Dietary Quality, Body Adiposity, and Risk of Rheumatoid Arthritis in Women

女性的饮食质量、身体肥胖和类风湿关节炎的风险

• 批准号: 9893820
• 负责人: Bing Lu
• 金额: $ 48.01万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9893820
• 关键词: Adherence; Adipose tissue; Adult; Affect; Age; American; Autoantibodies; Autoimmune; Benign; Biological; Biological Markers; Body Weight Changes; Body Weight decreased; Body fat; Body mass index; Central obesity; Chronic; Chronic Disease; Dairy Products; Data; Development; Diagnosis; Diet; Diet Modification; Dietary Factors; Dietary Practices; Disease; Eating; Energy Intake; Energy Metabolism; Environmental Exposure; Etiology; Fatty acid glycerol esters; First Degree Relative; Future; Genetic; Grain; Healthy Eating; Incidence; Individual; Inflammatory; Intake; Leptin; Link; Longitudinal Studies; Matched Case-Control Study; Measures; Mediating; Modeling; Modification; Nested Case-Control Study; Nurses' Health Study; Obesity; Overweight; Patients; Pattern; Play; Population; Prevention; Principal Component Analysis; Processed Meats; Rare Diseases; Reproductive History; Rheumatoid Arthritis; Risk; Risk Factors; Risk Reduction; Role; Smoking; Structural Models; Synovitis; Time; Waist-Hip Ratio; Weight Gain; Woman; Work; adipokines; case control; causal model; cohort; cost efficient; dietary; dietary guidelines; high risk; indexing; middle age; mortality; novel; nutritional epidemiology; obesity development; prevent; prospective; randomized trial; resistin; systemic inflammatory response; tool; trend; waist circumference; young adult

7. PROJECT SUMMARY / ABSTRACT Rheumatoid arthritis (RA) is the most common autoimmune inflammatory disease, characterized by persistent synovitis and systemic inflammation. RA is generally considered as a multifactorial disease, caused by both genetic factors and environmental exposures. Although some individual dietary factors have been identified to be associated with the development of RA, few studies have examined the effects of overall dietary quality and dietary patterns on RA risk. In our previous studies, we have demonstrated that adherence to the Dietary Guidelines for Americans or following a Prudent dietary pattern is associated with reduced RA risk, while a Western dietary pattern or a dietary inflammatory pattern, characterized by high intakes of red and processed meats, refined grains, desserts and sweets, and high-fat dairy products, increases RA risk in young and middle-aged women. However, little is known about whether modifying dietary quality influences subsequent RA risk. Often, it is not ethically or practically possible to conduct a perfectly randomized trial to study diet and risk of rare diseases, instead large longitudinal studies with repeated dietary measures can provide unique opportunities to evaluate the effect of diet changes on RA risk reduction using advanced causal inference models, which will have direct relevance for populations at highest risk such as first degree relatives of RA patients. Dietary factors directly and indirectly play an important role in the genesis of obesity. Individuals with obesity are at increased risk of major chronic diseases. We also identified obesity as a significant risk factor of RA, although the biologic mechanism is not yet understood. Further study is needed to evaluate the influences of weight gain or weight loss on the risk of RA using causal models. The adipokines produced by the adipose tissue, leading to a chronic inflammatory state, may play a central role in the development of obesity-related complications. In this application we propose to evaluate the modification of dietary quality as a potential strategy to prevent future development of RA using well-established causal inference models: Marginal Structural Models. This study also extends our earlier work to examine the influences of weight changes and body fat distribution on RA risk. We will also examine whether circulating adipokines associated with an increased risk of developing RA, and mediate the observed associations of dietary quality and obesity with RA risk in a matched case-control study nested in NHS and NHS II cohorts.

7.项目摘要/摘要 类风湿关节炎(RA)是最常见的自身免疫性炎症性疾病，其特点是持续性 滑膜炎和全身性炎症。类风湿关节炎通常被认为是一种多因素疾病，由两者共同引起 遗传因素和环境暴露。尽管一些个人饮食因素已被确定为 与RA的发展有关，很少有研究检查总体饮食质量和 饮食模式对类风湿关节炎风险的影响。在我们之前的研究中，我们已经证明了坚持饮食 美国人的指南或遵循谨慎的饮食模式与降低类风湿性关节炎的风险有关，而 西方饮食模式或饮食炎症模式，其特征是大量摄入红色和加工品 肉类、精制谷物、甜点和甜食以及高脂肪乳制品会增加年轻人和 中年女性。然而，人们对改变饮食质量是否会产生影响知之甚少。 随后的风湿性关节炎风险。通常，在道德上或实践上不可能进行完全随机的试验来 研究饮食和罕见疾病的风险，相反，重复饮食措施的大型纵向研究可以 提供独特的机会，使用高级因果关系评估饮食变化对降低RA风险的影响 推断模型，这将与风险最高的人群(如一级亲属)直接相关 类风湿性关节炎患者中。 饮食因素在肥胖的发生中起着直接和间接的重要作用。具有以下特征的个人 肥胖增加了罹患重大慢性病的风险。我们还发现肥胖是一个重要的风险因素。 RA，尽管其生物学机制尚不清楚。需要进一步的研究来评估这些影响 使用因果模型研究体重增加或减轻对类风湿性关节炎风险的影响。脂肪细胞产生的脂肪因子 导致慢性炎症状态的组织可能在肥胖相关疾病的发展中发挥核心作用 并发症。 在这个应用中，我们建议评估饮食质量的改变作为一种潜在的策略 使用公认的因果推理模型：边际结构模型来预防类风湿关节炎的未来发展。 这项研究还扩展了我们早期的工作，以检查体重变化和身体脂肪分布的影响 风湿性关节炎的风险。我们还将研究循环中的脂肪因子是否与糖尿病风险增加有关。 发生类风湿性关节炎，并中介观察到的饮食质量和肥胖与类风湿性关节炎风险的关联 病例对照研究嵌套在NHS和NHS II队列中。