饮食炎症指数（DII）与慢性腹泻的L型关联：2005 - 2010年美国国家健康与营养检查调查（NHANES）的结果

L-shaped association of dietary inflammatory index (DII) and chronic diarrhea: results from NHANES 2005-2010.

作者信息

Zhao Qing, Xu Yue, Li Xiangrui, Chen Xiaotian

机构信息

Department of Clinic Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.

出版信息

BMC Public Health. 2025 Jan 8;25(1):81. doi: 10.1186/s12889-025-21292-8.

DOI:10.1186/s12889-025-21292-8

PMID:39780113

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11707886/

Abstract

BACKGROUND

Since diet is a known modulator of inflammation, the Dietary Inflammatory Index (DII), which quantifies the inflammatory potential of an individual's diet, becomes a significant parameter to consider. Chronic diarrhea is commonly linked to inflammatory processes within the gut. Thus, this study aimed to explore the potential link between DII and chronic diarrhea.

METHODS

This research utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. The DII was calculated according to the average intake of 28 nutrients using information gathered from two 24-hour recall interviews. The Bristol Stool Form Scale (BSFS) was adopted to describe chronic diarrhea, identifying stool Type 6 and Type 7. Multivariate logistic regression models examined the causal connection between DII and chronic diarrhea. Additionally, subgroup analyses and interaction tests were conducted.

RESULTS

The study encompassed 11,219 adults, among whom 7.45% reported chronic diarrhea. Initially, multivariate logistic regression analysis revealed a positive association between DII and chronic diarrhea. Nevertheless, this connection lost statistical significance (OR = 1.00; 95% CI, 0.96-1.05; P = 0.8501) after adjusting for all confounding variables. Stratified by sex, the analysis revealed a notable rise in the risk of chronic diarrhea with increasing DII among female participants (all P for trend < 0.05). This tendency remained constant even after full adjustment (P for trend = 0.0192), whereas no significant association was noted in males (all P for trend > 0.05). Furthermore, an L-shaped association emerged between DII and chronic diarrhea, with an inflection point of -1.34. In the population with DII scores below -1.34, each unit increase in DII correlated with a 27% reduction in the probability of chronic diarrhea (OR = 0.73; 95% CI, 0.57-0.93), whereas in the population with DII scores above -1.34, the risk increased by 4% (OR = 1.04; 95% CI, 0.98-1.10). Merely, the gender interaction was shown to be statistically significant based on subgroup analyses and interaction tests.

CONCLUSIONS

A favorable association between DII and chronic diarrhea exists in adults in the United States. Nevertheless, additional long-term prospective studies are required to confirm and solidify those findings.

摘要

背景

由于饮食是已知的炎症调节因素，饮食炎症指数（DII）可量化个体饮食的炎症潜力，成为一个需要考虑的重要参数。慢性腹泻通常与肠道内的炎症过程有关。因此，本研究旨在探讨DII与慢性腹泻之间的潜在联系。

方法

本研究利用了2005 - 2010年美国国家健康与营养检查调查（NHANES）的数据。根据从两次24小时饮食回顾访谈收集的信息，通过28种营养素的平均摄入量计算DII。采用布里斯托大便分类法（BSFS）描述慢性腹泻，确定6型和7型大便。多变量逻辑回归模型检验了DII与慢性腹泻之间的因果关系。此外，还进行了亚组分析和交互作用检验。

结果

该研究纳入了11219名成年人，其中7.45%报告有慢性腹泻。最初，多变量逻辑回归分析显示DII与慢性腹泻之间存在正相关。然而，在对所有混杂变量进行调整后，这种关联失去了统计学意义（OR = 1.00；95% CI，0.96 - 1.05；P = 0.8501）。按性别分层分析显示，女性参与者中随着DII升高，慢性腹泻风险显著增加（所有趋势P < 0.05）。即使在完全调整后这种趋势仍然存在（趋势P = 0.0192），而男性中未发现显著关联（所有趋势P > 0.05）。此外，DII与慢性腹泻之间呈现L形关联，拐点为 - 1.34。在DII得分低于 - 1.34的人群中，DII每增加一个单位，慢性腹泻概率降低27%（OR = 0.73；95% CI，0.57 - 0.93），而在DII得分高于 - 1.34的人群中，风险增加4%（OR = 1.04；95% CI，0.98 - 1.10）。仅根据亚组分析和交互作用检验，性别交互作用显示具有统计学意义。