Association between dietary inflammatory index and metabolic syndrome with its components among children aged 6-14 years in Beijing City
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摘要:
目的 分析北京市6~14岁儿童膳食炎性指数(DII)与代谢综合征(MetS)及其组分之间的关系，为中国儿童MetS预防提供参考。 方法 采用横断面设计，数据来源于2017和2019年北京市中小学生营养与健康状况监测。共纳入1 832名儿童的2 086条记录，采用连续3 d 24 h膳食回顾结合家庭调味品称重法收集膳食摄入信息并计算DII评分。以《中国儿童青少年代谢综合征定义和防治建议》中的标准进行诊断，采用广义估计方程分析DII评分与MetS及其组分(腹部肥胖、高甘油三酯、低高密度脂蛋白胆固醇、高血压、高血糖)之间的相关性。 结果 纳入儿童的平均DII评分为(1.64±1.07)分。DII得分与MetS患病风险之间关联无统计学意义(每增加1分：OR=1.16，95%CI=0.92~1.48，P>0.05)。对MetS组分进一步分析，发现DII得分与高甘油三酯患病风险呈正相关(每增加1分：OR=1.17，95%CI=1.01~1.36，P < 0.05)，该关联在不同年龄分组中差异无统计学意义(交互作用P>0.05)，DII得分与MetS其他组分之间关联无统计学意义(P值均>0.05)。 结论 DII得分可能与MetS患病风险无关，但促炎膳食可能会增加高甘油三酯风险。应重视儿童期DII评分，尽早识别和预防儿童MetS的发生。 Abstract:Objective To explore the association between dietary inflammatory index (DII) and metabolic syndrome (MetS) and its components among children aged 6-14 years in Beijing, so as to provide a reference for preventing MetS. Methods A cross-sectional study was carried out in 2 086 records of 1 832 children from the 2017 and 2019 Nutrition and Health Surveillance in Primary and Secondary school students of Beijing (NHSPSB). Three-day consecutive 24-hour dietary recalls combined with weighing household cooking oils and condiments were used to collect dietary intake and calculate DII. MetS was diagnosed according to "Definition and Suggestion on the Metabolic Syndrome of Chinese Children and Adolescent". The Generalized estimating equations (GEEs) models were used to analyze the association between DII and the presence of MetS and its components (abdominal obesity, high triglyceride, low high-density lipoprotein cholesterol, hypertension, and hyperglycemia). Results The mean DII score was (1.64±1.07) for the included children. No significant association was found between DII scores and the likelihood of MetS (per 1-point increment: OR=1.16, 95%CI=0.92-1.48, P>0.05). In terms of the components of MetS, DII scores were positively associated with the odds of high triglyceride (per 1-point increment: OR=1.17, 95%CI=1.01-1.36, P < 0.05). There was no statistically significant difference in the association among different age groups (P>0.05). No significant associations were observed between DII and other MetS components(P>0.05). Conclusion DII scores may not be correlated with the risk of MetS, but proinflammatory diet might increase the risk of high triglyceride. DII score in childhood should be emphasized to identify and prevent MetS as soon as possible. -
Key words:
- Dietary inflammatory index /
- Metabolic syndrome X /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。2) 董小聪与张明洁为共同第一作者。 -
表 1 儿童DII(每增加1分)与MetS及其组分的关联[OR值(95%CI)，n=1 832]
Table 1. Association between DII (per 1 point increment) and MetS and its components [OR (95%CI), n=1 832]
