PDF(Pubmed)
Abstract：
Anemia is common in patients with rheumatoid arthritis (RA), and it is unknown whether the dietary inflammatory index (DII) is linked to anemia. This study aimed to clarify the prevalence of anemia in RA patients and its association with the DII. The data utilized in this study were collected from the National Health and Nutrition Examination Survey database from 1999 to 2018. The prevalence of anemia in RA patients was estimated by ethnicity, sex, and age. Weighted multivariate logistic regression was utilized to explore the correlation between anemia risk and DII. The most crucial dietary factors related to the risk of anemia in RA patients were screened by stepwise regression. A nomogram model was established according to key dietary factors. A total of 10.25% (confidence interval, 8.58-11.92%) of RA patients will develop anemia, with the lowest prevalence around the age of 60. In addition, higher DII levels were discovered in anemic patients than in nonanemic patients. In multivariate regression models, an important positive association was revealed between anemia and growing quartiles of DII (Q4 vs Q1: odds ratio = 1.98; confidence interval, 1.25-3.15). In the subgroup analysis, the adjusted relation of DII with anemia in females, Mexicans, smokers, nondrinkers, and age groups ≥ 60 years was statistically significant. The same association was observed in the sensitivity analysis. A nomogram model based on stepwise regression screening of key dietary factors showed good discriminatory power to identify anemic risk in RA patients (area under the curve: 0.707). In patients with RA, high DII levels were associated with the risk of anemia. More attention should be given to controlling dietary inflammation to better prevent and treat anemia.
摘要：
贫血在类风湿关节炎（RA）患者中很常见，目前尚不清楚饮食炎症指数（DII）是否与贫血有关。本研究旨在阐明RA患者贫血的患病率及其与DII的关系。这项研究中使用的数据是从1999年至2018年的国家健康和营养检查调查数据库中收集的。RA患者贫血的患病率按种族进行评估，性别,和年龄。采用加权多因素logistic回归分析贫血风险与DII的相关性。采用逐步回归法筛选与RA患者贫血风险相关的最关键的饮食因素。根据关键饮食因素建立列线图模型。总计10.25%(置信区间，8.58-11.92％）的RA患者会出现贫血，患病率最低的是60岁左右。此外,贫血患者的DII水平高于非贫血患者.在多元回归模型中，贫血与DII四分位数增长之间存在重要的正相关（Q4vsQ1：比值比=1.98；置信区间，1.25-3.15)。在亚组分析中，DII与女性贫血的调整关系，墨西哥人,吸烟者,不喝酒的人,≥60岁年龄组有统计学意义。在敏感性分析中观察到相同的关联。基于关键饮食因素的逐步回归筛选的列线图模型显示出很好的辨别能力，可以识别RA患者的贫血风险（曲线下面积：0.707）。在RA患者中，高DII水平与贫血风险相关.应更加注意控制饮食炎症，以更好地预防和治疗贫血。
