上海市松江区40岁及以上人群饮食模式与慢性阻塞性肺疾病的关联研究  

Study on the association of diet pattern with chronic obstructive pulmonary disease in population aged 40 years and above in Songjiang District,Shanghai

作　　者：庞欣悦 郁建国 尹欣 孙中兴[3] 刘星[1] 李静 吴毅凌[3] 赵琦[1] 姜永根[3] 赵根明[1] 王娜[1] 姜庆五[1] Pang Xinyue;Yu Jianguo;Yin Xin;Sun Zhongxing;Liu Xing;Li Jing;Wu Yiling;Zhao Qi;Jiang Yonggen;Zhao Genming;Wang Na;Jiang Qingwu(Department of Epidemiology,School of Public Health,Fudan University,Key Laboratory of Public Health Safety of Ministry of Education,Shanghai 200032,China;Zhongshan Community Health Center of Songjiang District of Shanghai,Shanghai 201613,China;Songjiang District Center for Disease Control and Prevention of Shanghai,Shanghai 201620,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室,教育部公共卫生安全重点实验室,上海200032 [2]上海市松江区中山社区卫生服务中心,上海201613 [3]上海市松江区疾病预防控制中心,上海201620

出　　处：《中华流行病学杂志》2024年第12期1649-1657,共9页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82073634);国家重点研发计划精准医学重点专项(2017YFC0907000);上海市公共卫生三年行动计划(GWVI-11.1-23)。

摘　　要：目的了解上海市松江区≥40岁人群慢性阻塞性肺疾病(COPD)的发病情况,分析地中海饮食模式、控制高血压饮食模式(DASH)与COPD发病风险的关联。方法基于上海市松江区自然人群队列,以基线未患COPD的27474名≥40岁人群为研究对象。采用Cox比例风险回归模型分析基线地中海饮食模式评分、DASH评分与COPD发病风险的关联,计算发病风险比(HR)及其95%CI。采用限制性立方样条分析2种饮食模式评分与COPD发病风险的非线性关联。根据性别、年龄、吸烟状况等进行分层分析,并删去基线调查后1年内诊断病例或有恶性肿瘤疾病史人群进行敏感性分析。结果截至2023年6月30日,研究对象中位随访时间为6.21年,随访期间新发COPD患者1089名(4.0%),发病密度为64.00/万人年。调整相关混杂因素后,在地中海饮食模式评分三分位数分组中,相较于低评分组,中评分组的COPD发病风险可降低14%(HR=0.86,95%CI:0.75~0.99),高评分组的发病风险可降低15%(HR=0.85,95%CI:0.72~0.99)。删去基线调查后1年内诊断的病例(HR=0.82,95%CI:0.70~0.95;HR=0.82,95%CI:0.68~0.97)或有恶性肿瘤疾病史人群(HR=0.84,95%CI:0.73~0.97;HR=0.84,95%CI:0.71~0.99)后,关联仍然存在。未发现DASH评分与COPD发病风险存在统计学关联。结论地中海饮食模式与较低的COPD发病风险存在关联,增加蔬菜、水果、豆类、全谷类食品并减少红肉等摄入,可降低COPD发病风险。未发现DASH与该社区人群COPD发病风险存在关联。Objective To explore the incidence of chronic obstructive pulmonary disease(COPD)in a cohort aged 40 years and above in Songjiang District,Shanghai,and to analyze the association of Mediterranean diet pattern and dietary approaches in stopping hypertension pattern(DASH)with the risk of developing COPD.Methods Based on a natural population cohort in Songjiang District,Shanghai,27474 adults aged 40 years and above who did not have COPD at baseline were enrolled in the study.The Cox proportional risk regression model was used to analyze the association of baseline Mediterranean diet pattern score and DASH score with the risk of COPD,and the hazard ratio(HR)of the risk and its 95%CI were calculated.Restricted cubic spline was used to analyze the nonlinear association between the two diet scores and the risk of COPD.Stratified analyses were performed according to gender,age,smoking status,etcetera.Sensitivity analyses were conducted by censoring cases diagnosed within one year after the baseline survey or people with a history of malignant tumor disease.Results As of June 30,2023,after a median follow-up time of 6.21 years,there were 1089(4.0%)new COPD cases with an incidence density of 64.00 per 10000 person-years.After adjusting for relevant confounders,in the Mediterranean tertile subgroups under diet pattern score,the risk of developing COPD could be reduced by approximately 14%in the intermediate scoring group(HR=0.86,95%CI:0.75-0.99)and 15%in the highest scoring group(HR=0.85,95%CI:0.72-0.99)compared to the lowest scoring group.The association remained after censoring cases diagnosed within one year of the baseline survey(HR=0.82,95%CI:0.70-0.95;HR=0.82,95%CI:0.68-0.97)or censoring people with a history of malignant tumor disease(HR=0.84,95%CI:0.73-0.97;HR=0.84,95%CI:0.71-0.99).No statistical association was found between the DASH score and the risk of COPD.Conclusions The Mediterranean diet pattern was associated with a lower risk of COPD.Increasing the intake of vegetables,fruits,legumes,and whole grains and d

关 键 词：慢性阻塞性肺疾病 地中海饮食模式 控制高血压饮食模式 饮食模式 

分 类 号：R563.9[医药卫生—呼吸系统]