目的 探索美国成年人的膳食模式和高尿酸血症(hyperuricemia,HUA)之间的关系.方法 本研究基于美国国家健康和营养调查(National Health and Nutrition Examination Survey,NHANES)2007-2018年人群数据开展研究.按纳入排除标准,最终纳入25 526名美国成年居民.采用主成分分析提取调查对象的膳食模式,利用限制立方样条(restricted cubic spline,RCS)回归模型检测各膳食模式因子得分与HUA之间可能的线性或非线性依赖关系.采用3个节点的RCS进行建模分析,调整了所有混杂因素.将膳食模式因子得分四分位后,以最低四分位为参考,采用多因素logistic回归分析不同的膳食模式与HUA患病风险的关系.logistic回归模型中协变量包括年龄、性别、种族、教育程度、家庭收入贫困率、体质量指数(body mass index,BMI)、吸烟、饮酒、身体活动、膳食补充剂使用、健康饮食指数、总能量和高嘌呤食物摄入.结果 利用主成分分析共提取出3种膳食模式,分别为脂肪-加工谷物-奶酪-添加糖(fat-processed-grains-cheese-added sugars,FPCS)模式、油-蔬菜-坚果-全谷物(oil-vegetables-nuts-whole grains,OVNW)模式和油-白薯-饮料-海产品(oil-white potatoes-drink-seafood,OPDS)模式.RCS分析表明,FPCS 模式得分与HUA患病风险呈线性关系(P-线性<0.001),FPCS 模式得分越高,HUA患病率降低.OVNW 模式得分与HUA患病风险呈线性关系(P-线性<0.001),OVNW模式得分越高,HUA患病率降低.OPDS模式得分与HUA患病风险呈线性关系(P-线性<0.001).OPDS模式得分越高,HUA患病率增加.在多因素logistic回归中,FPCS和OVNW模式与HUA患病风险呈负相关(Q4:OR=0.74,95%CI:0.62~0.87)和(Q4:OR=0.76,95%CI:0.66~0.87).而OPDS模式与HUA患病风险呈正相关(Q4:OR=1.54,95%CI:1.41~1.70).结论 FPCS和OVNW模式与美国成人HUA患病风险的降低有关,而OPDS模式与HUA患病风险增加有关.
Dietary patterns and hyperuricemia of adult population in United States
Objective:To investigate the relationship between dietary patterns and hyperuricemia(HUA)in American adults.Methods:This study was based on population data of the National Health and Nutrition Examination Survey(NHANES)2007-2018 year.According to the inclusion and exclusion criteria,25,526 US adult residents were finally included in this study.Principal component analysis was used to extract the dietary patterns of the survey respondents.Restricted cubic spline(RCS)regression model was applied to detect the possible linear or non-linear dependency of the relationship between dietary patterns and the prevalence risk of HUA with 3 knots adjusting for all confounders.The association between different dietary patterns and the risk of prevalence of hyperuricemia was analyzed by multifactorial logistic regression after quartiles of dietary pattern factor scores,with the lowest quartile as the reference.The covariates in the logistic regression model include age,gender,race,education,family income poverty rate,BMI,smoking,drinking,physical activity,dietary supplement use,Healthy Eating Index,total energy,and high-purine food intake.Results:Three patterns were extracted by principal component analysis.These are labeled as fat-processed grain-cheese-added sugar(FPCS),oil-vegetables-nuts-whole grains(OVNW)pattern and oil-white potatoes-drink-seafood(OPDS)pattern.RCS analysis showed that FPCS pattern score was linearly related to the risk of HUA(P-linear<0.001),and the higher the FPCS pattern score,the lower the prevalence of HUA.The OVNW pattern score was linearly related to the risk of HUA(P-linear<0.001)and the higher the OVNW pattern score,the lower the prevalence of HUA.There was a linear relationship between the OPDS pattern score and the risk of HUA(P-linear<0.001)and the higher the OPDS pattern score,the higher the prevalence of HUA.In logistic regression,FPCS and OVNW patterns were negatively associated with prevalence risk of hyperuricemia(Q4:OR=0.74,95%CI 0.62-0.87)and(Q4:OR=0.76,95%CI 0.66-0.87)respectively.However,OPDS pattern was positively associated with prevalence risk of hyperuricemia(Q4:OR=1.54,95%CI 1.41-1.70).Conclusion:FPCS and OVNW patterns were associated with decreased prevalence risk of hyperuricemia in the Adults of United States,whereas OPDS patterns were associated with increased prevalence risk of hyperuricemia.
hyperuricemiaNational Health and Nutrition Examination Surveydietary patterns