Association Between Dietary Nutrient Composition and the Incidence of Cirrhosis or Liver Cancer in the United States Population
Association Between Dietary Nutrient Composition and the Incidence of Cirrhosis or Liver Cancer in the United States Population
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DOI：
10.1002/hep.22941
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发表时间：
2009-07-01
期刊：
影响因子：
13.5
通讯作者：
Lee, Sum P.
中科院分区：
文献类型：
--
作者：
Ioannou, George N.;Morrow, Olivia B.;Lee, Sum P.
人们对饮食因素对肝病进展的影响知之甚少。我们的目的是确定饮食摄入量是否与美国人口中与肝硬变或肝癌相关的死亡或住院风险有关。参与者包括9221名年龄在25-74岁之间，在进入研究时或在最初5年的随访中没有肝硬变证据的人，作为第一次全国健康和营养检查调查的一部分，他们随后进行了平均13.3年的跟踪调查。膳食摄入量在基线时使用24小时饮食回忆问卷来确定。在随访期间，9221名参与者中有123人在住院记录或死亡证明中被诊断为肝硬变(n=118)或肝癌(n=5)，其中36人仅根据死亡证明被诊断。报告高蛋白饮食的参与者因肝硬化或肝癌而住院或死亡的风险更高(P=0.001)，而那些报告高碳水化合物饮食的参与者风险较低(P=0.003)，调整了潜在的混杂因素(每日蛋白质、碳水化合物、脂肪、茶或咖啡的消费量，以及酒精、性别、种族、年龄、教育程度、美国地理区域、糖尿病、体重指数和肩下与三头肌皮褶的比率)。尽管总脂肪摄入量与肝硬变或肝癌的风险无显著相关性，但胆固醇摄入量与更高的风险相关(P=0.007)，而血清胆固醇水平与肝硬变或肝癌的风险无关。结论：饮食可能是肝病的一个重要和潜在的可改变的决定因素。(《肝病》2009；50：175-184。)
Little is known about the impact of dietary factors on the progression of liver disease. Our aim was to determine whether dietary intake was associated with the risk of cirrhosis-related or liver cancer-related death or hospitalization in the U.S. population. Participants included 9221 persons aged 25-74 years without evidence of cirrhosis at entry into the study or during the first 5 years of follow-up, who were subsequently followed for a mean of 13.3 years as part of the first National Health and Nutrition Examination Survey. Dietary intake was ascertained at baseline using a 24-hour dietary recall questionnaire. During follow-up, 123 of 9221 participants had a diagnosis of cirrhosis (n = 118) or liver cancer (n = 5) in hospitalization records or death certificates, including 36 who were diagnosed only on the basis of death certificates. Participants who reported a diet high in protein were at a higher risk of hospitalization or death due to cirrhosis or liver cancer (P = 0.001), whereas those who reported a diet high in carbohydrates were at a lower risk (P = 0.003), after adjusting for potential confounders (daily consumption of protein, carbohydrate, fat, tea or coffee, and alcohol, gender, race, age, educational attainment, U.S. geographical region, diabetes, body mass index, and subscapular-to-triceps skinfold ratio). Although total fat consumption was not significantly associated with the risk of cirrhosis or liver cancer, cholesterol consumption was associated with higher risk (P = 0.007), whereas serum cholesterol level was not associated with risk of cirrhosis or liver cancer. Conclusion: Diet may be an important and potentially modifiable determinant of liver disease. (HEPATOLOGY 2009;50:175-184.)