成人中重度哮喘患者的饮食炎症指数和临床转归指标
2023/09/21
摘要
背景：饮食越来越被认为是肺部健康的一个可改变因素，主要是由于营养素的免疫调节作用。饮食炎症指数（DII）是一种用来表达饮食炎症潜能的评分。
目的：我们旨在评估成人哮喘患者的DII和食物组与临床、功能和炎症性哮喘结果的关系。
方法：将2019年6月至2021年10月期间患有中度至重度哮喘的患者纳入这项横断面研究，并完成为期3天的食物日记，以计算DII和食物组（即水果、全谷物、加工肉类和含糖饮料）的摄入量。功能结果包括肺功能测试和6分钟步行距离，而临床结果则使用哮喘控制、生活质量和医疗保健利用率问卷进行评估。炎症标志物是呼出的一氧化氮和血液白细胞、嗜酸性粒细胞和白细胞介素-6。使用多变量回归分析来检验DII和食物组与哮喘结果的相关性。
结果：共有109名患者参与（35%为男性，平均±SD年龄51.8±14.2岁，BMI 27.4±5.3 kg/m2）。总体而言，62%的患者DII评分>0，表明其饮食具有促炎性，与哮喘严重程度无关。更具促炎性的饮食与较低的FVC（%pred）始终相关，但在气道阻塞方面观察到不一致的结果。DII和食物组均与临床结果无关。除与抗炎饮食相关的呼出一氧化氮水平较高外，我们没有发现炎症标志物与DII之间的关联。
结论：这项针对中度至重度哮喘患者的横断面研究的结果并不支持促炎饮食与更糟糕的哮喘结果相关的假设，尽管应该考虑研究设计和饮食摄入量估计的局限性。未来需要精心设计的实验研究来评估针对饮食的炎症潜能是否可以为哮喘成年人带来更好的结果。
Dietary Inflammatory Index and clinical outcome measures in adults with moderate to severe asthma
Edith Visser, Kim de Jong, Tim van Zutphen, Huib A M Kerstjens, Anneke Ten Brinke
Abstract
Background: Diet is increasingly recognized as a modifiable factor in lung health, predominantly due to the immunomodulatory effects of nutrients. The Dietary Inflammatory Index (DII) is a score developed to express the inflammatory potential of a diet.
Objective: We aimed to assess the association of the DII and food groups, with clinical, functional and inflammatory asthma outcomes in adults with asthma.
Methods: Patients with moderate to severe asthma were included in this cross-sectional study between June 2019 and October 2021, and completed a 3-day food diary, to calculate the DII and intake of food groups (i.e. fruits, whole grains, processed meats and sugar-sweetened beverages). Functional outcomes included pulmonary function tests and the 6-minute walking distance, while clinical outcomes were assessed using questionnaires on asthma control, quality of life, and healthcare utilization. Inflammatory markers were exhaled nitric oxide and blood leukocytes, eosinophils and interleukin-6. Multivariable regression analyses were used to examine the association of DII and food groups with asthma outcomes.
Results: A total of 109 patients participated (35% male, mean±SD age 51.8 ± 14.2 years, BMI 27.4 ± 5.3 kg/m2). Overall, 62% had a DII score >0, indicating a pro-inflammatory diet, which was not related to asthma severity. A more pro-inflammatory diet was consistently associated to lower FVC (%pred), but inconsistent results were observed with respect to airway obstruction. Neither the DII nor food groups were associated with clinical outcomes. Except for higher levels of exhaled nitric oxide in relation to an anti-inflammatory diet, we found no associations between inflammatory markers and the DII.
Conclusion: Results from this cross-sectional study among patients with moderate to severe asthma do not support the hypothesis that a pro-inflammatory diet is associated with worse asthma outcomes, although limitations in study design and dietary intake estimation should be considered. Future well-designed experimental studies are needed to assess whether targeting the inflammatory potential of diet could lead to better outcomes in adults with asthma.
