A study on the relationship between the dietary inflammatory index and hypertension among residents of the Xinjiang region
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摘要:
目的 探讨新疆维吾尔自治区居民膳食炎症指数(dietary inflammatory index, DII)与高血压患病风险的关系。 方法 采用整群抽样的方法，选取石河子市和图木舒克市成年居民作为研究对象，收集研究对象的一般人口学信息、饮食信息和体格检查。采用t检验、方差分析、Wilcoxon秩和检验分析研究对象膳食营养素的摄入情况；采用限制性立方样条分析DII与高血压患病风险的剂量-反应关系；将研究对象按DII得分分为3组(T1~T3组)，采用logistic回归分析模型分析DII与高血压患病风险的关系。 结果 除碳水化合物、胆固醇和维生素E外，高血压人群其他营养素摄入量与对照组的差异均有统计学意义(均P < 0.05)。限制性立方样条结果显示，DII连续变化与高血压患病的关联强度呈非线性剂量-反应关系。调整混杂因素后，随着DII的升高，高血压患病风险呈上升趋势(P趋势 < 0.001)，与T1组相比，T2和T3组高血压患病风险分别为1.68倍(95% CI：1.12~2.51)和2.95倍(95% CI：2.11~4.11)。 结论 新疆维吾尔自治区高血压人群的DII得分高于非高血压人群，且DII的得分越高，高血压的患病风险越高。 -
关键词:
- 高血压 /
- 膳食炎症指数 /
- Logistic回归分析模型
Abstract:Objective To explore the relationship between dietary inflammatory index(DII) and hypertension risk among Xinjiang Uygur Autonomous Region residents. Methods Using whole cluster sampling, adult residents of Shihezi and Tumushuk cities were selected for the study. General demographic information, dietary information, and physical examination of the study subjects were collected. The t-test, ANOVA, and Wilcoxon rank-sum test were used to analyze the dietary nutrient intake of the study population. A restricted cubic spline was used to analyze the dose-response relationship between DII and the risk of developing hypertension. The DII of the study subjects was divided into T1-T3, and the relationship between DII and the risk of hypertension was analyzed using logistic regression models. Results Except for carbohydrates, cholesterol, and vitamin E, intakes of other nutrients differed significantly between hypertensive populations and control (all P < 0.05). Restricted cubic spline results showed a nonlinear dose-response relationship for the strength of the association between successive changes in DII and the prevalence of hypertension. After adjusting for confounders, the risk of hypertension tended to increase with higher DII (Ptrend < 0.001). The risk of developing hypertension was 1.68 (95% CI: 1.12-2.51) and 2.95 (95% CI: 2.11-4.11) in the T2 and T3, respectively, compared with T1. Conclusions In Xinjiong Uyqur Autonomous Region, the hypertensive population had a higer DII score than the non-hypertensive population, and the higher the DII score, the higher the risk of hypertension. -
图 1 膳食炎症指数与高血压患病风险的限制性立方样条曲线
Figure 1. Restricted cubic spline curve for dietary inflammatory index and risk of developing hypertension
表 1 研究人群中高血压的发生情况
Table 1. Incidence of hypertension in the study population
变量
Variable总人群
Total population①
(n=930)非高血压人群
Non hypertensive population①
(n=501)高血压人群
Hypertensive population①
(n=429)χ2值
valueP值
value性别Gender 5.778 0.016 男Male 388(41.72) 191(49.23) 197(50.77) 女Female 542(58.28) 310(57.20) 232(42.80) 年龄组/岁Age group/years 59.580 < 0.001 20~54 417(44.84) 283(67.87) 134(32.13) ＞54~80 513(55.16) 218(42.50) 295(57.50) 民族Nation 2.341 0.126 维吾尔族The Uygurs 587(63.12) 305(51.96) 282(48.04) 汉族The Han nationality 343(36.88) 196(57.14) 147(42.86) 文化程度Degree of education 15.201 0.002 小学及以下Elementary school and below 450(48.39) 215(47.78) 235(52.22) 初中Middle school 297(31.93) 184(61.95) 113(38.05) 中专/高中Technical secondary school/high school 115(12.37) 62(53.91) 53(46.09) 大专/本科College/undergraduate 68(7.31) 40(58.82) 28(41.18) 吸烟Smoking 7.966 0.005 是Yes 160(17.20) 70(57.50) 90(42.50) 否No 770(82.58) 431(52.99) 339(47.01) 饮酒Drinking 5.662 0.017 是Yes 125(13.44) 55(53.60) 70(45.60) 否No 805(86.56) 446(53.79) 359(46.21) 糖尿病Diabetes 5.356 0.021 是Yes 50(5.38) 19(38.00) 31(62.00) 否No 880(94.62) 482(54.77) 398(45.23) CVD 25.344 < 0.001 是Yes 95(10.22) 28(29.47) 67(70.53) 否No 835(89.78) 473(56.65) 362(43.35) BMI/(kg·m-2) 33.717 < 0.001 < 18.5 10(1.07) 8(80.00) 2(20.00) 18.5~＜24.0 243(26.13) 159(65.43) 84(34.57) 24.0~＜28.0 337(36.24) 189(56.08) 148(43.92) ≥28.0 340(36.56) 145(42.65) 195(57.35) 注: CVD, 心血管病。
①以人数(占比/%)表示。
Note: CVD, cardiovascular disease.
