Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Shaanxi Province Key Laboratory of Gastrointestinal Motility Disorders, Xi'an, China.
Dig Dis Sci. 2024 Nov;69(11):4140-4151. doi: 10.1007/s10620-024-08638-9. Epub 2024 Oct 4.
Patients with irritable bowel syndrome (IBS) often have chronic low-grade inflammation in the intestinal mucosa. Some dietary components are known to be associated with inflammation. However, there is currently limited research on the relationship between dietary inflammatory potential and the risk of IBS.
A total of 129,408 participants in the UK Biobank were included in this study. Energy-Adjusted Dietary Inflammatory Index (E-DII) based on 26 nutrients and the Empirical Dietary Inflammatory Pattern (EDIP) based on 17 food groups were constructed, and on the basis of the tertiles, the continuous score was categorized into proinflammatory, neutral, and antiinflammatory categories. Associations between IBS and E-DII and EDIP were investigated by multivariable Cox proportional hazard models. Potential confounders including sociodemographic, lifestyle, body mass index (BMI), psychological state, type 2 diabetes, and thyroiditis were adjusted. In addition, subgroup analysis and sensitivity analysis were also performed. Finally, a two-sample Mendelian randomization (MR) analysis was employed to explore the independent causality of nutrients and dietary-derived serum antioxidants with IBS.
In the cohort study, over a median follow-up period of 13.26 years, 2421(1.87%) participants developed IBS. In the E-DII categories, after adjusting for the confounders, individuals in the proinflammatory diet category had a higher risk of IBS compared with the antiinflammatory category (HR 1.15, 95% CI 1.03-1.28, p = 0.015, p trend = 0.017) and neutral category (HR 1.13, 95% CI 1.01-1.26, p = 0.030, p trend = 0.017). In the EDIP categories, after adjusting for the confounders, individuals in the proinflammatory diet category had a higher risk of IBS compared with antiinflammatory category (HR 1.19, 95% CI 1.06-1.33, p = 0.002, p trend = 0.002) but no significant association compared with neutral category (HR 1.10, 95% CI 0.99-1.23, p = 0.067, p trend = 0.002). In the MR analysis, genetically determined intake levels of 16 nutrients and 6 dietary sources of circulating antioxidants did not have a causal effect on IBS.
Our findings indicate that proinflammatory dietary components are independent risk factors for IBS. However, there is no causal relationship between individual nutrient intake or serum antioxidants from dietary sources and IBS.
肠易激综合征（IBS）患者的肠道黏膜常有慢性低度炎症。一些饮食成分已知与炎症有关。然而，目前关于饮食炎症潜能与 IBS 风险之间的关系的研究还很有限。
这项研究共纳入了英国生物库中的 129408 名参与者。基于 26 种营养素的能量调整饮食炎症指数（E-DII）和基于 17 种食物组的经验性饮食炎症模式（EDIP）被构建出来，并根据三分位数将连续得分分为促炎、中性和抗炎类别。使用多变量 Cox 比例风险模型研究 E-DII 和 EDIP 与 IBS 之间的关联。调整了包括社会人口统计学、生活方式、体重指数（BMI）、心理状态、2 型糖尿病和甲状腺炎在内的潜在混杂因素。此外，还进行了亚组分析和敏感性分析。最后，采用两样本 Mendelian 随机化（MR）分析来探讨营养素和饮食源性血清抗氧化剂与 IBS 的独立因果关系。
在队列研究中，在中位随访 13.26 年期间，有 2421（1.87%）名参与者患上了 IBS。在 E-DII 类别中，在校正混杂因素后，与抗炎类别相比，处于促炎饮食类别的个体患 IBS 的风险更高（HR 1.15，95%CI 1.03-1.28，p=0.015，p 趋势=0.017）和中性类别（HR 1.13，95%CI 1.01-1.26，p=0.030，p 趋势=0.017）。在 EDIP 类别中，在校正混杂因素后，与抗炎类别相比，处于促炎饮食类别的个体患 IBS 的风险更高（HR 1.19，95%CI 1.06-1.33，p=0.002，p 趋势=0.002），但与中性类别无显著关联（HR 1.10，95%CI 0.99-1.23，p=0.067，p 趋势=0.002）。在 MR 分析中，遗传决定的 16 种营养素和 6 种饮食来源的循环抗氧化剂摄入量与 IBS 没有因果关系。
我们的研究结果表明，促炎饮食成分是 IBS 的独立危险因素。然而，个体营养素摄入或饮食来源的血清抗氧化剂与 IBS 之间没有因果关系。
