Grade 11, Upper School, Hamden Hall Country Day School, Hamden, CT, USA.
Business School, The Chinese University of Hong Kong, Sanxiang Haishang D2- 25CD at the intersection of Keyuan South Road and Dongbin Road, Nanshan District, Shenzhen City, 518000, China.
BMC Public Health. 2024 Aug 10;24(1):2167. doi: 10.1186/s12889-024-19620-5.
OBJECTIVE: This study focused on the investigation of the correlation between dietary retinol intake and rheumatoid arthritis (RA) using the National Health and Nutrition Examination Survey (NHANES) database. METHODS: Data from five NHANES cycles from 2003 to 2012 were utilized for this study. Dietary retinol intake was considered as the independent variable, and RA was the dependent variable. A weighted logistic regression method was applied to construct the relational model of the two variables. Stratified analysis without adjusting for confounding factors and subgroup analysis with confounding factors adjusted were conducted to explore the association between dietary retinol intake and RA. The optimal intake of dietary retinol was determined by the restricted cubic splines (RCS) analysis. RESULTS: 22,971 samples were included in this study. The weighted logistic regression model was employed to construct the relational model of dietary retinol intake and RA (OR: 0.95, 95% CI: 0.91-0.99, p = 0.019). Stratified analysis displayed a great influence on the relational model exerted by the interaction between gender and retinol intake (p for interaction = 0.014). A significant association between retinol intake and RA was also indicated in the model adjusted for demographic characteristics (OR: 0.95, 95% CI: 0.90-1.00, p = 0.029). Subgroup analysis by gender showed that in the female population, unadjusted model (OR: 0.90, 95% CI: 0.84-0.96, p = 0.002), model adjusted for demographic characteristics only (OR: 0.89, 95% CI: 0.83-0.96, p = 0.002), and model adjusted for all confounding factors (OR: 0.91, 95% CI: 0.85-0.99, p = 0.019) indicated dietary retinol intake as a protective factor against RA. RCS analysis demonstrated that in the female population, regardless of the model used (Crude, Model I, and Model II), an intake of dietary retinol > 354.86 mcg was associated with RA disease reduction (OR < 1.0, p-non-linear < 0.05, p-overall < 0.05). CONCLUSION: Increased dietary retinol intake was associated with RA disease reduction, particularly in the female population. Women are recommended to increase their dietary retinol intake (> 354.86 mcg) to reduce the risk of RA.
目的：本研究利用国家健康和营养检查调查（NHANES）数据库，重点研究饮食视黄醇摄入量与类风湿关节炎（RA）之间的相关性。
方法：本研究使用了 2003 年至 2012 年五个 NHANES 周期的数据。饮食视黄醇摄入量被视为自变量，RA 为因变量。应用加权逻辑回归方法构建两变量的关系模型。进行分层分析，不调整混杂因素，以及调整混杂因素的亚组分析，以探讨饮食视黄醇摄入量与 RA 之间的关系。采用受限立方样条（RCS）分析确定饮食视黄醇的最佳摄入量。
结果：本研究共纳入 22971 例样本。采用加权逻辑回归模型构建饮食视黄醇摄入与 RA 的关系模型（OR：0.95，95%CI：0.91-0.99，p=0.019）。分层分析显示，性别与视黄醇摄入之间的相互作用对关系模型有很大影响（p 交互=0.014）。在调整人口统计学特征的模型中，也显示出视黄醇摄入与 RA 之间存在显著关联（OR：0.95，95%CI：0.90-1.00，p=0.029）。按性别进行的亚组分析显示，在女性人群中，未经调整模型（OR：0.90，95%CI：0.84-0.96，p=0.002）、仅调整人口统计学特征模型（OR：0.89，95%CI：0.83-0.96，p=0.002）和调整所有混杂因素模型（OR：0.91，95%CI：0.85-0.99，p=0.019）均表明，饮食视黄醇摄入是 RA 的保护因素。RCS 分析表明，在女性人群中，无论使用何种模型（未校正模型、模型 I 和模型 II），饮食视黄醇摄入量>354.86 mcg 与 RA 疾病减少相关（OR<1.0，p-非线性<0.05，p-总体<0.05）。
结论：增加饮食视黄醇摄入量与 RA 疾病减少相关，尤其是在女性人群中。建议女性增加饮食视黄醇摄入量（>354.86 mcg），以降低 RA 风险。
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