目的:研究遵守饮食指南与类风湿关节炎(RA)发病风险之间的关系。
方法:马尔默饮食与癌症研究(MDCS)队列中诊断为RA的参与者通过注册链接进行鉴定,并在结构化审查中进行验证。每个病例选择四个对照,匹配性别,出生年份,以及被纳入MDCS的年份。在基线(1991-1996)时使用验证的饮食史方法评估饮食。饮食质量指数(DQI)基于对瑞典饮食指南的遵守,包括纤维的摄入量,蔬菜和水果,鱼和贝类,饱和脂肪,多不饱和脂肪,和蔗糖,被使用。使用条件logistic回归分析评估DQI及其组成部分与RA风险之间的关联。调整总能量摄入,吸烟,休闲时间体育活动和饮酒。
结果:我们在队列中确定了172例确诊的RA病例。总体遵守饮食指南与RA的风险无关。在粗和多变量调整分析中,坚持推荐的纤维摄入量与RA风险降低相关。比值比(OR)0.60(95%置信区间(CI)0.39-0.93),和0.51(95%CI0.29-0.90),分别,与不坚持的受试者相比。
结论:达到膳食纤维的推荐摄入水平,但不是整体饮食质量,与RA风险降低独立相关。需要进一步的研究来评估不同食物来源的膳食纤维与RA风险的关系及其潜在机制。
OBJECTIVE: To examine the relationship between adherence to dietary
guidelines and the risk of developing RA.
METHODS: Participants in the Malmö Diet and Cancer Study (MDCS) cohort diagnosed with RA were identified through register linkage and validated in a structured review. Four controls per case were selected, matched for sex, year of birth, and year of inclusion in the MDCS. Diet was assessed at baseline (1991-1996) using a validated diet history method. A Diet Quality Index (DQI) based on adherence to the Swedish dietary
guidelines including intakes of fibre, vegetables and fruits, fish and shellfish, saturated fat, polyunsaturated fat, and sucrose, was used. The associations between the DQI and its components and the risk of RA were assessed using conditional logistic regression analysis, adjusting for total energy intake, smoking, leisure time physical activity and alcohol consumption.
RESULTS: We identified 172 validated cases of incident RA in the cohort. Overall adherence to the dietary
guidelines was not associated with the risk of RA. Adherence to recommended fibre intake was associated with decreased risk of RA in crude and multivariable-adjusted analyses, with odds ratios (ORs) 0.60 (95% CI 0.39, 0.93) and 0.51 (95% CI 0.29, 0.90), respectively, compared with subjects with non-adherence.
CONCLUSIONS: Reaching the recommended intake level of dietary fibre, but not overall diet quality, was independently associated with decreased risk of RA. Further studies are needed to assess the role of different food sources of dietary fibre in relation to risk of RA and the underlying mechanisms.