背景：饮食越来越被认为是肺部健康的一个可改变因素，主要是由于营养素的免疫调节作用。饮食炎症指数（DII）是一种用来表达饮食炎症潜能的评分。
目的：我们旨在评估成人哮喘患者的DII和食物组与临床、功能和炎症性哮喘结果的关系。
方法：将2019年6月至2021年10月期间患有中度至重度哮喘的患者纳入这项横断面研究，并完成为期3天的食物日记，以计算DII和食物组（即水果、全谷物、加工肉类和含糖饮料）的摄入量。功能结果包括肺功能测试和6分钟步行距离，而临床结果则使用哮喘控制、生活质量和医疗保健利用率问卷进行评估。炎症标志物是呼出的一氧化氮和血液白细胞、嗜酸性粒细胞和白细胞介素-6。使用多变量回归分析来检验DII和食物组与哮喘结果的相关性。
结果：共有109名患者参与（35%为男性，平均±SD年龄51.8±14.2岁，BMI 27.4±5.3 kg/m2）。总体而言，62%的患者DII评分>0，表明其饮食具有促炎性，与哮喘严重程度无关。更具促炎性的饮食与较低的FVC（%pred）始终相关，但在气道阻塞方面观察到不一致的结果。DII和食物组均与临床结果无关。除与抗炎饮食相关的呼出一氧化氮水平较高外，我们没有发现炎症标志物与DII之间的关联。
结论：这项针对中度至重度哮喘患者的横断面研究的结果并不支持促炎饮食与更糟糕的哮喘结果相关的假设，尽管应该考虑研究设计和饮食摄入量估计的局限性。未来需要精心设计的实验研究来评估针对饮食的炎症潜能是否可以为哮喘成年人带来更好的结果。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2023 Aug 29;S2213-2198(23)00955-8. doi: 10.1016/j.jaip.2023.08.032.)
(J Allergy Clin Immunol Pract. 2023 Aug 29;S2213-2198(23)00955-8. doi: 10.1016/j.jaip.2023.08.032.)
Dietary Inflammatory Index and clinical outcome measures in adults with moderate to severe asthma
Edith Visser, Kim de Jong, Tim van Zutphen, Huib A M Kerstjens, Anneke Ten Brinke
Abstract
Background: Diet is increasingly recognized as a modifiable factor in lung health, predominantly due to the immunomodulatory effects of nutrients. The Dietary Inflammatory Index (DII) is a score developed to express the inflammatory potential of a diet.
Objective: We aimed to assess the association of the DII and food groups, with clinical, functional and inflammatory asthma outcomes in adults with asthma.
Methods: Patients with moderate to severe asthma were included in this cross-sectional study between June 2019 and October 2021, and completed a 3-day food diary, to calculate the DII and intake of food groups (i.e. fruits, whole grains, processed meats and sugar-sweetened beverages). Functional outcomes included pulmonary function tests and the 6-minute walking distance, while clinical outcomes were assessed using questionnaires on asthma control, quality of life, and healthcare utilization. Inflammatory markers were exhaled nitric oxide and blood leukocytes, eosinophils and interleukin-6. Multivariable regression analyses were used to examine the association of DII and food groups with asthma outcomes.
Results: A total of 109 patients participated (35% male, mean±SD age 51.8 ± 14.2 years, BMI 27.4 ± 5.3 kg/m2). Overall, 62% had a DII score >0, indicating a pro-inflammatory diet, which was not related to asthma severity. A more pro-inflammatory diet was consistently associated to lower FVC (%pred), but inconsistent results were observed with respect to airway obstruction. Neither the DII nor food groups were associated with clinical outcomes. Except for higher levels of exhaled nitric oxide in relation to an anti-inflammatory diet, we found no associations between inflammatory markers and the DII.
Conclusion: Results from this cross-sectional study among patients with moderate to severe asthma do not support the hypothesis that a pro-inflammatory diet is associated with worse asthma outcomes, although limitations in study design and dietary intake estimation should be considered. Future well-designed experimental studies are needed to assess whether targeting the inflammatory potential of diet could lead to better outcomes in adults with asthma.
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SARS-CoV-2大流行与哮喘：我们已经了解了什么以及什么仍然不清楚
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