①Number of people (proportion/%).
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表 2 调查对象各种膳食营养素的比较
Table 2. Comparison of various dietary nutrients among survey respondents
变量
Variable非高血压人群
Non hypertensive population① (n=501)高血压人群
Hypertensive population① (n=429)t/Z
值valueP值
valueDII -0.26(-1.21, 0.81) 0.75(-0.21, 1.94) 9.390 < 0.001 能量Energy/kcal 2 057.52±113.58 2 025.54±119.16 3.761 < 0.001 蛋白质Protein/g 105.65(100.36, 112.26) 102.11(95.26, 110.61) 4.835 < 0.001 总脂肪Total fat/g 68.88(62.95, 75.48) 65.91(60.31, 73.33) 3.650 0.003 碳水化合物Carbohydrates/g 363.05±22.39 360.09±22.17 1.829 0.068 膳食纤维Dietary fiber/g 12.85(12.24, 13.72) 12.50(11.64, 13.45) 5.520 < 0.001 胆固醇Cholesterol/mg 312.39(198.25, 376.19) 302.23(204.76, 355.15) 1.734 0.083 维生素A Vitamin A/RE 826.54(776.10, 875.35) 797.08(749.95, 846.06) 4.260 < 0.001 胡萝卜素Carotene/μg 2 952.29(2 613.81, 3 270.17) 2 813.91(2 526.87, 3 140.21) 2.866 0.004 硫胺素Thiamine/mg 1.26±0.06 1.24±0.07 4.633 < 0.001 核黄素Riboflavin/mg 1.02(0.98, 1.08) 0.99(0.92, 1.06) 6.061 < 0.001 镁Magnesium/mg 375.70(121.42, 402.58) 367.87(122.83, 391.13) 2.085 0.037 铁Iron/mg 27.55±2.11 26.88±2.34 4.121 < 0.001 锌Zinc/mg 14.39(13.41, 15.23) 13.92(13.22, 14.83) 3.701 < 0.001 硒Selenium/μg 51.07(48.57, 54.41) 49.40(46.03, 53.34) 5.113 < 0.001 维生素C Vitamin C/mg 72.84(65.25, 100.18) 66.95(60.38, 93.66) 4.851 < 0.001 维生素D Vitamin D/μg 1.60(1.38, 4.58) 1.45(1.28, 4.41) 3.515 < 0.001 维生素E Vitamin E/mg 13.60(7.15, 14.64) 13.48(7.28, 14.28) 1.563 0.118 维生素B6 Vitamin B6/mg 0.85(0.72, 1.12) 0.79(0.68, 1.06) 3.588 < 0.001 维生素B12 Vitamin B12/μg 4.69(4.36, 5.05) 4.44(4.13, 4.79) 3.070 0.002 叶酸Folic acid/μg 187.33(173.64, 201.16) 175.25(162.24, 194.39) 5.903 < 0.001 烟酸Niacin/mg 19.94(18.54, 21.46) 18.90(17.38, 21.04) 4.507 < 0.001 花青素Anthocyanin/mg 20.49(17.05, 25.13) 19.19(16.07, 23.46) 2.424 0.015 异黄酮素Isoflavones/mg 0.05(0.04, 0.67) 0.04(0.03, 0.63) 2.774 0.006 注: DII，膳食炎症指数。
①以x±s或M(P25, P75)表示。
Note: DII, dietary inflammatory index.
① x±s or M(P25, P75).
