| Objectives:As more and more people age,osteoporosis has become a complex and intractable public health problem that needs to be urgently addressed.Diet affects inflammation,which can lead to the development of osteoporosis through a variety of mechanisms.Dietary inflammatory index(DII)is a new way to study the relationship between dietary nutrients and osteoporosis,especially by focusing on the impact of an individual’s overall dietary inflammatory properties(proinflammatory or anti-inflammatory)on bone health in order to draw reliable conclusions.In order to investigate the association between DII and osteoporosis,as well as bone mineral density(BMD)in women and men aged 50 and above,the National Health and Nutrition Examination Survey(NHANES)data was used.The analysis was further divided into groups by age and body mass index(BMI)to investigate the potential impact of DII on osteoporosis and BMD across different age and BMI groups,and to analyze the impact of DII on BMD in different bone sites,in order to provide basis for more accurate prevention and control measures in the future.Methods:In this study,using 2017-2018 NHANES data,2103 subjects with complete and valid data on BMD of total hip,spine and femoral neck were included.First,a descriptive analysis was performed on 2103 subjects,and then osteoporosis patients were removed from all subjects,and the remaining 1907 subjects were analyzed descriptively.Then DII was used as a continuous and quartile variable,respectively,and the logistic regression model was used to estimate the correlation between the formal variables of DII and the risk of osteoporosis and osteopenia.The median of each quartile of DII was used as a continuous variable to test the trend P value across the quartile when Q1 of the quartile was used as the reference group.Finally,the correlation between continuous DII and BMD was estimated by multiple linear regression model.Age and BMI were also grouped,and by multifactor logistic regression model,the relationship between two formal variables of DII and osteoporosis was analyzed,and by linear regression model,the relationship between continuous DII and BMD was analyzed.Results:1.In this study,2103 subjects were analyzed and found that in the total population,osteoporosis patients were older,thinner,and calcium intake is higher,most of them non-Hispanic white;Among women,patients with osteoporosis were older,predominantly non-Hispanic white,and had higher DII scores than those without osteoporosis;Among men,osteoporosis patients were found to be thinner.2.After removing patients with osteoporosis,an analysis of 1907 subjects revealed that,patients with osteopenia were older,had a serum phosphate intake of3.60 mg/dl,had the largest number of people with a BMI of 25-30 kg/m~2,and had a higher proportion of non-Hispanic whites;Among women,osteopenia patients were older and the proportion of non-Hispanic whites was higher;Among men,osteopenia patients had the largest number of BMI between 25-30 kg/m~2.3.The multifactor logistic regression analysis found a significant association between continuous DII and osteoporosis in women,with OR(95%CI)of 1.47(1.25,1.74),and the quantile of DII also showed an increasing trend associated with an increased risk of osteoporosis,with OR(95%CI)of 2.95(1.08,8.09),5.63(2.87,11.04)and 6.14(2.55,14.78),respectively;But not among men.In addition,no association between DII and osteopenia was found in either sex.When stratified by age,both formal variables of DII observed in women were positively correlated with the risk of osteoporosis,and in Q4,the OR(95%CI)under 65 years old was higher than that over65 years old(7.48(1.72,32.49)vs 4.07(1.36,12.23);No association was found among men.When stratified by BMI,both formal variables of DII were found to be positively correlated with the risk of osteoporosis in women when BMI<25 kg/m~2,with the OR(95%CI)of 1.75(1.20,2.56)for the former and 7.74(1.45,41.33),6.14(2.29,16.48),and 19.82(3.69,106.40)for the latter,respectively.However,when BMI≥30 kg/m~2,only a correlation between continuous DII and osteoporosis was observed.No statistical significance was found among men.4.Multiple linear regression analysis found that increased DII was associated with decreased BMD in women’s total hip and femoral neck,β(95%CI)was-0.009(-0.014,-0.003)and-0.009(-0.015,-0.002),respectively;In men,DII was only negatively correlated with BMD in the spine,β(95%CI)was-0.020(-0.034,-0.007).And women’s DII was negatively correlated with total hip BMD when age<65,β(95%CI)was-0.009(-0.016,-0.001);In men,the study found a negative association between DII and spinal BMD,β(95%CI)was-0.018(-0.033,-0.004),which was not associated with total hip and femoral neck BMD.When age≥65,a negative correlation between DII and femoral neck BMD was found in women,β(95%CI)was-0.010(-0.018,-0.001),which was not associated with spine and total hip BMD;In men,the study also found a negative association between DII and spinal BMD,β(95%CI)was-0.028(-0.051,-0.006),which was not associated with total hip and femoral neck BMD.Stratified by BMI,and when BMI was 25-30kg/m~2,women’s DII was negatively correlated with spinal BMD,β(95%CI)was-0.020(-0.034,-0.005),while no statistical significance was found in men.Conclusions:1.The diet with high inflammatory potential was associated with an increased risk of osteoporosis in women aged 50 years and above,but not significantly in men.In addition,no association between DII and osteopenia was found in either sex.2.The increase of DII was related to the decrease of total hip and femoral neck BMD in women aged 50 years and above.When the age was<65 years old,women DII was negatively related to total hip BMD.When the age was≥65 years old,women DII was negatively related to femoral neck BMD.3.An increase in DII was negatively correlated with spinal BMD in men aged 50and above,but not with other regions. |
PDF Full Text Request