行星健康饮食指数（PHDI）与慢性阻塞性肺疾病（COPD）之间的关联：饮食炎症指数（DII）的中介作用。

The association between Planetary Health Diet Index (PHDI) and chronic obstructive pulmonary disease (COPD): the mediating role of dietary inflammatory index (DII).

作者信息

Gong Hongyang, Zhang Kaifeng, Choi Seok, Huang Shaoqun

机构信息

Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou City, Fujian Province, China.

Department of Physiology, College of Medicine, Chosun University, Gwangju, Korea.

出版信息

BMC Pulm Med. 2025 Jan 31;25(1):53. doi: 10.1186/s12890-025-03501-7.

DOI:10.1186/s12890-025-03501-7

PMID:39891128

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11786581/

Abstract

BACKGROUND

Given global changes in the environment and dietary habits, it is critical to understand the potential impact of dietary factors and dietary inflammation on respiratory diseases, including COPD. Studying these relationships can help develop more effective prevention strategies. PHDI is a dietary scoring system designed to balance human health and environmental sustainability by promoting increased consumption of plant-based foods and reduced intake of red meat, sugar, and highly processed foods. In contrast, DII quantifies the inflammatory potential of a diet. This study examines the association between PHDI and COPD and assesses whether DII mediates this relationship.

METHODS

We used subgroup analysis, smooth curve fitting, and multivariable logistic regression to investigate the connection between PHDI and the occurrence of COPD. Furthermore, a mediation analysis was carried out to investigate any possible correlation between DII and the link between PHDI and COPD.

RESULTS

30,304 participants were included in this investigation, and 1,498 of them reported COPD events. For every 10-point increase in PHDI and each unit increase in DII was associated with a 9% reduction (OR = 0.91, 95% CI: 0.86, 0.97) and an 8% increase (OR = 1.08, 95% CI: 1.02, 1.13) in the prevalence of COPD, respectively, when all variables were adjusted for using multivariable logistic regression. Additionally, the results remain robust when PHDI and DII are converted to tertile. An investigation of smooth curve fitting showed a linear correlation between the risk of COPD and PHDI. The results of the mediation analysis showed that 17.95% of the relationship between PHDI and COPD was mediated by DII (p = 0.034).

CONCLUSIONS

Higher PHDI levels are associated with a lower prevalence of COPD. Additionally, DII appears to mediate this relationship, suggesting that an anti-inflammatory diet may provide benefits.

摘要

背景

鉴于全球环境和饮食习惯的变化，了解饮食因素和饮食炎症对包括慢性阻塞性肺疾病（COPD）在内的呼吸系统疾病的潜在影响至关重要。研究这些关系有助于制定更有效的预防策略。植物性饮食指数（PHDI）是一种饮食评分系统，旨在通过促进增加植物性食物的消费以及减少红肉、糖和高度加工食品的摄入量，来平衡人类健康与环境可持续性。相比之下，饮食炎症指数（DII）量化了饮食的炎症潜力。本研究考察了PHDI与COPD之间的关联，并评估DII是否介导了这种关系。

方法

我们采用亚组分析、平滑曲线拟合和多变量逻辑回归来研究PHDI与COPD发生之间的联系。此外，进行了中介分析以研究DII与PHDI和COPD之间联系的任何可能相关性。

结果

本研究纳入了30304名参与者，其中1498人报告了COPD事件。当使用多变量逻辑回归对所有变量进行调整时，PHDI每增加10分以及DII每增加一个单位，分别与COPD患病率降低9%（OR = 0.91，95%CI：0.86，0.97）和升高8%（OR = 1.08，95%CI：1.02，1.13）相关。此外，当将PHDI和DII转换为三分位数时，结果仍然稳健。平滑曲线拟合研究显示COPD风险与PHDI之间存在线性相关性。中介分析结果表明，PHDI与COPD之间17.95%的关系由DII介导（p = 0.034）。