目的:本研究的重点是使用国家健康与营养调查(NHANES)数据库对膳食视黄醇摄入量与类风湿性关节炎(RA)之间的相关性进行调查。
方法:本研究利用了2003年至2012年5个NHANES周期的数据。膳食视黄醇摄入量被认为是自变量,RA是因变量。应用加权logistic回归方法构建了两个变量的关系模型。进行不调整混杂因素的分层分析和调整混杂因素的亚组分析,以探索饮食视黄醇摄入量与RA之间的关联。通过限制性立方样条(RCS)分析确定膳食视黄醇的最佳摄入量。
结果:本研究包括22,971个样本。采用加权logistic回归模型构建膳食视黄醇摄入量与RA的关系模型(OR:0.95,95%CI:0.91~0.99,p=0.019)。分层分析显示,性别与视黄醇摄入量之间的相互作用对关系模型有很大影响(相互作用的p=0.014)。根据人口统计学特征调整后的模型也显示了视黄醇摄入量与RA之间的显着关联(OR:0.95,95%CI:0.90-1.00,p=0.029)。按性别分组分析表明,在女性人群中,未调整模型(OR:0.90,95%CI:0.84-0.96,p=0.002),模型仅针对人口统计特征进行了调整(OR:0.89,95%CI:0.83-0.96,p=0.002),模型校正了所有混杂因素(OR:0.91,95%CI:0.85-0.99,p=0.019),表明膳食视黄醇摄入是抗RA的保护因素.RCS分析表明,在女性人群中,无论使用哪种模型(原油,型号I,和模型II),膳食视黄醇摄入>354.86mcg与RA疾病减少相关(OR<1.0,p-非线性<0.05,p-总体<0.05).
结论:增加膳食视黄醇摄入量与RA疾病减少有关,尤其是在女性人群中。建议女性增加饮食视黄醇摄入量(>354.86mcg)以降低RA的风险。
OBJECTIVE: This study focused on the investigation of the correlation between dietary retinol intake and rheumatoid arthritis (RA) using the National Health and Nutrition Examination Survey (NHANES) database.
METHODS: Data from five NHANES cycles from 2003 to 2012 were utilized for this study. Dietary retinol intake was considered as the independent variable, and RA was the dependent variable. A weighted logistic regression method was applied to construct the relational model of the two variables. Stratified analysis without adjusting for confounding factors and subgroup analysis with confounding factors adjusted were conducted to explore the association between dietary retinol intake and RA. The optimal intake of dietary retinol was determined by the restricted cubic splines (RCS) analysis.
RESULTS: 22,971 samples were included in this study. The weighted logistic regression model was employed to construct the relational model of dietary retinol intake and RA (OR: 0.95, 95% CI: 0.91-0.99, p = 0.019). Stratified analysis displayed a great influence on the relational model exerted by the interaction between gender and retinol intake (p for interaction = 0.014). A significant association between retinol intake and RA was also indicated in the model adjusted for demographic characteristics (OR: 0.95, 95% CI: 0.90-1.00, p = 0.029). Subgroup analysis by gender showed that in the female population, unadjusted model (OR: 0.90, 95% CI: 0.84-0.96, p = 0.002), model adjusted for demographic characteristics only (OR: 0.89, 95% CI: 0.83-0.96, p = 0.002), and model adjusted for all confounding factors (OR: 0.91, 95% CI: 0.85-0.99, p = 0.019) indicated dietary retinol intake as a protective factor against RA. RCS analysis demonstrated that in the female population, regardless of the model used (Crude, Model I, and Model II), an intake of dietary retinol > 354.86 mcg was associated with RA disease reduction (OR < 1.0, p-non-linear < 0.05, p-overall < 0.05).
CONCLUSIONS: Increased dietary retinol intake was associated with RA disease reduction, particularly in the female population. Women are recommended to increase their dietary retinol intake (> 354.86 mcg) to reduce the risk of RA.