食物及营养素摄入水平与幽门螺旋杆菌感染风险分析  

FOOD AND NUTRIENT INTAKE AND RISK OF HELICOBACTER PYLORI INFECTION

作　　者：潘欣 高桃[2] 刘成霞[2] 孙重秀[1] 贾梦茹 林松 马爱国[1] PAN Xin;GAO Tao;LIU Cheng-xia;SUN Chong-xiu;JIA Meng-ru;LIN Song;MA Ai-guo(Department of Nutrition and Food Hygiene,College of Public Health,Qingdao University,Qingdao 266023;Binzhou Medical University Hospital,Binzhou 256000,China)

机构地区：[1]青岛大学公共卫生学院,青岛266023 [2]滨州医学院附属医院,滨州256000

出　　处：《营养学报》2020年第2期140-148,共9页Acta Nutrimenta Sinica

基　　金：国家自然科学基金(No.81373000)。

摘　　要：目的探讨各类食物及营养素摄入水平与幽门螺旋杆菌(Helicobacter pylori,Hp)感染风险的关系,为Hp感染的膳食预防提供理论指导。方法采用1:1匹配病例对照研究的方法,随机选择山东滨州地区某医院Hp感染者441例和正常对照人群441名,利用食物频率表收集其过去6月内的食物摄入种类及平均每次的食物消费水平,并将其折算成21种营养素的日均摄入量。根据肉及水产品类、蔬菜水果类、奶类、蛋类及各类营养素摄入量的不同,采用四分位数法对其进行分组。采用条件Logistic回归法分析各类食物和营养素的摄入水平与Hp感染的关系。结果Hp感染者肉及水产品类、蛋类、奶类和蔬菜水果类的摄入量均显著低于对照组;经多因素条件logistic回归分析,与最低摄入量组比较,肉及水产品类(≥45.35 g/d)和奶类(≥21.53 g/d)的摄入均与Hp感染呈负相关(均P<0.05),蔬菜水果类的摄入量超过509.45g/d时,与Hp感染呈负相关(OR=0.69,95%CI:0.52-0.93,P=0.015);当蛋类的摄入量控制在50.00~68.98 g/d时,可能为Hp感染的保护因素(OR=0.41,95%CI:0.29-0.57,P<0.001)。膳食营养素中,Hp感染组能量和碳水化合物的摄入量均显著高于对照组,而维生素B 1、维生素B 2、尼克酸、维生素C、Ca、Mg、K、Mn和Se的平均摄入水平均明显低于对照组的摄入水平;经多因素条件Logistic回归分析,与最低摄入量相比,碳水化合物(≥216.82 g/d)的摄入与Hp感染呈正相关(P<0.05);而中、较高和最高水平的膳食纤维、维生素B 1、维生素B 2、尼克酸和Ca的摄入可能为Hp感染的保护因素(P均<0.05);当维生素C的摄入量达到74.51mg/d以上或K的摄入量每天超过1676.02 mg时,与Hp感染呈负相关(P=0.039和P<0.001)。结论滨州地区人群肉及水产品类、奶类、蛋类和蔬菜水果类的增加,富含膳食纤维、水溶性维生素、Ca和K等营养素食物摄入的增加,碳水化合物摄入量的减少,可减少该地区Objective To explore the relationships between the intakes of various foods and nutrients and the risk of Helicobacter pylori(Hp)infection,and provide reference for dietary prevention of Hp infection.Methods The 1:1 matched case-control study was conducted to randomly select 441 Hp-infected cases and 441 healthy-controlled people in a hospital in Binzhou,Shandong Province.The Food Frequency Questionnaire(FFQ)was used to collect information on the consumption of food groups and average foods during the previous six months before converting them into the daily average consumption of 21 nutrients.According to the different levels of consumption of meat and aquatic products,vegetables and fruits,milk,eggs and other nutrients,they were grouped using the quartile method.Conditional logistic regression was used to analyze the association between the consumption of different food groups and nutrients and the risk of Hp infection.Results In terms of food groups,the intakes of meat and aquatic products,eggs,milk,vegetables and fruits of Hp-infected group were significantly lower than those of the control group.Multivariate conditional logistic regression analysis showed that compared with the lowest intake group,the consumption of meat and aquatic products(≥45.35g/d,P<0.05)and milk(≥21.53g/d,P<0.05)was negatively correlated with Hp infection.The intake of vegetables and fruits that exceeded 509.45g/d was negatively correlated with Hp infection(OR=0.69,95%CI:0.52-0.93,P=0.015).The intake of eggs controlled at 50.00-68.98g/d might be a protective factor for Hp infection(OR=0.41,95%CI:0.29-0.57,P<0.001).As for dietary nutrients,the intakes of energy and carbohydrates in the Hp-infected group were significantly higher than those of the control group,while the average intakes of vitamin B 1,vitamin B 2,niacin,vitamin C,Ca,Mg,K,Mn and Se of this group were significantly lower.Multivariate conditional logistic regression analysis showed that compared with the lowest intake,the intake of carbohydrates(≥216.82g/d)was positive

关 键 词：幽门螺旋杆菌 食物种类 膳食营养素 病例对照研究 

分 类 号：R151.2[医药卫生—营养与食品卫生学]