超加工食品摄入量与护士健康研究队列中妇女患系统性红斑狼疮的风险。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-06-27 DOI:10.1002/acr.25395
Sinara Rossato, Emily G Oakes, Medha Barbhaiya, Jeffrey A Sparks, Susan Malspeis, Walter C Willett, Neha Khandpur, Karen H Costenbader
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引用次数: 0

摘要

目的:我们评估了前瞻性护士健康研究队列中超加工食品(UPF)的摄入量和系统性红斑狼疮的发病率。方法:我们对204175名女性进行了跟踪调查,NHS:1984-2016年;NHSII:1991-2017年。每2-4年填写一次半定量食物频率问卷。根据诺瓦分类法确定 UPF 摄入量。护士自我报告新的医生诊断的系统性红斑狼疮,并由医疗记录确认。时变 Cox 回归估算了诊断时抗双链 DNA 抗体(dsDNA)的系统性红斑狼疮和系统性红斑狼疮的发病危险比(HR,95% 置信区间),根据每天累计更新的 a) UPF 份数、b) 总摄入量(克+毫升)和 c) 总摄入量百分比。分析调整了年龄、种族、队列、热量和酒精摄入量、家庭收入、吸烟、体重指数 (BMI)、体力活动、男性年龄和口服避孕药使用情况。我们测试了与体重指数的交互作用,并检查了 UPF 类别:平均基线年龄约为 50 岁(NHS)和约为 36 岁(NHSII);93% 的自述者为白种人。共发现 212 例系统性红斑狼疮病例。UPF三等分位数第三位与第一位相比,系统性红斑狼疮风险更高(份数/天集合多变量[MV] HR 1.56 (1.04-2.32);P趋势 0.03)。dsDNA+系统性红斑狼疮的结果更明显(份数/天集合多变量 HR 2.05 (1.15-3.65);P 趋势 0.01),绝对摄入量(份数或总量)比总摄入量百分比的结果更明显。糖/人工加糖饮料与系统性红斑狼疮风险有关(第 3 与第 1 三等分MV HR 1.45 (1.01-2.09))。没有观察到体重指数之间的相互作用:结论:较高的累积平均每日UPF摄入量与系统性红斑狼疮风险增加50%以上有关,与抗dsDNA+系统性红斑狼疮风险加倍有关。推测UPF对全身炎症和免疫有许多有害影响。
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Ultraprocessed Food Intake and Risk of Systemic Lupus Erythematosus Among Women Observed in the Nurses' Health Study Cohorts.

Objective: We assessed ultraprocessed food (UPF) intake and systemic lupus erythematosus (SLE) incidence within the prospective Nurses' Health Study (NHS) cohorts.

Methods: A total of 204,175 women were observed (NHS 1984-2016; NHSII 1991-2017). Semiquantitative food frequency questionnaires were completed every two to four years. UPF intake was determined as per the Nova classification. Nurses self-reported new doctor-diagnosed SLE, confirmed by medical records. Time-varying Cox regressions estimated hazard ratios (HRs; 95% confidence intervals [CIs]) for patients with incident SLE and SLE by anti-double-stranded DNA (dsDNA) antibody at diagnosis, according to cumulatively updated daily (a) UPF servings, (b) total intake (in grams and milliliters), and (c) percentage of total intake. Analyses adjusted for age, race, cohort, caloric and alcohol intakes, household income, smoking, body mass index (BMI), physical activity, menarchal age, and oral contraceptive use. We tested for interaction with BMI and examined UPF categories.

Results: Mean baseline age was ~50 years (NHS) and ~36 years (NHSII); 93% self-reported White race. A total of 212 patients with incident SLE were identified. SLE risk was higher in the third versus first UPF tertile (servings per day pooled multivariable [MV] HR 1.56, 95% CI 1.04-2.32; P = 0.03). Results were stronger for dsDNA antibody in patients with SLE (servings per day pooled MV HR 2.05, 95% CI 1.15-3.65; P = 0.01) and for absolute (servings or total) than percentage of total intake. Sugar-sweetened/artificially sweetened beverages were associated with SLE risk (third vs first tertile MV HR 1.45, 95% CI 1.01-2.09). No BMI interactions were observed.

Conclusion: Higher cumulative average daily UPF intake was associated with >50% increased SLE risk and with doubled risk for anti-dsDNA antibody in patients with SLE. Many deleterious effects on systemic inflammation and immunity are postulated.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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