Chunhua Zhou, Jiawei Geng, Zhipeng Wu, Lintao Dan, Hanyi Huang, Xixian Ruan, Jie Chen, Yao Zhang, Duowu Zou
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引用次数: 0
Abstract
Background: The relationship between Mediterranean diet (MedDiet) adherence and acute pancreatitis (AP) risk is largely unknown.
Objectives: To investigate the associations between MedDiet adherence and AP risk and joint associations of genetic risk and MedDiet adherence with AP risk.
Design: A prospective cohort study using data from UK Biobank, a large population-based prospective study that recruited over 500,000 participants aged 40-69 between 2006 and 2010 across the United Kingdom.
Methods: We included 103,449 participants free of AP with typical dietary intake from 24-h dietary recalls. MedDiet adherence was measured via the Mediterranean Diet Adherence Screener (MEDAS) continuous score. Genetic predisposition to AP was estimated by polygenic risk score (PRS). Incident AP cases were identified via electronic medical records. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated by Cox proportional hazards models. Mediation analyses were further applied to explore the mediating effects of the low-grade inflammation (INFLA) score and metabolic status.
Results: Over a mean follow-up period of 10.4 years, 371 AP cases were documented. Higher MedDiet adherence defined by MEDAS continuous score was inversely associated with lower AP risk (highest vs lowest tertiles: HR 0.60, 95% CI 0.46-0.79, p < 0.001), with the INFLA score and metabolic status mediating 10% and 7.1% of the association, respectively. Although no interaction was observed between PRS and MedDiet adherence, participants with combined low genetic risk and the highest MedDiet adherence had the lowest risk of AP (HR 0.54, 95% CI 0.36-0.80, p = 0.002).
Conclusion: The study suggests that higher adherence to the MedDiet is associated with a decreased risk of AP, which is partially mediated by inflammation and metabolic status, and may attenuate the deleterious impact of genetics on AP risk.
背景：地中海饮食（MedDiet）依从性与急性胰腺炎（AP）风险之间的关系在很大程度上是未知的。目的：探讨MedDiet依从性与AP风险之间的关系，以及遗传风险和MedDiet依从性与AP风险的联合关系。设计：一项前瞻性队列研究，使用来自UK Biobank的数据，这是一项基于人群的大型前瞻性研究，在2006年至2010年期间在英国招募了50多万名年龄在40-69岁之间的参与者。方法：我们从24小时饮食回顾中纳入了103,449名无AP的典型饮食摄入的参与者。通过地中海饮食依从性筛查（MEDAS）连续评分来测量MedDiet依从性。通过多基因风险评分（PRS）评估AP的遗传易感性。通过电子医疗记录确定事件AP病例。采用Cox比例风险模型估计95%置信区间的风险比（hr）。采用中介分析进一步探讨低度炎症（INFLA）评分与代谢状态的中介作用。结果：在平均10.4年的随访期间，记录了371例AP病例。MEDAS连续评分定义的较高的MedDiet依从性与较低的AP风险呈负相关（最高和最低位数：HR 0.60, 95% CI 0.46-0.79, p p = 0.002）。结论：本研究表明，较高的MedDiet依从性与AP风险降低相关，这部分是由炎症和代谢状态介导的，并可能减弱遗传对AP风险的有害影响。
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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