Gao Tao, Chen Zhi-Yu, Li Tao, Tang Jian-Dong, Lin Xu, Hu Hai-Gang, Wan Sheng-Yu, Wu Chao
Orthopaedics of Zigong Fourth People's Hospital, Zigong, Sichuan, China.
Respiratory Medicine of Zigong Fourth People's Hospital, Zigong, Sichuan, China.
Front Immunol. 2025 Apr 9;16:1560570. doi: 10.3389/fimmu.2025.1560570. eCollection 2025.
The Clinical Dietary Antioxidant Index (CDAI) is a dietary antioxidant assessment index. Although CDAI has been shown to play a role in various chronic diseases, its association with rheumatoid arthritis (RA) remains underexplored. The aim of this study was to investigate the relationship between the CDAI and RA in U.S. adults, and to examine the mediating role of body mass index (BMI) in the relationship between CDAI and RA incidence.
This cross-sectional study utilized data from the 2015-2023 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate logistic regression models, restricted cubic spline (RCS) functions, and subgroup analyses were employed to examine the association between CDAI levels and RA in American adults. Mediation analysis was conducted to explore the mediating role of BMI in the relationship between CDAI and RA incidence.
A total of 13,288 participants were included, of whom 787 were diagnosed with RA, with a prevalence rate of 5.9%. Weighted multivariate logistic regression analyses across all four models showed a negative correlation between CDAI levels in the highest quartile and RA incidence. Restricted cubic spline curves revealed a non-linear negative association between CDAI, vitamin E, carotenoids, selenium, and RA incidence. As levels of CDAI, vitamin E, carotenoids, and selenium increased, the risk of RA decreased. Subgroup analyses and forest plots indicated significant associations between CDAI levels and RA across subgroups, including females, individuals aged over 60 years, Other Race - Including Multi-Racial groups, smokers, non-drinkers, individuals with heavy physical activity, hypertension, and BMI >25 (P < 0.05). Mediation analysis showed that BMI partially mediated the relationship between CDAI and RA, accounting for 10.88% of the effect.
CDAI levels were negatively associated with RA incidence, particularly the components of CDAI such as vitamin E, carotenoids, and selenium. BMI mediated the relationship between CDAI and RA.
临床膳食抗氧化指数（CDAI）是一种膳食抗氧化评估指标。尽管CDAI已被证明在各种慢性疾病中发挥作用，但其与类风湿性关节炎（RA）的关联仍未得到充分研究。本研究的目的是调查美国成年人中CDAI与RA之间的关系，并检验体重指数（BMI）在CDAI与RA发病率关系中的中介作用。
这项横断面研究利用了2015 - 2023年国家健康与营养检查调查（NHANES）的数据。采用加权多元逻辑回归模型、受限立方样条（RCS）函数和亚组分析来检验美国成年人中CDAI水平与RA之间的关联。进行中介分析以探讨BMI在CDAI与RA发病率关系中的中介作用。
总共纳入了13288名参与者，其中787人被诊断为RA，患病率为5.9%。所有四个模型的加权多元逻辑回归分析均显示，最高四分位数的CDAI水平与RA发病率之间呈负相关。受限立方样条曲线显示CDAI、维生素E、类胡萝卜素、硒与RA发病率之间呈非线性负相关。随着CDAI、维生素E、类胡萝卜素和硒水平的升高，RA风险降低。亚组分析和森林图表明，CDAI水平与RA在各亚组中均存在显著关联，包括女性、60岁以上个体、其他种族（包括多种族群体）、吸烟者、不饮酒者、体力活动量大的个体、高血压患者以及BMI>25者（P<0.05）。中介分析表明，BMI部分介导了CDAI与RA之间的关系，占效应的10.88%。
CDAI水平与RA发病率呈负相关，特别是CDAI的成分如维生素E、类胡萝卜素和硒。BMI介导了CDAI与RA之间的关系。
