Relationship between the dietary inflammatory index and gastrointestinal symptoms in middle-aged and elderly residents in a high-incidence-of -gastric-cancer county in Anhui Province
-
摘要:
目的 探究安徽省某胃癌高发县中老年居民膳食炎症指数(dietary inflammatory index, DII)与消化道症状的关系，为提高居民健康素养和开展肿瘤预防提供依据。 方法 采用多阶段整群随机抽样方法，于2019年在庐江县随机抽取45岁以上居民共1 229人进行问卷调查，分析DII与消化道症状的关系。 结果 消化道症状为无、食欲不振、上腹部不适和消瘦/贫血的居民人数和占比分别为953(77.5%)、87(7.1%)、171(13.9%)、18(1.5%)。调整变量后的多因素分析显示，与DII按照四分位数由低到高分为Q1(P0~P25)相比，DII为Q4(P75~P100)的居民具有上腹部不适症状的风险更高(OR=2.326，95% CI: 1.350~4.008，P=0.002)。 结论 安徽省某胃癌高发县中老年居民DII评分越高，则消化道不良症状风险越高。 Abstract:Objective To explore the relationship between dietary inflammatory index (DII) and gastrointestinal symptoms of middle-aged and elderly residents in a county with high incidence of gastric cancer in Anhui Province. Methods In this study, a total of 1 229 residents over 45-year old were randomly selected from Lujiang County, Anhui Province to conduct a questionnaire survey. The relationship between DII and gastrointestinal symptoms was analyzed. Results There were residents with gastrointestinal symptoms. For instance, 87 (7.1%) residents had anorexia, 171 (13.9%) had epigastric discomfort, and 18 (1.5%) had emaciation/anemia, respectively. Multivariate analysis showed that, residents with DII of Q4(P75-P100) had a higher risk of epigastric discomfort (OR=2.326, 95% CI: 1.350-4.008, P=0.002) than those with DII of Q1(P0-P25) from lowest to highest according to quartiles. Conclusion With the increase of DII scores of middle-aged and elderly residents in that area of Anhui province, the risk of gastrointestinal symptoms increase. -
表 1 消化道症状情况描述[n(%)]
Table 1. Description of gastrointestinal symptoms[n(%)]
变量及分类 总数(N) 消化道症状 χ2值 P值 无(n=953) 食欲不振(n=87) 上腹部不适(n=171) 消瘦/贫血(n=18) 性别a 5.756 0.124 男 407 322(79.1) 34(8.4) 48(11.8) 3(0.7) 女 822 631(76.8) 53(6.4) 123(15.0) 15(1.8) 年龄(岁) b 11.274 0.010 45~ < 55 557 414(74.3) 49(8.8) 84(15.1) 10(1.8) 55~65 399 309(77.4) 27(6.8) 56(14.0) 7(1.8) >65 273 230(84.2) 11(4.0) 31(11.4) 1(0.4) BMI(kg/m2) b 3.144 0.370 ＜24.0 778 589(75.7) 59(7.6) 117(15.0) 13(1.7) 24.0~ < 28.0 356 292(82.0) 20(5.6) 41(11.5) 3(0.8) ≥28.0 95 72(75.8) 8(8.4) 13(13.7) 2(2.1) 婚姻状况a 2.375 0.469 未婚/离异/丧偶 121 97(80.2) 6(5.0) 18(14.9) 0(0) 已婚 1 108 856(77.3) 81(7.3) 153(13.8) 18(1.6) 文化程度b 0.495 0.920 文盲 588 454(77.2) 44(7.5) 81(13.8) 9(1.5) 小学 389 307(78.9) 24(6.2) 51(13.1) 7(1.8) 初中及以上 252 192(76.2) 19(7.5) 39(15.5) 2(0.8) 职业a 5.010 0.171 非农民 241 189(78.4) 23(9.5) 27(11.2) 2(0.8) 农民 988 764(77.3) 64(6.5) 144(14.6) 16(1.6) 家庭年人均收入b(元) 0.168 0.983 < 3万 425 328(77.2) 32(7.5) 57(13.4) 8(1.9) 3万~＜6万 581 455(78.3) 39(6.7) 83(14.3) 4(0.7) ≥6万 223 170(76.2) 16(7.2) 31(13.9) 6(2.7) 吸烟a 5.706 0.127 是 231 188(81.4) 19(8.2) 22(9.5) 2(0.9) 否 998 765(76.7) 68(6.8) 149(14.9) 16(1.6) 饮酒a 6.956 0.073 是 363 295(81.3) 27(7.4) 36(9.9) 5(1.4) 否 866 658(76.0) 60(6.9) 135(15.6) 13(1.5) 饮茶a 5.875 0.118 是 680 530(77.9) 53(7.8) 84(12.4) 13(1.9) 否 549 423(77.0) 34(6.2) 87(15.8) 5(0.9) 消化道疾病a 73.398 < 0.001 是 325 204(62.8) 25(7.7) 90(27.7) 6(1.8) 否 904 749(82.9) 62(6.9) 81(9.0) 12(1.3) HP感染情况a 1.107 0.775 阳性 509 391(76.8) 37(7.3) 66(13.0) 15(2.9) 阴性 437 334(76.4) 31(7.1) 63(14.4) 9(2.1) 注：a表示变量为无序分类变量，使用χ2检验；b表示变量为有序分类变量，使用秩和检验。 
