Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Pediatric Clinical Research Institute, Children's Hospital of Soochow University, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China; Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou, China.
Am J Clin Nutr. 2024 Oct;120(4):927-935. doi: 10.1016/j.ajcnut.2024.08.014. Epub 2024 Aug 18.
Limited studies explored the association between consumption of ultraprocessed food (UPF) and rheumatoid arthritis (RA).
This study aimed to examine the association between UPF consumption and RA risk and explore the potential mediating effects of RA-related biomarkers.
This retrospective cohort study included 207,012 participants without RA at recruitment and completed 24-h dietary recalls. UPF was defined based on the NOVA food classification system. Incident RA was ascertained using the International Classification of Diseases version 10. Cox regression models were used to examine the association between UPF consumption and the incidence of RA. Additionally, mediation analyses were conducted to evaluate the contribution of biomarkers related to the lipid profile, systemic inflammatory factors, serum liver enzymes, and glucose metabolism to the observed associations.
The participants' mean (standard deviation [SD]) age at recruitment was 56.08 (7.95) y. During a median follow-up of 12.24 (interquartile range: 11.66-13.03) y, 1869 RA events were recorded. Compared with the lowest quintile of UPF consumption (weight percentage of the UPF), the adjusted hazard ratio (HR) of RA in the highest quintile was 1.17 (95% confidence interval (CI): 1.01, 1.36). There was a 6% elevated risk of RA incidence per SD increase in UPF intake (HR: 1.06; 95% CI: 1.01, 1.11). In the mediation analyses, the biomarkers explained 3.07%-14.80% of the association between UPF intake and RA.
Higher UPF consumption was associated with an increased risk of RA, which may be mediated by inflammation, lipids, and liver enzymes. Lower UPF consumption is recommended to reduce RA incidence.
有限的研究探讨了超加工食品（UPF）消费与类风湿关节炎（RA）之间的关联。
本研究旨在检验 UPF 消费与 RA 风险之间的关联，并探讨 RA 相关生物标志物的潜在中介作用。
这是一项回顾性队列研究，纳入了 207012 名在招募时无 RA 的参与者，并完成了 24 小时膳食回忆。根据 NOVA 食品分类系统定义 UPF。使用国际疾病分类第 10 版确定 RA 的发病情况。使用 Cox 回归模型检验 UPF 消费与 RA 发病之间的关联。此外，还进行了中介分析，以评估与脂质谱、系统性炎症因子、血清肝酶和葡萄糖代谢相关的生物标志物对观察到的关联的贡献。
参与者招募时的平均（标准差[SD]）年龄为 56.08（7.95）岁。在中位随访 12.24（四分位间距：11.66-13.03）年后，记录到 1869 例 RA 事件。与 UPF 消费最低五分位数（UPF 的体重百分比）相比，最高五分位数的 RA 调整后危险比（HR）为 1.17（95%置信区间[CI]：1.01，1.36）。UPF 摄入量每增加 1 个标准差，RA 发病的风险增加 6%（HR：1.06；95% CI：1.01，1.11）。在中介分析中，生物标志物解释了 UPF 摄入与 RA 之间关联的 3.07%-14.80%。
较高的 UPF 消费与 RA 风险增加相关，这可能是由炎症、脂质和肝酶介导的。建议减少 UPF 消费以降低 RA 发病率。
