成人饮食炎症指数与冠心病之间的关系：基于1999 - 2018年美国国家健康与营养检查调查（NHANES）

The relationship between dietary inflammatory index in adults and coronary heart disease: from NHANES 1999-2018.

作者信息

Xu Hong, Xie Pengxin, Liu Hui, Tian Zhenyu, Zhang Ruitao, Cui Ming

机构信息

College of Science, Minzu University of China, Beijing, China.

Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.

出版信息

Front Nutr. 2025 Mar 21;12:1564580. doi: 10.3389/fnut.2025.1564580. eCollection 2025.

DOI:10.3389/fnut.2025.1564580

PMID:40191797

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11970130/

Abstract

BACKGROUND

Previous studies have shown that pro-inflammatory diets increase the risk of coronary heart disease (CHD) and all-cause mortality. The dietary inflammatory index (DII) is a quantitative measure of dietary inflammation, and its accuracy has been validated by several studies.

METHODS

This study included 43,842 participants aged ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The data of CHD was obtained through a questionnaire survey, and the DII was calculated using 24-h dietary recall data. Generalized linear models and logistic regression were used to determine the mediation factors, and subgroup analyses were conducted to evaluate the interaction between DII and CHD. Mean decrease in Gini (MDG) was used to determine the importance of individual dietary components.

RESULTS

The age of the participants was 49.81 ± 18.10 years, with 20,793 (47.4%) being male. A total of 1,892 (4.3%) participants were diagnosed with CHD, and the median DII score was 1.33 (0.11, 2.40). After adjusting for potential confounders, logistic regression analysis revealed that DII independently associated with CHD [OR: 1.049 (1.012-1.087),  = 0.008]. Triglyceride-glucose index, visceral adiposity index, body mass index, waist-to-height ratio, high-density lipoprotein, and glomerular filtration rate (all  < 0.05) may mediate the relationship between DII and CHD. Subgroup analyses showed that DII was more sensitive in participants aged <75 years ( < 0.001), females ( = 0.028), those with low cholesterol levels ( = 0.004), and individuals with low Framingham risk scores ( = 0.005). MDG analysis indicated that carbohydrate, vitamin C and iron intake have the greatest impact on CHD.

CONCLUSION

This study suggests that various metabolic and lipid indicators play a mediating role in the relationship between DII and CHD. DII may have a greater adverse impact on traditional low-risk CHD populations.

摘要

背景

先前的研究表明，促炎性饮食会增加冠心病（CHD）风险和全因死亡率。饮食炎症指数（DII）是饮食炎症的一种定量测量方法，其准确性已得到多项研究的验证。

方法

本研究纳入了1999 - 2018年美国国家健康与营养检查调查（NHANES）中43842名年龄≥18岁的参与者。通过问卷调查获取冠心病数据，并使用24小时饮食回忆数据计算DII。采用广义线性模型和逻辑回归确定中介因素，并进行亚组分析以评估DII与冠心病之间的相互作用。使用基尼系数平均下降值（MDG）来确定个体饮食成分的重要性。

结果

参与者年龄为49.81±18.10岁，其中男性20793名（47.4%）。共有1892名（4.3%）参与者被诊断为冠心病，DII评分中位数为1.33（0.11，2.40）。在调整潜在混杂因素后，逻辑回归分析显示DII与冠心病独立相关[比值比：1.049（1.012 - 1.087），P = 0.008]。甘油三酯 - 葡萄糖指数、内脏脂肪指数、体重指数、腰高比、高密度脂蛋白和肾小球滤过率（均P < 0.05）可能介导DII与冠心病之间的关系。亚组分析表明，DII在年龄<75岁的参与者中更敏感（P < 0.001）、女性（P = 0.028）、胆固醇水平低的个体（P = 0.004）以及弗雷明汉风险评分低的个体（P = 0.005）中更敏感。MDG分析表明，碳水化合物、维生素C和铁的摄入量对冠心病影响最大。