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表 3 不同DII人群膳食营养素的比较
Table 3. Comparison of dietary nutrients among different DII populations
变量
VariableT1组group①
(n=522)T2组group①
(n=140)T3组group①
(n=268)F/H
值valueP值
value能量Energy/kcal 2 079.97±114.18 2 035.13±101.35 1 969.53±95.43 94.089 < 0.001 蛋白质Protein/g 107.26(102.33, 112.79) 104.75(99.67, 114.87) 95.70(92.12, 101.82) 218.704 < 0.001 总脂肪Total fat/g 71.09(65.04, 77.39) 67.15(61.79, 74.59) 61.61(57.87, 66.68) 126.228 < 0.001 碳水化合物Carbohydrates/g 366.10±23.55 357.87±20.42 354.56±18.16 27.890 < 0.001 膳食纤维Dietary fiber/g 13.00(12.53, 13.74) 12.98(11.95, 14.05) 11.59(11.17, 12.20) 256.470 < 0.001 胆固醇Cholesterol/mg 329.98(198.36, 384.58) 222.43(190.81, 339.79) 305.09(251.36, 337.12) 21.374 < 0.001 维生素A Vitamin A/RE 825.52(773.69, 871.64) 816.94(770.86, 886.33) 772.32(735.10, 821.91) 81.653 < 0.001 胡萝卜素Carotene/μg 2 948.93(2 589.32, 3 287.41) 2 909.86(2 627.75, 3 218.91) 2 724.60(2 476.54, 3 054.93) 28.854 < 0.001 硫胺素Thiamine/mg 1.27(1.23, 1.31) 1.25(1.22, 1.29) 1.20(1.16, 1.24) 194.312 < 0.001 核黄素Riboflavin/mg 1.04±0.07 1.04±0.09 0.95±0.07 155.034 < 0.001 镁Magnesium/mg 394.29(121.14, 409.17) 127.64(118.62, 385.49) 366.06(349.00, 377.02) 65.224 < 0.001 铁Iron/mg 28.04±1.93 27.32±2.17 25.52±1.91 146.271 < 0.001 锌Zinc/mg 14.55(13.62, 15.36) 14.05(13.22, 15.03) 13.60(12.92, 14.26) 92.451 < 0.001 硒Selenium/μg 51.56(49.60, 54.38) 51.25(47.89, 56.18) 46.13(44.48, 48.22) 234.159 < 0.001 维生素C Vitamin C/mg 72.60(65.63, 97.42) 91.41(66.32, 105.46) 62.37(58.30, 70.09) 145.111 < 0.001 维生素D Vitamin D/μg 1.59(1.39, 4.54) 4.02(1.42, 4.96) 1.33(1.21, 1.57) 122.870 < 0.001 维生素E Vitamin E/mg 14.27(7.15, 15.05) 7.71(7.06, 13.84) 13.32(12.61, 13.76) 70.610 < 0.001 维生素B6 Vitamin B6/mg 0.86(0.74, 1.11) 0.98(0.75, 1.18) 0.72(0.63, 0.86) 105.381 < 0.001 维生素B12 Vitamin B12/μg 4.63(4.35, 4.98) 4.71(4.39, 5.10) 4.32(4.02, 4.61) 93.975 < 0.001 叶酸Folic acid/μg 186.31(174.84, 200.51) 187.25(172.72, 208.43) 164.45(155.96, 177.20) 176.584 < 0.001 烟酸Niacin/mg 20.16(18.89, 21.53) 20.07(18.49, 22.70) 17.46(16.67, 18.98) 196.086 < 0.001 花青素Anthocyanin/mg 20.04(16.63, 24.72) 20.12(16.13, 24.35) 19.04(16.24, 23.03) 5.868 0.053 异黄酮素Isoflavones/mg 0.05(0.04, 0.64) 0.08(0.04, 0.15) 0.04(0.03, 0.05) 104.466 < 0.001 注: DII，膳食炎症指数。
①以x±s或M(P25, P75)表示。
Note: DII, dietary inflammatory index.
① x±s or M(P25, P75).
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表 4 研究人群DII与高血压患病风险的关联
Table 4. Association between DII and risk of hypertension in the study population
DII分组
Group模型1 Model 1 模型2 Model 2 模型3 Model 3 OR值value
(95% CI)P值
valueOR值value
(95% CI)P值
valueOR值value
(95% CI)P值
valueT1 1.00 1.00 1.00 T2 1.79(1.20~2.60) 0.003 1.72(1.16~2.57) 0.007 1.68(1.12~2.51) 0.012 T3 3.74(2.74~5.10) < 0.001 3.08(2.22~4.27) < 0.001 2.95(2.11~4.11) < 0.001 P趋势值Ptrend value < 0.001 < 0.001 < 0.001 注: 1. DII，膳食炎症指数。
2. 以T1为参照；模型1无调整；模型2调整年龄、性别、民族和文化程度；模型3是在模型2基础上进一步调整吸烟、饮酒、糖尿病、CVD；趋势检验是将每个分位组的中位数作为连续性变量纳入模型。
Note: 1. DII, dietary inflammatory index.
2. Referring to T1; Model 1 has no adjustments; Model 2 adjusts for age, gender, ethnicity, and educational level; Model 3 is to further adjust smoking, drinking, diabetes and CVD on the basis of model 2; Trend test is to include the median of each quantile into the model as a continuous variable.
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