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烟酸和维生素B6摄入量与子宫内膜异位症的关联研究:来自2003 - 2006年美国国家健康与营养检查调查(NHANES)的证据

Study of the association of niacin and vitamin B6 intake with endometriosis: Evidence from NHANES 2003-2006.

作者信息

Sheng Jiangxin, Chen Limei, Yan Han, Nie Jichan

机构信息

Department of General Gynecology, Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.

Hysteroscoy Center, Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.

出版信息

Int J Gynaecol Obstet. 2025 May;169(2):773-780. doi: 10.1002/ijgo.16096. Epub 2024 Dec 22.

Abstract

OBJECTIVE

This study aims to investigate the association between dietary intake of niacin and vitamin B6 and the prevalence of endometriosis using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.

METHODS

We conducted a cross-sectional analysis using data from women aged 25-45 years in the 2003-2006 NHANES. Niacin and vitamin B6 intake were assessed using 24-h dietary recalls, and endometriosis status was determined by self-report. Covariates included age, race, body mass index, poverty income ratio, smoking status, and alcohol consumption. Weighted logistic regression models were used to evaluate the association between vitamin intake and endometriosis, with stratified analyses performed for different age groups. Data visualization included scatter plots with locally estimated scatterplot smoothing (LOESS) curves to illustrate the relationship between nutrient intake and the probability of endometriosis.

RESULTS

A total of 1467 participants were included, of whom 7.17% (105 individuals) reported having endometriosis. There were significant differences in dietary intake of niacin and vitamin B6 between participants with and without endometriosis. In the unadjusted model, vitamin B6 intake was significantly negatively associated with endometriosis (odds ratio [OR], 0.79 [95% confidence interval (CI), 0.62-0.99], P = 0.033), and niacin intake showed a marginally significant negative association (OR, 0.98 [95% CI, 0.96-1.00], P = 0.019). In the models adjusted for age and race, the negative association between vitamin B6 and endometriosis remained significant (OR, 0.80 [95% CI, 0.63-1.01], P = 0.044), and the association for niacin remained marginally significant (OR, 0.98 [95% CI, 0.96-1.00], P = 0.023). In the fully adjusted model, the negative association for vitamin B6 remained significant (OR, 0.79 [95% CI, 0.63-0.99], P = 0.033), and the association for niacin remained marginally significant (OR, 0.98 [95% CI, 0.96-1.00], P = 0.021). Age-stratified analysis showed that niacin intake was not significantly associated with endometriosis in women aged 35 years and younger (OR, 0.98 [95% CI, 0.95-1.02], P = 0.3), whereas vitamin B6 intake was significantly negatively associated with endometriosis in women older than 35 years (OR, 0.75 [95% CI, 0.56-0.99], P = 0.048). Scatter plots with LOESS curves indicated a negative trend between higher intakes of niacin and vitamin B6 and the probability of endometriosis.

CONCLUSIONS

The findings suggest that dietary vitamin B6 intake is negatively associated with the prevalence of endometriosis, particularly among women older than 35 years, highlighting the potential role of dietary adjustments in managing endometriosis. Niacin intake also showed a protective effect, although this was less pronounced than vitamin B6. These results provide a basis for further research into the relationship between diet and endometriosis.

摘要

目的

本研究旨在利用2003 - 2006年美国国家健康与营养检查调查(NHANES)的数据,调查烟酸和维生素B6的饮食摄入量与子宫内膜异位症患病率之间的关联。

方法

我们使用2003 - 2006年NHANES中25 - 45岁女性的数据进行横断面分析。通过24小时饮食回忆法评估烟酸和维生素B6的摄入量,并通过自我报告确定子宫内膜异位症状态。协变量包括年龄、种族、体重指数、贫困收入比、吸烟状况和饮酒情况。使用加权逻辑回归模型评估维生素摄入量与子宫内膜异位症之间 的关联,并对不同年龄组进行分层分析。数据可视化包括带有局部加权散点平滑(LOESS)曲线的散点图,以说明营养摄入量与子宫内膜异位症概率之间的关系。

结果

共纳入1467名参与者,其中7.17%(105人)报告患有子宫内膜异位症。患有和未患有子宫内膜异位症的参与者在烟酸和维生素B6的饮食摄入量上存在显著差异。在未调整模型中,维生素B6摄入量与子宫内膜异位症显著负相关(比值比[OR],0.79[95%置信区间(CI),0.62 - 0.99],P = 0.033),烟酸摄入量显示出边缘显著的负相关(OR,0.98[95% CI,0.96 - 1.00],P = 0.-019)。在调整年龄和种族的模型中,维生素B6与子宫内膜异位症之间的负相关仍然显著(OR,0.80[95% CI,0.63 - 1.01],P = 0.044),烟酸的关联仍然边缘显著(OR,0.98[95% CI,0.96 - 1.00],P = 0.023)。在完全调整模型中,维生素B6的负相关仍然显著(OR,0.79[95% CI,0.63 - 0.99],P = 0.033),烟酸的关联仍然边缘显著(OR,0.98[95% CI,0.96 - 1.00],P = 0.021)。年龄分层分析显示,35岁及以下女性的烟酸摄入量与子宫内膜异位症无显著关联(OR,0.98[95% CI,0.95 - 1.02],P = 0.3),而35岁以上女性的维生素B6摄入量与子宫内膜异位症显著负相关(OR,0.75[95% CI,0.56 - 0.99],P = 0.048)。带有LOESS曲线的散点图表明,较高的烟酸和维生素B6摄入量与子宫内膜异位症概率之间呈负趋势。

结论

研究结果表明,饮食中维生素B6摄入量与子宫内膜异位症患病率呈负相关,尤其是在35岁以上的女性中,这突出了饮食调整在管理子宫内膜异位症方面的潜在作用。烟酸摄入量也显示出保护作用,尽管不如维生素B6明显。这些结果为进一步研究饮食与子宫内膜异位症之间的关系提供了基础。

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