体重指数在健康饮食与老年女性哮喘症状演变的前瞻性关联中的中介作用。

Mediating role of the body mass index in the prospective association between a healthy diet and evolution of asthma symptoms in elderly women.

作者信息

Ait-Hadad Wassila, Bédard Annabelle, Orsi Laurent, Chanoine Sébastien, Dumas Orianne, Laouali Nasser, Moual Nicole Le, Leynaert Bénédicte, Siroux Valérie, Boutron-Ruault Marie-Christine, Varraso Raphaëlle

机构信息

Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP Villejuif France.

Inserm U1209, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology applied to the Development and Respiratory Health Grenoble France.

出版信息

JAR Life. 2025 Apr 7;14:100011. doi: 10.1016/j.jarlif.2025.100011. eCollection 2025.

DOI:10.1016/j.jarlif.2025.100011

PMID:40255288

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12008553/

Abstract

OBJECTIVES

Diet and obesity exhibit complex interrelationships with asthma, particularly among elderly women. We aimed to clarify the impact of healthy diet assessed by the Alternate Healthy Eating Index-2010 (AHEI-2010) on: 1) the incidence of asthma symptoms, and 2) among women with symptoms in 2011, the change in asthma symptoms, while accounting for the potential mediating role of BMI.

DESIGN

A nested case-control study on asthma with follow-up data.

SETTING

Within the French E3N cohort.

PARTICIPANTS

8621 elderly women (62 years on average in 1993).

MEASUREMENTS

Dietary data were collected in 1993 and 2005 using semi-quantitative questionnaires. Using the validated asthma symptom score assessed in 2011 and 2018, asthma symptom incidence among women with no asthma symptom in 2011 ( = 5700) and change in asthma symptoms (reduced, stable, increased) among those with asthma symptoms in 2011 ( = 2921) were defined. BMI was calculated in 2008. Marginal structural models were used to estimate total, direct and indirect effects mediated by BMI.

RESULTS

After adjustment for potential confounders, we found a significant indirect effect of healthier diet on lower risk of asthma symptoms incidence mediated by lower BMI (OR for AHEI-2010 quintile 5 vs quintile 1 = 0.95 (0.92-0.97)), without significant total (OR=0.87 (0.66-1.10)) nor direct (OR=0.92 (0.71-1.15)) effects. Among women with asthma symptoms, we also found a significant indirect effect of healthier diet on reduced asthma symptoms mediated by lower BMI (OR for AHEI-2010 >median ≤median=1.02 (1.00-1.03)) without significant total (OR=1.12 (0.94-1.34)) nor direct effects (OR=1.10 (0.93-1.31)).

CONCLUSION

A healthy diet was associated with reduced risk of asthma symptoms over time, partly through a lower BMI.

摘要

目的

饮食与肥胖和哮喘之间存在复杂的相互关系，在老年女性中尤为明显。我们旨在阐明通过替代健康饮食指数 - 2010（AHEI - 2010）评估的健康饮食对以下方面的影响：1）哮喘症状的发生率；2）在2011年有症状的女性中，哮喘症状的变化，同时考虑BMI的潜在中介作用。

设计

一项关于哮喘的巢式病例对照研究，并带有随访数据。

背景

在法国E3N队列中。

参与者

8621名老年女性（1993年平均年龄62岁）。

测量方法

1993年和2005年使用半定量问卷收集饮食数据。利用2011年和2018年评估的经过验证的哮喘症状评分，确定2011年无哮喘症状的女性（n = 5700）中的哮喘症状发生率，以及2011年有哮喘症状的女性（n = 2921）中哮喘症状的变化（减轻、稳定、加重）。2008年计算BMI。使用边际结构模型估计由BMI介导的总效应、直接效应和间接效应。

结果

在对潜在混杂因素进行调整后，我们发现更健康的饮食通过较低的BMI对降低哮喘症状发生率有显著的间接效应（AHEI - 2010五分位数5与五分位数1相比的OR = 0.95（0.92 - 0.97）），总效应（OR = 0.87（0.66 - 1.10））和直接效应（OR = 0.92（0.71 - 1.15））均无显著意义。在有哮喘症状的女性中，我们还发现更健康的饮食通过较低的BMI对减轻哮喘症状有显著的间接效应（AHEI - 2010＞中位数与≤中位数相比的OR = 1.02（1.00 - 1.03）），总效应（OR = 1.12（0.94 - 1.34））和直接效应（OR = 1.10（0.93 - 1.31））均无显著意义。