中国骨质疏松杂志

非酒精性脂肪肝膳食炎症指数与骨质疏松症的关联

The association between dietary inflammatory index and osteoporosis in non-alcoholic fatty liver disease

DOI：10.3969/j.issn.1006-7108.2024.12.010

英文关键词:Dietary inflammatory index non-alcoholic fatty liver disease osteoporosis

基金项目:

作者	单位
王先耀施荣杰* 字颖龙均	大理大学第一附属医院消化内科，云南大理 671000

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中文摘要:

目的探讨非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）人群中膳食炎症指数（dietary inflammatory index，DII）与骨质疏松症的相关性。方法本研究采用美国国家健康与营养调查（National Health and Nutrition Examination Survey，NHANES）2017—2018年的数据，纳入1 686名参与者，按是否患骨质疏松症将参与者分为两组，比较两组的一般资料，按照DII 3分位数分组，基于NHANES推荐的权重，采用二元Logistic回归来分析DII和骨质疏松症之间的关系，采用线性相关来分析DII与骨密度（bone mineral density，BMD）的相关性。结果相较于非骨质疏松症组，骨质疏松症组中的参与者年龄更大、BMI更低、女性占比更高、DII评分更高，差异具有统计学意义（均P＜0.05）；二元Logistic回归分析，DII与NAFLD人群发生骨质疏松症风险相关（调整所有潜在混杂因素后OR=1.34，95 %CI：1.07~1.68，P=0.010）；与T1组相比，T3组发生骨质疏松症的风险更高（调整所有潜在混杂因素后OR=3.19，95 %CI：1.34~7.58，P=0.009）。相关性分析发现，DII评分与股骨颈BMD、腰椎BMD及全髋BMD呈负相关（r=?0.0661、?0.0649、?0.1329，P=0.032、0.049、＜0.001）。结论较高的DII评分所代表的促炎饮食与NAFLD人群中骨质疏松症的发生风险相关，DII评分与骨密度呈负相关，高DII评分是NAFLD人群发生骨质疏松症的危险因素。

英文摘要:

Objective To investigate the association between dietary inflammatory index (DII) and osteoporosis in the population with non-alcoholic fatty liver disease (NAFLD). Methods The data from the National Health and Nutrition Examination Survey (NHANES) for the years 2017-2018 were utilized in this study, with a total of 1686 participants included. Participants were divided into two groups based on whether they had osteoporosis, and the general characteristics of the two groups were compared. The participants were stratified into tertiles based on the DII score. Utilizing the recommended NHANES weights, binary logistic regression was employed to analyze the relationship between DII and osteoporosis. Additionally, linear correlation analysis was conducted to examine the correlation between DII and bone mineral density (BMD). Results Compared with the non-osteoporosis group, participants in the osteoporosis group were found to have older age, lower BMI, higher proportion of females, and higher DII scores, with statistically significant differences (all P < 0.05); Binary logistic regression analysis revealed a significant association between DII and the risk of osteoporosis in the NAFLD population (adjusted odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.07-1.68, P = 0.010) after adjusting for all potential confounding factors. Compared to the T1 group, the T3 group had a higher risk of developing osteoporosis (adjusted OR = 3.19, 95% CI: 1.34-7.58, P = 0.009) after adjusting for all potential confounding factors. Correlation analysis showed a negative correlation between DII scores and femoral neck BMD, lumbar spine BMD, and total hip BMD (r = ?0.0661, ?0.0649, ?0.1329, P = 0.032, 0.049, <0.001, respectively). Conclusions The association between a higher DII score, representing a pro-inflammatory diet, and the risk of osteoporosis in the NAFLD population was observed. Furthermore, there was a negative correlation between DII scores and bone density. Thus, a high DII score serves as a risk factor for osteoporosis in the NAFLD population.

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