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| 饮食炎症指数与骨质疏松症关系：基于NHANES 2003年–2010年证据 |
| The relationship between the dietary inflammatory index and osteoporosis: Evidence from NHANES |
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| DOI：10.3969/j.issn.1006-7108.2025.09.008 |
| 中文关键词: 美国国家健康与营养调查 饮食炎症指数 骨质疏松症 横断面研究 LASSO |
| 英文关键词:NHANES DII osteoporosis cross-sectional study LASSO |
| 基金项目:广州市荔湾区科技计划项目（20240612）；国家自然科学基金项目（82374482；82274551） |
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| 中文摘要: |
| 目的 本研究旨在利用2003年-2010年美国国家健康与营养调查（NHANES）数据，探讨饮食炎症指数（dietary inflammatory index，DII）与美国人群骨质疏松症患病率的关系。方法 分析NHANES 2003年–2010 年调查中7 290 名参与者的数据。使用加权多变量逻辑回归评估 DII 与骨质疏松症之间的关系，并采用限制性立方样条回归（RCS）探索可能的非线性关联。亚组分析的分层模型结果以森林图展示。通过最小绝对收缩和LASSO回归确定与骨质疏松症相关的关键饮食因素，并将这些因素整合到列线图中预测风险，模型的鉴别能力通过接收者操作特性（ROC）曲线进行评估。结果 骨质疏松症患者的DII 得分显著高于未患病者（1.61 vs. 1.18，P < 0.001）。在调整协变量后，DII位于最高四分位的参与者患骨质疏松症的风险增加了88%（OR: 1.88，95% CI: 1.41~2.52，趋势P < 0.001）。限制性立方样条分析验证了DII与骨质疏松症风险之间的线性关系。亚组分析展示了不同人群中相似的趋势，并通过森林图展示。LASSO 回归识别的关键饮食因素被用于构建AUC为83.6%的列线图，显示出较高的预测精度。结论 较高的DII与骨质疏松症风险增加密切相关，强调减少饮食炎症在预防骨质疏松症中的重要性。 |
| 英文摘要: |
| Objective This study aims to explore the relationship between the Dietary Inflammatory Index (DII) and the prevalence of osteoporosis in the U.S. population using data from the 2003–2010 National Health and Nutrition Examination Survey (NHANES). Methods Data from 7 290 participants in the 2003–2010 NHANES survey were analyzed. Weighted multivariate logistic regression was used to assess the relationship between DII and osteoporosis, and restricted cubic spline regression (RCS) was employed to explore possible non-linear associations. Subgroup analysis results were presented using forest plots. Key dietary factors associated with osteoporosis were identified using least absolute shrinkage and selection operator (LASSO) regression and incorporated into a nomogram to predict risk. The model's discriminative ability was evaluated using the receiver operating characteristic (ROC) curve. Results The DII scores of osteoporosis patients were significantly higher than those of non-osteoporosis patients (1.61 vs. 1.18, P<0.001). After adjusting for covariates, participants in the highest quartile of DII had an 88% increased risk of osteoporosis (OR: 1.88, 95% CI: 1.41–2.52, trend P<0.001). The restricted cubic spline analysis confirmed a linear relationship between DII and osteoporosis risk. Subgroup analysis demonstrated similar trends across different populations, displayed via forest plots. The key dietary factors identified by LASSO regression were used to construct a nomogram with an AUC of 83.6%, showing high predictive accuracy. Conclusion A higher DII is closely associated with an increased risk of osteoporosis, underscoring the importance of reducing dietary inflammation in osteoporosis prevention. |
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