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

基本信息

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
项目类别：
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&apos 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

项目摘要

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. 项目概要/摘要类风湿性关节炎（RA）是最常见的自身免疫性炎症性疾病，其特点是持续存在滑膜炎和全身炎症。 RA 通常被认为是一种多因素疾病，由以下两种因素引起：遗传因素和环境暴露。尽管一些个人饮食因素已被确定虽然与 RA 的发展相关，但很少有研究考察整体饮食质量和饮食模式对 RA 风险的影响。在我们之前的研究中，我们已经证明，坚持饮食美国人的指南或遵循审慎的饮食模式与降低 RA 风险相关，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食品肉类、精制谷物、甜点和糖果以及高脂肪乳制品会增加年轻人和青少年患 RA 的风险中年妇女。然而，人们对于改变饮食质量是否会影响健康知之甚少。随后的 RA 风险。通常，从道德上或实践上来说，进行完全随机的试验来研究饮食和罕见疾病的风险，而不是重复饮食措施的大型纵向研究可以提供独特的机会，利用高级因果关系来评估饮食改变对降低 RA 风险的影响推理模型，与一级亲属等风险最高的人群有直接相关性 RA 患者。饮食因素直接和间接在肥胖的发生中发挥着重要作用。个人有肥胖会增加患主要慢性疾病的风险。我们还确定肥胖是一个重要的危险因素 RA，尽管其生物学机制尚不清楚。需要进一步研究来评估影响使用因果模型评估体重增加或体重减轻对 RA 风险的影响。脂肪细胞产生的脂肪因子组织，导致慢性炎症状态，可能在肥胖相关疾病的发展中发挥核心作用并发症。在本申请中，我们建议评估饮食质量的改变作为潜在的策略使用完善的因果推理模型来防止 RA 的未来发展：边际结构模型。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关于 RA 风险。我们还将检查循环脂肪因子是否与增加的风险相关发展 RA，并调节匹配的饮食质量和肥胖与 RA 风险之间观察到的关联嵌套在 NHS 和 NHS II 队列中的病例对照研究。