基于国家健康与营养调查数据库研究饮食炎症指数与慢性肾脏病患者肌少症的关联分析  

Correlation of dietary inflammation index with sarcopenia in patients with chronic kidney disease based on the NHANES database

作　　者：马小艳 姚瑞 倪琳[1] 戴静静[1] Ma Xiao-yan;Yao Rui;Ni Lin;Dai Jing-jing(Department of Nephrology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院肾脏内科,上海200092

出　　处：《临床肾脏病杂志》2025年第1期1-6,共6页Journal Of Clinical Nephrology

摘　　要：目的基于国家健康与营养调查(national health and nutrition survey,NHANES)数据库探究饮食炎症指数(dietary inflammatory index,DⅡ)与慢性肾脏病(chronic kidney disease,CKD)患者肌少症的关系。方法采用1999至2006年和2012至2018年NHANES网站资料。通过膳食数据计算DⅡ,根据DⅡ四分位数将患者分为DⅡQ1组、DⅡQ2组、DⅡQ3组、DⅡQ4组,比较组间年龄、性别及肌少症患病率等的差异。采用Logistic回归模型分析患者DⅡ与肌少症的关系,并进行趋势分析和分层分析。利用限制性立方样条图分析二者是否存在非线性关系。结果本研究共纳入1660例CKD患者。DⅡQ1组(42.17%)、DⅡQ2组(46.99%)、DⅡQ3组(52.05%)、DⅡQ4组(58.80%)肌少症患病率比较,差异有统计学意义(χ^(2)=25.224,P<0.001)。完全调整混杂因素后,DⅡ与CKD患者肌少症风险仍显著相关(OR=1.214,95%CI:1.135~1.299,P<0.001),与DⅡQ1组相比,DⅡQ3组(OR=1.467,95%CI:1.106~1.948,P=0.008)、DⅡQ4组(OR=1.876,95%CI:1.405~2.511,P<0.001)CKD患者患肌少症的风险显著增加,且OR值呈增加趋势(P趋势<0.001)。分层后,女性CKD患者DⅡ与肌少症风险仍呈正相关(P=0.024)。结论DⅡ与CKD患者肌少症风险密切相关,DⅡ评分越高,患肌少症的风险越高。Objective To identify the correlation of dietary inflammatory index(DII)with sar-copenia in patients with chronic kidney disease(CKD)based on the National Health and Nutrition Exami-nation Survey(NHANES)database.Methods Data from 1999-2006 and 2012-2018 in the NHANES database were analyzed.DII was calculated from dietary data,and patients were divided into DII Q1,DII Q2,DII Q3,and DII Q4 groups based on DII quartiles.Age,gender and the prevalence of sarcopenia were compared between the groups.Logistic regression model was used to analyze the relationship be-tween DII and sarcopenia in patients with trend and stratification analysis.Restricted cubic spline plots(RCS)were used to analyze a nonlinear relationship between DII and sarcopenia.Results A total of 1,660 CKD patients were included in this study.There was a significant difference in the prevalence of sar-copenia in CKD patients among the DII Q1(42.17%),DII Q2(46.99%),DII Q3(52.05%),and DII Q4(58.80%)groups(χ^(2)=25.224,P<0.001).After adjusting for confounders,DII was still significantly as-sociated with the risk of sarcopenia in CKD patients(OR=1.214,95%CI:1.135-1.299,P<0.001).Compared with the DII Q1 group,CKD patients in the DII Q3(OR=1.467,95%CI:1.106-1.948,P=0.008),and DII Q4 groups(OR=1.876,95%CI:1.405-2.511,P<0.001)had a significantly higher risk of developing sarcopenia,with an increasing odds ratio(OR)(Pfortrend<0.001).After stratifica-tion,DII remained positively associated with the risk of sarcopenia in female CKD patients(P=0.024).Conclusion DII is strongly associated with the risk of sarcopenia in CKD patients,with higher DII scores associated with a higher risk of developing sarcopenia.

关 键 词：慢性肾脏病 肌少症 饮食炎症指数 国家健康与营养调查数据库 

分 类 号：R692[医药卫生—泌尿科学] R685[医药卫生—外科学]