下载: 导出CSV
表 2 DII与消化道症状的多因素分析
Table 2. Multivariate analysis of DII and gastrointestinal symptoms
消化道症状a DII β值 Waldχ2值 P值 OR(95% CI)值 食欲不振 Q1(≤0.84) 1.000 Q2(＞0.84~1.07) -0.775 5.583 0.018 0.461(0.242~0.876) Q3(＞1.07~1.26) -0.462 2.644 0.104 0.630(0.361~1.100) Q4(>1.26) 0.142 0.147 0.701 1.153(0.558~2.384) 上腹部不适 Q1(≤0.84) 1.000 Q2(＞0.84~1.07) -0.159 0.367 0.545 0.853(0.510~1.427) Q3(＞1.07~1.26) 0.102 0.186 0.666 1.108(0.696~1.762) Q4(>1.26) 0.844 9.246 0.002 2.326(1.350~4.008) 消瘦/贫血 Q1(≤0.84) 1.000 Q2(＞0.84~1.07) 0.246 0.170 0.680 1.279(0.396~4.129) Q3(＞1.07~1.26) -0.312 0.235 0.628 0.732(0.208~2.580) Q4(>1.26) -0.814 0.506 0.477 0.443(0.047~4.169) 注：a参考类别为无症状；校正因素包括：性别(男、女)、年龄(45~ < 55岁、55~65岁、>65岁)、BMI(＜24.0 kg/m2、24.0~ < 28.0 kg/m2、≥28.0 kg/m2)、经济收入(< 3万元、3万元~ < 6万元、≥6万元)、文化程度(文盲、小学、初中及以上)、职业(非农民、农民)、是否吸烟(是、否)、是否饮酒(是、否)、消化道疾病(是、否)。
下载: 导出CSV
-
[1] 严小兵, 刘未东. 庐江县居民胃癌死亡情况动态分析[J]. 安徽预防医学杂志, 2000, 6(5): 351. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF200005032.htmYan XB, Liu WD. Dynamic analysis of gastric cancer death in residents of Lujiang County[J]. Anhui J of Prev Med, 2000, 6(5): 351. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF200005032.htm [2] Ford AC, Mahadeva S, Carbone MF, et al. Functional dyspepsia[J]. Lancet, 2020, 396(10263): 1689-1702. DOI: 10.1016/S0140-6736(20)30469-4. [3] Silva AR, Moraes BPT, Gonçalves-de-Albuquerque CF. Mediterranean diet: lipids, inflammation, and malaria infection[J]. Int J Mol Sci, 2020, 21(12): 4489. DOI: 10.3390/ijms21124489 [4] Tabung FK, Smith-Warner SA, Chavarro JE, et al. Development and validation of an empirical dietary inflammatory index[J]. J Nutr, 2016, 146(8): 1560-1570. DOI: 10.3945/jn.115.228718. [5] 杨月欣. 中国食物成分表标准版第6版[M]. 北京: 北京大学医学出版社, 2020.03.Yang YX. Chinese food composition tables, standard edition, 6th ed. [M]. Beijing: Peking University Medical Press, 2020.03. [6] Akhondi-Meybodi M, Aghaei MA, Hashemian Z. The role of diet in the management of non-ulcer dyspepsia[J]. Middle East J Dig Dis, 2015, 7(1): 19-24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293796/ [7] Du S, Li Y, Su Z, et al. Index-based dietary patterns in relation to gastric cancer risk: a systematic review and meta-analysis[J]. Br J Nutr, 2020, 123(9): 964-974. DOI: 10.1017/S0007114519002976. [8] Zamani M, Ebrahimtabar F, Zamani V, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2018, 47(7): 868-876. DOI: 10.1111/apt.14561. -
