背景:多发病率正在成为老龄化人口中日益严重的公共卫生挑战。营养素对多发病率的影响仍有待确定,并使用英国队列研究的数据进行了探索。
方法:我们的研究分析主要基于英国妇女队列研究(UKWCS)收集的数据,在基线(1995年至1998年)招募了35372名35-69岁的妇女,旨在探讨饮食与慢性病之间的潜在关联。在招募时,使用经过验证的217项食物频率问卷估算每日能量和营养素的摄入量。截至2019年3月,通过与医院事件统计的电子链接,使用Charlson合并症指数(CCI)评估多症。Cox的比例风险模型用于估计每日营养素摄入量与多患病风险之间的关联。这些关联也在多项逻辑回归中进行了分析,作为敏感性分析。此外,我们以60岁为分界点进行了分层分析.
结果:在25,389名参与者中,在22年的中位随访中,7,799名受试者(30.7%)被证实患有多发病。与最低的五分之一相比,每日能量和蛋白质摄入量最高的五分之一分别与多患病风险增加8%和12%相关(HR1.08(95%CI1.01,1.16),能量的p线性=0.022;1.12(1.04,1.21),蛋白质的p线性=0.003)。每日摄入较高的五分之一维生素C和铁的多发病风险略有降低,与最低的五分之一相比。在Cox模型中,发现多发病的风险显着升高与维生素B12和维生素D的摄入量增加线性相关(p线性分别为0.001和0.002)。在多项逻辑回归中变得微不足道。有一些证据表明,随着年龄的增长,铁和维生素B1的摄入量与多发病风险相关(p-交互作用分别为0.006和0.025)。
结论:我们的研究结果强调了营养素摄入与多患病风险之间的联系。然而,我们的结果存在不确定性,在得出明确的结论之前,还需要进行更多的研究。
BACKGROUND: Multimorbidity is becoming an increasingly serious public health challenge in the aging population. The impact of nutrients on multimorbidity remains to be determined and was explored using data from a UK cohort study.
METHODS: Our research analysis is mainly based on the data collected by the United Kingdom Women\'s Cohort Study (UKWCS), which recruited 35,372 women aged 35-69 years at baseline (1995 to 1998), aiming to explore potential associations between diet and chronic diseases. Daily intakes of energy and nutrients were estimated using a validated 217-item food frequency questionnaire at recruitment. Multimorbidity was assessed using the Charlson comorbidity index (CCI) through electronic linkages to Hospital Episode Statistics up to March 2019. Cox\'s proportional hazards models were used to estimate associations between daily intakes of nutrients and risk of multimorbidity. Those associations were also analyzed in multinomial logistic regression as a sensitivity analysis. In addition, a stratified analysis was conducted with age 60 as the cutoff point.
RESULTS: Among the 25,389 participants, 7,799 subjects (30.7%) were confirmed with multimorbidity over a median follow-up of 22 years. Compared with the lowest quintile, the highest quintile of daily intakes of energy and protein were associated with 8% and 12% increased risk of multimorbidity respectively (HR 1.08 (95% CI 1.01, 1.16), p-linearity = 0.022 for energy; 1.12 (1.04, 1.21), p-linearity = 0.003 for protein). Higher quintiles of daily intakes of vitamin C and iron had a slightly lowered risk of multimorbidity, compared to the lowest quintile. A significantly higher risk of multimorbidity was found to be linearly associated with higher intake quintiles of vitamin B12 and vitamin D (p-linearity = 0.001 and 0.002, respectively) in Cox models, which became insignificant in multinomial logistic regression. There was some evidence of effect modification by age in intakes of iron and vitamin B1 associated with the risk of multimorbidity (p-interaction = 0.006 and 0.025, respectively).
CONCLUSIONS: Our findings highlight a link between nutrient intake and multimorbidity risk. However, there is uncertainty in our results, and more research is needed before definite conclusions can be reached.