Dietary Patterns / Dietary Quality and Risk of RA in Women

描述（由申请人提供）：类风湿性关节炎（RA）的病因尚不完全清楚。它被认为是一种多因素疾病，是遗传和环境因素共同作用的结果。流行病学研究已经提供了令人信服的数据，证明环境风险因素（包括吸烟、外源性激素使用和女性生殖因素）与类风湿性关节炎易感性之间存在关联。饮食研究表明，大量摄入某些抗氧化剂、鱼、橄榄油和煮熟的蔬菜对类风湿关节炎的发展具有保护作用，而红肉、脂肪、乳制品和谷物可能会增加类风湿关节炎的风险，尽管饮食病因的证据尚无定论。然而，在以前的研究中，单个食物组和营养素的影响可能太小，无法在有限的样本量下检测到。总体饮食模式和饮食质量分析检查多种营养素的累积效应，因此可能比单个食物或营养素更能预测疾病风险。到目前为止，还没有研究评估总体饮食模式/饮食质量与RA风险之间的关系，特别是在一项控制良好的大型前瞻性队列研究中。拟议调查的目的是利用世界上最大的风湿病环境流行病学研究——两个护士健康研究队列（NHS I和NHS II）的数据，探讨总体饮食模式/饮食质量是否与女性患RA的风险相关。我们还将研究饮食模式/饮食质量、生化测量（包括血浆抗氧化剂和炎症标志物）与NHS I和II队列中匹配的病例对照亚样本中发生RA风险之间的因果关系。此外，我们将调查饮食模式/饮食质量与RA易感性遗传因素之间可能的相互作用。随着遗传流行病学和高通量基因分型技术的发展，基因-饮食相互作用的研究已成为营养流行病学研究的一个重要方向。总的来说，这些队列的规模大，前瞻性设计，饮食和协变量的重复和详细测量，高随访率，以及生化测量的可用性，为以极具成本效益的方式研究总体饮食模式/饮食质量与RA风险之间的关系提供了独特的机会。我们相信这个项目提出了一种研究饮食与ra关系的新方法，并将具有重要的公共卫生意义。

DESCRIPTION (provided by applicant): The etiology of rheumatoid arthritis (RA), remains incompletely understood. It is considered to be a multifactorial disease, resulting from the interaction of both genetic and environmental factors. Epidemiologic research has produced convincing data for associations between environmental risk factors, including cigarette smoking, exogenous hormone use and female reproductive factors and RA susceptibility. Dietary studies suggest that high intake of certain antioxidants, fish, olive oil and cooked vegetables confer a protective effect against the development of RA, whereas red meat, fat, dairy and cereals may increase the risk of RA, although evidence for dietary etiology is inconclusive. However, the effect of individual food groups and nutrients may be too small to detect with limited sample sizes in previous studies. Overall dietary pattern and dietary quality analysis examines the cumulative effects of multiple nutrients, and may thus be more predictive of disease risk than individual foods or nutrients. To date, no studies have assessed the association between overall dietary patterns / dietary quality and RA risk, especially in the setting of a well-controlled large prospective cohort study. The goal of the proposed investigation is to address whether overall dietary patterns / dietary quality are associated with risk of RA in women using data from the largest rheumatic disease environmental epidemiology study in the world, the two Nurses' Health Study Cohorts (NHS I and NHS II). We will also examine the causal pathways between dietary patterns / dietary quality, biochemical measurements including plasma antioxidants and markers of inflammation, and risk of developing RA in a matched case-control subsample nested in NHS I and II cohorts. In addition, we will investigate possible interactions between dietary patterns / dietary quality and genetic factors in RA susceptibility. With recent advances in genetic epidemiology and high throughput genotying, the study of gene-diet interactions has become an exciting direction in the field of nutritional epidemiology. Overall, the large size of these cohorts, the prospective design, the repeated and detailed measurements of diet and covariates, the high follow-up rates, and the availability of biochemical measurements provide a unique opportunity to study the relationship between overall dietary patterns /dietary quality and risk of RA in an extremely cost-efficient manner. We believe that this project presents a novel approach to study diet-RA relationships and will have important public health implications. PUBLIC HEALTH RELEVANCE: The evidence for dietary etiology of RA is inconclusive. To date, no studies have assessed the association between overall dietary patterns / dietary quality, gene by dietary pattern interaction, and risk of RA. Findings from this large cohort study will furnish novel information about diet and etiology of RA, and have large potential public health implications for RA prevention.