海口地区中老年男性膳食抗炎指数与慢性阻塞性肺疾病的关联研究

目的 研究中老年男性膳食抗炎指数(Dietary anti-inflammatory index, DII)与慢性阻塞性肺疾病(chronicobstructive pulmonary disease, COPD)风险的关联,并观察DII对研究对象肺功能和血清炎症标志物水平的影响。 方法 采用病例对照研究设计,选取2017年8月—2019年6月在海口地区确诊的COPD中老年男患者201例,同期经年龄(±3岁)个体匹配的社区健康男性201名作为对照组。采用食物频率问卷,获得确诊前一年(病例)或既往一年(对照)膳食摄入情况,计算其膳食DII得分,并根据三分位划分为抗炎倾向组、中间组和促炎倾向组。检测研究对象血清的炎症标志水平并进行肺功能测试。采用条件logistic回归分析DII与COPD患病风险的OR及其95%CI;采用Spearman偏相关分析DII与肺功能及炎性指标的相关性。结果 COPD病例组DII评分为(1.02±0.86),高于对照组的(0.05±0.27),差异有统计学意义(t=15.245,P<0.001)。研究结果显示,DII水平越高,COPD风险越高。在控制了混杂因素后,促炎倾向组研究对象COPD患病风险是抗炎倾向组研究对象的2.13倍(OR=2.13, 95%CI:1.24, 3.67)。COPD患者的DII与肺功能指标(FEV1,FEV1预计值及FEV1/FVC)呈正相关,而健康对照组研究对象DII仅与FEV1 正相关。此外,COPD患者与健康对照组DII与炎性因子(hs-CRP、IL-6和TNF-α)水平均呈正相关。结论 促炎性膳食是COPD患病的危险因素。提示针对COPD高危人群改变膳食结构,加强COPD患者营养知识教育,以延缓疾病的进一步恶化,为COPD的预防和治疗提供参考。

Correlation between dietary anti-inflammatory index and chronic obstructive pulmonary disease in middle-aged and elderly males in Haikou

Objective To study the relationship between dietary anti-inflammatory index (DII) and risk of chronic obstructive pulmonary disease (COPD) in middle-aged and elderly men, and to observe the effect of DII on lung function and the levels of serum inflammatory markers. Methods Using a matched case-control study design, 201 middle-aged or elderly male patients with COPD diagnosed in Haikou from August 2017 to June 2019 were selected, and 201 healthy males from a community who were matched by age (±3 years) during the same period were selected as the control group. Food frequency questionnaire was used to obtain the data regarding dietary intake in the previous year of being diagnosed with COPD (cases) or the previous year (controls). All the subjects’ DII scores were calculated, and then they were divided into three categories, the anti-inflammatory group, the intermediate group and the pro-inflammatory group. The levels of serum inflammatory markers in all the subjects were detected, and lung function test was performed. Conditional logistic regression analysis was used to analyze the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between DII and the risk of COPD. Spearman partial correlation was used to analyze the correlation between DII and lung function and inflammatory index. Results The DII score was higher in the COPD group than in the control group ((1.02±0.86) vs. (0.05±0.27)), with a statistically significant difference (t=15.245, P<0.001). The results of this study showed that the higher the level of DII, the higher the risk of COPD. After controlling for confounding factors, the risk of suffering from COPD in the pro-inflammatory group was 2.13 times that of the anti-inflammatory group (OR=2.13, 95%CI:1.24, 3.67). The DII scores of the COPD patients were positively correlated with lung functionindicators (including forced expiratory volume in 1 second (FEV1), the predicted value of FEV1 and forced exhalation in 1 second/forced vital capacity(FEV1/FVC)), while the DII scores of the healthy controls were only positively correlated with FEV1. In addition, the DII scores were positively correlated with inflammatory factors (including hs-CRP, IL-6 and TNF-α) in the COPD patients and the healthy controls. Conclusion Pro-inflammatory diet is a risk factor for COPD, suggesting thattargeted effortsshould be made to change the dietary structure for the high-risk population of COPD and strengthen the education about nutrition knowledge for COPD patients so as to delay further deterioration of the disease and provide guidance for COPD prevention andtreatment.