结局变量 模型 < 10岁 ≥10岁 总体 交互作用P值 MetS 粗模型 1.49(0.95~2.33) 1.12(0.86~1.47) 1.19(0.94~1.52) 0.18 调整模型 1.42(0.90~2.24) 1.10(0.84~1.44) 1.16(0.92~1.48) 0.27 MetS组分 腹部肥胖 粗模型 1.10(0.93~1.29) 0.99(0.87~1.11) 1.02(0.93~1.13) 0.07 调整模型 1.05(0.89~1.24) 0.98(0.86~1.11) 1.01(0.91~1.12) 0.18 高TG 粗模型 1.02(0.80~1.30) 1.27(1.06~1.53)* 1.19(1.02~1.38)* 0.30 调整模型 0.99(0.77~1.28) 1.25(1.04~1.51)* 1.17(1.01~1.36)* 0.18 低HDL-C 粗模型 1.25(0.87~1.79) 1.19(0.92~1.53) 1.21(0.98~1.49) 0.63 调整模型 1.22(0.85~1.77) 1.17(0.91~1.51) 1.19(0.97~1.47) 0.86 高血压 粗模型 1.03(0.90~1.19) 1.00(0.87~1.15) 1.02(0.92~1.12) 0.42 调整模型 1.02(0.88~1.18) 0.99(0.86~1.14) 1.00(0.91~1.11) 0.63 高血糖 粗模型 1.24(0.89~1.74) 1.10(0.90~1.35) 1.14(0.96~1.36) 0.41 调整模型 1.15(0.81~1.64) 1.11(0.90~1.36) 1.12(0.94~1.34) 0.53 注：*P < 0.05。 
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表 2 2017年儿童DII(每增加1分)与MetS及其组分的关联[OR值(95%CI)，n=788]
Table 2. Association between DII (per 1 point increment) and MetS and its components in 2017 [OR(95%CI), n=788]
结局变量 模型 < 10岁 ≥10岁 总体 交互作用P值 MetS 粗模型 1.40(0.73~2.67) 1.07(0.70~1.63) 1.16(0.81~1.67) 0.36 调整模型 1.32(0.67~2.60) 1.01(0.68~1.51) 1.08(0.76~1.53) 0.43 MetS组分 腹部肥胖 粗模型 1.20(0.97~1.50) 0.90(0.75~1.07) 1.00(0.87~1.15) 0.03 调整模型 1.12(0.90~1.40) 0.88(0.73~1.05) 0.97(0.84~1.12) 0.09 高TG 粗模型 1.43(0.98~2.09) 1.22(0.92~1.63) 1.29(1.03~1.63)* 0.84 调整模型 1.39(0.92~2.10) 1.17(0.88~1.55) 1.24(0.98~1.56) 0.99 低HDL-C 粗模型 1.67(0.80~3.50) 1.43(0.93~2.21) 1.51(1.04~2.20)* 0.79 调整模型 1.60(0.74~3.45) 1.36(0.89~2.08) 1.43(0.97~2.10) 0.87 高血压 粗模型 1.09(0.90~1.34) 1.05(0.86~1.28) 1.07(0.93~1.23) 0.44 调整模型 1.08(0.88~1.33) 1.04(0.85~1.28) 1.06(0.91~1.22) 0.62 高血糖 粗模型 1.08(0.70~1.68) 0.97(0.75~1.24) 1.01(0.81~1.25) 0.34 调整模型 1.00(0.62~1.61) 0.97(0.75~1.24) 0.98(0.79~1.21) 0.39 注：*P < 0.05。
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表 3 2019年儿童DII(每增加1分)与MetS及其组分的关联[OR值(95%CI)，n=790]
Table 3. Association between DII (per 1 point increment) and MetS and its components in 2019 [OR (95%CI), n=790]
结局变量 模型 < 10岁 ≥10岁 总体 交互作用P值 MetS 粗模型 1.61(0.88~2.94) 1.17(0.83~1.65) 1.22(0.89~1.68) 0.29 调整模型 1.74(0.94~3.22) 1.16(0.80~1.69) 1.21(0.89~1.64) 0.44 MetS组分 腹部肥胖 粗模型 0.99(0.78~1.25) 1.08(0.90~1.29) 1.04(0.90~1.20) 0.68 调整模型 1.00(0.78~1.29) 1.09(0.90~1.32) 1.05(0.91~1.22) 0.83 高TG 粗模型 0.82(0.61~1.10) 1.32(1.04~1.68)* 1.10(0.91~1.34) 0.07 调整模型 0.80(0.58~1.11) 1.34(1.05~1.71)* 1.12(0.92~1.36) 0.04 低HDL-C 粗模型 1.08(0.79~1.50) 1.07(0.79~1.43) 1.07(0.85~1.34) 0.58 调整模型 1.06(0.76~1.49) 1.10(0.81~1.49) 1.08(0.86~1.35) 0.89 高血压 粗模型 0.98(0.80~1.19) 0.96(0.79~1.17) 0.97(0.84~1.12) 0.72 调整模型 0.97(0.79~1.19) 0.95(0.78~1.16) 0.96(0.83~1.10) 0.87 高血糖 粗模型 1.39(0.84~2.30) 1.27(0.91~1.79) 1.31(0.98~1.74) 0.96 调整模型 1.32(0.80~2.17) 1.27(0.90~1.79) 1.28(0.96~1.69) 0.95 注：*P < 0.05。
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