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| DII与OP患者全因死亡相关性及表型年龄加速中介效应 |
| The correlation between dietary inflammatory index and all-cause mortality in osteoporosis patients and the mediating effect of accelerated pheno age advance |
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| DOI：10.3969/j.issn.1006-7108.2026.08.014 |
| 中文关键词: 膳食炎症指数 骨质疏松症 表型年龄加速 全因死亡 NHANES数据库 |
| 英文关键词:dietary inflammatory index osteoporosis pheno age advance all-cause mortality NHANES database |
| 基金项目:江苏省中医药和中西医结合学会科研项目（PDJH2026044）；江苏省中医药科技发展计划项目（MS2025076）；江苏省中医药学会“振兴发展”项目（ZXFZ2024082）；昆山高层次卫生人才项目（昆卫[2024]9号） |
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| 中文摘要: |
| 目的 研究膳食炎症指数（dietary inflammatory index，DII）与骨质疏松症（osteoporosis，OP）患者全因死亡的相关性及表型年龄加速(Pheno Age Advance)的中介效应。方法 研究是基于美国NHANES（National Health and Nutrition Examination Survey）数据库的队列研究。
研究共纳入了1999—2018年566例OP患者，死亡数据从美国国家死亡索引（National Death Index，NDI）匹配获得。使用加权Cox比例风险回归模型分析DII与OP患者全因死亡的相关性，并进行亚组分析。绘制Kaplan-Meier生存曲线，Log-rank检验比较3组患者随访过程中生存率的差异。使用限制性立方样条（RCS）拟合DII与OP患者全因死亡之间非线性关系，并进一步进行阈值效应分析。分析pheno age advance在DII与OP患者全因死亡风险之间的中介作用。结果 DII最高三分位OP患者全因死亡发生率是最低三分位的1.77倍，亚组分析的结果提示，各亚组的效应与总人群一致。Kaplan-Meier生存分析发现，高水平的DII组（Q3：DII> 2.41）的生存率明显低于低水平组（Q1：DII<0.70）。RCS发现DII与OP患者全因死亡之间存在非线性关系，进一步的阈值效应分析显示，当DII≥3.231时，DII与OP患者全因死亡之间存在正相关性，而当DII<3.231，两者没有相关性。中介分析提示，PhenoAge Advance在DII与OP患者全因死亡风险之间具有中介作用，中介效应值为15.81 %。结论 DII增加OP患者全因死亡风险，Pheno Age Advance在DII与OP患者全因死亡风险之间具有中介效应。 |
| 英文摘要: |
| Objective To explore the correlation between the Dietary Inflammatory Index（DII） and all-cause mortality in osteoporosis（OP）patients and the mediating effect of PhenoAge Advance. Methods This cohort study was based on data from the US National Health and Nutrition Examination Survey (NHANES).A total of 566 patients with OP from 1999 to 2018 were included in the study, mortality data obtained through matching with the U.S. National Death Index (NDI). Weighted Cox proportional hazards regression model was used to analyze the correlation between DII and all-cause mortality in OP patients. Kaplan-Meier survival curve was plotted，and Log-rank tests were performed to compare survival differences among the three DII groups. Restrictive cubic splines（RCS）were used to examine the nonlinear relationship between DII and all-cause mortality in OP patients, and further threshold effect analysis was performed. Mediation analysis was used to analyze the mediation role of PhenoAge Advance between DII and the risk of all-cause mortality in OP patients. Results The highest DII tertile had a 1.77-fold higher incidence of all-cause mortality in OP patients compared to the lowest tertile.Subgroup analyses indicated consistent effects across all subgroups. Kaplan-Meier survival analysis found that the survival rate of high-level DII group（Q3：DII> 2.41）was significantly lower than that of low-level group（Q1: DII<0.70）. RCS found that there was a nonlinear relationship between DII and all-cause mortality in OP patients.Further threshold effect analysis showed that when DII≥3.231, there was a positive correlation between DII and all-cause mortality in OP patients;but when DII<3.231, there was no correlation between them.Mediation analysis suggested that PhenoAge Advance played a mediating role between DII and the risk of all-cause mortality in OP patients, with a mediating effect value of 15.81%. Conclusion DII increases the risk of all-cause mortality in OP patients, and PhenoAge Advance has a mediating effect between DII and the risk of all-cause mortality in OP patients. |
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