| Purpose:There are relatively few and controversial studies on the relationship between caffeine and alcohol intake and osteoporosis.The purpose of this study is to explore the relationship between caffeine and alcohol intake and osteoporosis by utilizing the database of the National Health and Nutrition Examination Survey?NHANES?.Methods:In this study,adults aged 20 and above in the 2005-2006,2007-2008 and2009-2010 cycles of NHANES database were selected as subjects.Dietary information was obtained through a 24 hour dietary recall.Bone mineral density was measured by dual energy X-ray absorptiometry in the mobile examination center.In this study,t-test and chi square test were used to compare the basic characteristics of osteoporosis group and non-osteoporosis group.A robust poisson regression model in generalized linear model was adopted to assess the association between caffeine and alcohol intake and risk of osteoporosis.Stratified analysis was conducted by age,gender,menopausal status and calcium intake.The dose-response relationship between caffeine and alcohol intake with osteoporosis was evaluated by the restricted cubic spline model.The relative importance of caffeine,alcohol intake and other factors on osteoporosis was evaluated by dominance analysis.Results:The study ultimately included 8961 adults aged 20 and over.The total weighted prevalence rate of osteoporosis was 15.37%,of which the male weighted prevalence rate was 10.09%and female 20.57%.1.The association between caffeine intake and osteoporosis?1?after adjusting factors such as age,gender,race,annual income level,body mass index?BMI?,total energy intake,calcium intake,smoking status,alcohol intake,personal fracture status,glucocorticoid use and hip fracture status of parents,the results of multivariate robust poisson regression analysis?model 2?indicated that compared with Q1,the caffeine intake of Q3 group was between the risk of osteoporosis prevalence ratio?PR?and 95%confidence interval?CI?were 1.23?95%CI:1.05-1.44?;?2?different age groups:model 2 results showed that compared with Q1,the association between caffeine intake and the risk of osteoporosis in the age group of 20-39 years old was statistically significant,and the PR and 95%CI were1.66?95%CI:1.07-2.58?in group Q3;?3?different gender groups:model 2 results illustrated that compared with Q1,the association between caffeine intake and osteoporosis risk in male Q3 group was statistically significant,and PR and 95%CI were 1.47?95%CI:1.10-1.98?;?4?different calcium intake groups:the results of model 2 showed that compared with Q1,the correlation between caffeine intake and osteoporosis risk in Q2 and Q3 groups in low calcium intake group was statistically significant,with PR and 95%CI of 1.32?95%CI:1.00-1.74?and 1.47?95%CI:1.13-1.93?,respectively;?5?there was a linear relationship between caffeine intake and the risk of osteoporosis(P nonlinear=0.121).2.The relationship between alcohol intake and osteoporosis?1?after adjusting the factors such as age,gender,race,annual income level,BMI,total energy intake,calcium intake,smoking status,caffeine intake,personal fracture,glucocorticoid use and hip fracture of parents,the results of multivariate robust poisson regression analysis?model 2?showed that compared with the reference group,moderate alcohol intake with PR and 95%CI were 0.74?95%CI:0.64-0.85?;?2?different age groups:the results of model 2 showed that,compared with the reference group,the correlation between moderate alcohol intake and the risk of osteoporosis was statistically significant in the age groups of 40-59,60 and above,with PR and 95%CI of 0.68?95%CI:0.53-0.88?and 0.78?95%CI:0.65-0.93?,respectively;?3?different gender groups:the results of model 2 showed that there was a statistically significant correlation between moderate alcohol intake and osteoporosis risk in men and women compared with the reference group,with PR and 95%CI of 0.76?95%CI:0.59-0.98?,0.71?95%CI:0.59-0.84?,respectively;?4?different menopause groups:the results of model 2 showed that,compared with the reference group,the relationship between the premenopausal and postmenopausal women's moderate alcohol intake and the risk of osteoporosis was statistically significant,with PR and 95%CI of 0.53?95%CI:0.30-0.93?,0.76?95%CI:0.64-0.91?,respectively;?5?the results of restricted cubic spline model showed that there was a nonlinear relationship between alcohol intake and the risk of osteoporosis(P nonlinear=0.001).3.The results of dominance analysis showed that the relative importance of the influencing factors of osteoporosis ranked in the top three in order of age,gender and BMI.Conclusion:In the United States,the increase in caffeine intake may be associated with an increased risk of osteoporosis in adults aged 20 and over,and moderate alcohol intake may be associated with a lower risk of osteoporosis. |
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