.001）。CDAI 与全因死亡率之间呈负线性关系。在分层分析中，在 PA 不足的组中，CDAI 与全因死亡率呈负相关。而在低 PA 和充足 PA 组中，CDAI 与全因死亡率之间存在非线性关系。
在 OA 患者中，CDAI 与全因死亡率之间存在负线性关系，这种关系受 PA 的显著影响。较高的饮食抗氧化剂摄入量可能是降低美国 OA 人群全因死亡率的干预目标。
