膳食炎症指数与骨质疏松、骨折风险关系的Meta分析

Relationship between dietary inflammatory index and risk of osteoporosis and bone fractures:a Meta-analysis

目的探讨在普通人群中膳食炎症指数(dietary inflammatory index,DII)与骨质疏松及骨折发生风险之间的关系。方法系统检索PubMed、Embase、Cochrane Library和Web of Science数据库至2020年6月公开发表的相关文献,按纳入与排除标准对文献进行筛选。采用NOS量表对文献进行质量评估,使用Stata软件进行Meta分析,选择随机效应模型和固定效应模型汇总相对风险(relative risks,RR)和95%置信区间(confidence intervals,CI)。结果本研究共纳入9项观察性研究(4项队列研究,4项横断面研究,1项病例对照研究),共涉及192736名参与者。Meta分析结果显示,较高的DII与骨质疏松风险增加相关(RR=1.31,95%CI:1.16~1.48,I^(2)=0,P=0.523);此外,最高和最低(参考)类别DII间的骨折风险差异有统计学意义(RR=1.17,95%CI:1.03~1.33,I^(2)=87%,P<0.001)。在亚组分析中,除研究设计类型(横断面研究RR=1.26,95%CI:1.09~1.46,I^(2)=22.4%,P=0.272)外,其余各亚组分析均差异无统计学意义。结论高促炎饮食可能与普通人群发生骨质疏松、骨折风险增加有关,多吃水果和蔬菜等抗炎食物对保持骨骼健康具有重要作用。

Objective To explore the association between dietary inflammation index(DII)and the risk of osteoporosis and bone fractures in the general population.Methods PubMed,Embase,Cochrane Library,and Web of Science databases were searched for studies published up to June 2020 without language limitation.The random effects model and fixed effects model were selected to aggregate the relative risks(RRs)and 95%confidence intervals(CIs)in this study.Results A total of nine observational studies involving 192736 participants were included.Results of the Meta-analysis showed that higher DII was associated with an increased risk of osteoporosis(RR=1.31,95%CI:1.16-1.48,I^(2)=0,P=0.523).In addition,the risk of fracture was statistically different between the highest and lowest(reference)categories of DII(RR=1.17,95%CI:1.03-1.33,I^(2)=87%,P<0.001).In the subgroup analyses,there were no statistically significant differences[including gender,geographic location,specific fracture site(any site,hip,and other sites),and adjustments for covariates body mass index(BMI),fracture history,and smoking status]except for study design type(cross-sectional study,RR=1.26,95%CI:1.09-1.46,I^(2)=22.4%,P=0.272).ConclusionsHigh pro-inflammatory diet is associated with an increased risk of bone fractures in the general population.Consuming more anti-inflammatory foods such as fruits and vegetables,may be important for maintaining bone health.