李静, 王彩, 雷雨, 杨成梅, 张萌, 张洳锋, 李彦红. 抗炎饮食与心力衰竭及其亚型的相关性[J]. 心脏杂志, 2023, 35(5): 563-569. DOI: 10.12125/j.chj.202212056
    引用本文: 李静, 王彩, 雷雨, 杨成梅, 张萌, 张洳锋, 李彦红. 抗炎饮食与心力衰竭及其亚型的相关性[J]. 心脏杂志, 2023, 35(5): 563-569. DOI: 10.12125/j.chj.202212056
    Jing LI, Cai WANG, Yu LEI, Cheng-mei YANG, Meng ZHANG, Ru-feng ZHANG, Yan-hong LI. Correlation between anti-inflammatory diet and heart failure and its subtypes[J]. Chinese Heart Journal, 2023, 35(5): 563-569. DOI: 10.12125/j.chj.202212056
    Citation: Jing LI, Cai WANG, Yu LEI, Cheng-mei YANG, Meng ZHANG, Ru-feng ZHANG, Yan-hong LI. Correlation between anti-inflammatory diet and heart failure and its subtypes[J]. Chinese Heart Journal, 2023, 35(5): 563-569. DOI: 10.12125/j.chj.202212056

    抗炎饮食与心力衰竭及其亚型的相关性

    Correlation between anti-inflammatory diet and heart failure and its subtypes

    • 摘要:
        目的  探讨抗炎饮食与心力衰竭(HF)及其亚型的相关性。
        方法  入选2021年10月~2022年9月山西医科大学第二医院心内科住院患者278例,根据是否患有HF,分为HF组(n=204)和非HF组(n=74)。HF组患者根据左室射血分数(LVEF)分为射血分数保留型心力衰竭(HFpEF)组(n=77)、射血分数降低型心力衰竭(HFrEF)组(n=70)和射血分数中间值心力衰竭(HFmrEF)组(n=57)。通过电子病历系统收集患者的一般临床资料、生化指标、营养风险评分(NRS-2002)。采用经验证的半定量食物频度问卷(FFQ)收集患者入院前的饮食信息,并根据《中国居民膳食指南科学研究报告(2021)》计算抗炎饮食评分。超声心动图测量左房内径(LAD)、左室舒张末期内径(LVEDd)与LVEF。
        结果  心力衰竭及其亚型HFrEF组、HFmrEF组、HFpEF组患者抗炎饮食评分均低于非HF组患者(均P<0.01),HFrEF组、HFmrEF组、HFpEF组患者组间差异无统计学意义。HF组地高辛、髓过氧化物酶数据高于非HF组(均P<0.05),CCB低于非HF组(P<0.05),螺内酯、利尿药、RDW、NLR、ST2、BNP、K、LAD、LVEDd、NRS-2002高于非HF组(均P<0.01),BMI、合并高血压、受教育程度大专及以上、TC、TG、HDL-C、LDL-C、LVEF、血浆白蛋白低于非HF组(均P<0.01)。Spearman相关分析显示抗炎饮食评分与HF发生呈负相关(P<0.01),经BMI、药物治疗、合并高血压、受教育程度、RDW、NLR、ST2、BNP、K、TC、TG、HDL-C、LDL-C、LAD、LVEDd、LVEF、血浆白蛋白及NRS-2002校正后,这种相关性依然存在。二元Logistic回归分析显示,低水平抗炎饮食评分为HF的影响因素(P<0.05)。绘制受试者工作特征(ROC)曲线分析结果显示,抗炎饮食评分预测HF发生的曲线下面积(AUC)为0.773(95% CI:0.707~0.839,P<0.01),最佳临界值为8.5分,灵敏度与特异度分别为72.5%和73.0%。
        结论  低水平抗炎饮食评分是HF的危险因素之一,可据此对患者进行健康饮食管理。

       

      Abstract:
        AIM  To explore the correlation between anti-inflammatory diet and different types of heart failure (HF). MEHTODS From October 2021 to September 2022, 278 hospitalized patients in the Department of Cardiology of the Second Hospital of Shanxi Medical University were divided into HF group (n=204) and non HF group (n=74) based on whether they had HF. Patients in the HF group were divided into ejection fraction retention heart failure (HFpEF) group (n=77), ejection fraction reduction heart failure (HFrEF) group (n=70), and ejection fraction median heart failure (HFmrEF) group (n=57) based on left ventricular ejection fraction (LVEF). The general clinical data, biochemical indicators, and nutritional risk scores of patients were collected through the electronic medical record system (NRS-2002). The validated semi quantitative food frequency questionnaire (FFQ) was used to collect dietary information of patients before admission, and the anti-inflammatory dietary score was calculated based on the “Scientific Research Report on Chinese Dietary Guidelines (2021)”. Left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDd), and LVEF were measured by echocardiography.
        RESULTS  The anti-inflammatory dietary scores of patients with heart failure and its subtypes in the HFrEF group, HFmrEF group, and HFpEF group were lower than those in the non HF group (all P<0.01). There was no statistically significant difference between the HFrEF group, HFmrEF group, and HFpEF group. The data of digoxin and myeloperoxidase in the HF group were higher than those in the non HF group (all P<0.05), and the CCB was lower than those in the non HF group (P<0.05). Spironolactone, diuretics, RDW, NLR, ST2, BNP, K, LAD, LVEDd, and NRS-2002 were higher than those in the non HF group (all P<0.01). BMI, hypertension, college education or above, TC, TG, HDL-C, LDL-C, LVEF, and plasma albumin were lower than those in the non HF group (all P<0.01). Spearman correlation analysis showed a negative correlation between anti-inflammatory dietary scores and the occurrence of HF (P<0.01). After adjustment for BMI, medication, hypertension, education, RDW, NLR, ST2, BNP, K, TC, TG, HDL-C, LDL-C, LAD, LVEDd, LVEF, plasma albumin, and NRS-2002, this correlation still exists. Binary logistic regression analysis showed that the low level anti-inflammatory diet score was the influencing factor for HF (P<0.05). The analysis results of the subject work characteristic curve (ROC) drawn showed that the area under the curve (AUC) of the anti-inflammatory diet score predicting the occurrence of HF was 0.773 (95% CI: 0.707~0.839, P<0.01), the optimal threshold was 8.5 points, and the sensitivity and specificity were 72.5% and 73.0%, respectively.
        CONCLUSION  Low level anti-inflammatory diet score is one of the risk factors for HF, which can be used for healthy diet management.

       

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