超加工食品的消费与 SUN 项目中消化性溃疡病发病率的关系：一项西班牙前瞻性队列研究。

Association between the consumption of ultra-processed foods and the incidence of peptic ulcer disease in the SUN project: a Spanish prospective cohort study.

机构信息

International Center for the Assessment of Nutritional Status and The Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.

Clinical Nutrition Unit, Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, Milan, 20100, Italy.

出版信息

Eur J Nutr. 2024 Sep;63(6):2367-2378. doi: 10.1007/s00394-024-03439-2. Epub 2024 May 29.

DOI:10.1007/s00394-024-03439-2

PMID:38809325

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11377682/

Abstract

PURPOSE

Consumption of ultra-processed foods (UPF) has increased despite potential adverse health effects. Recent studies showed an association between UPF consumption and some gastrointestinal disorders. We evaluated the association between UPF consumption and peptic ulcer disease (PUD) in a large Spanish cohort.

METHODS

We conducted a prospective analysis of 18,066 participants in the SUN cohort, followed every two years. UPF was assessed at baseline and 10 years after. Cases of PUD were identified among participants reporting a physician-made diagnosis of PUD during follow-ups. Cases were only partially validated against medical records. Cox regression was used to assess the association between baseline UPF consumption and PUD risk. Based on previous findings and biological plausibility, socio-demographic and lifestyle variables, BMI, energy intake, Helicobacter pylori infection, gastrointestinal disorders, aspirin and analgesic use, and alcohol and coffee consumption were included as confounders.We fitted GEE with repeated dietary measurements at baseline and after 10 years of follow-up. Vanderweele's proposed E value was calculated to assess the sensitivity of observed associations to uncontrolled confounding.

RESULTS

During a median follow-up of 12.2 years, we recorded 322 new PUD cases (1.56 cases/1000 person-years). Participants in the highest baseline tertile of UPF consumption had an increased PUD risk compared to participants in the lowest tertile (HR = 1.52, 95% CI: 1.15, 2.00, P=0.002). The E-values for the point estimate supported the observed association. The OR using repeated measurements of UPF intake was 1.39 (95% CI: 1.03, 1.87) when comparing extreme tertiles.

CONCLUSION

The consumption of UPF is associated with an increased PUD risk.

摘要

目的

尽管超加工食品（UPF）可能对健康有不良影响，但人们对其的消费仍在增加。最近的研究表明，UPF 的消费与一些胃肠道疾病之间存在关联。我们在一个大型的西班牙队列中评估了 UPF 消费与消化性溃疡病（PUD）之间的关联。

方法

我们对 SUN 队列中的 18066 名参与者进行了前瞻性分析，每两年随访一次。在基线和 10 年后评估 UPF 的摄入量。在随访期间，通过报告医生诊断为 PUD 的参与者来确定 PUD 病例。病例仅部分与医疗记录进行了验证。使用 Cox 回归评估基线 UPF 摄入量与 PUD 风险之间的关联。基于先前的发现和生物学合理性，社会人口统计学和生活方式变量、BMI、能量摄入、幽门螺杆菌感染、胃肠道疾病、阿司匹林和镇痛药的使用以及酒精和咖啡的摄入被纳入混杂因素。我们在基线和 10 年随访后使用重复的饮食测量值拟合了 GEE。计算了 Vanderweele 提出的 E 值，以评估观察到的关联对未控制混杂因素的敏感性。

结果

在中位数为 12.2 年的随访期间，我们记录了 322 例新发 PUD 病例（1.56 例/1000 人年）。与最低 tertile 相比，UPF 摄入量最高 tertile 的参与者 PUD 风险增加（HR=1.52，95%CI：1.15，2.00，P=0.002）。点估计的 E 值支持观察到的关联。当比较极端 tertiles 时，使用 UPF 摄入量的重复测量得到的 OR 为 1.39（95%CI：1.03，1.87）。