Dietary Habits and Chronic Obstructive Pulmonary Disease in Middle Aged to Elderly Chinese —A Case-control Study in Hong Kong

《目的》研究食物和慢性阻塞性肺病及肺功能的關係。《研究設計與對象》採用回歸性病例對照的方法。病例及對照來自社區，慢性阻塞性肺病由肺功能測試診斷(FEV1/FVC比例少於0.7)。共612人符合進入研究的條件﹝252個病例和360個對照﹞。《資料收集》兩名受過訓練的研究員，對所有研究對象進行面對面訪問，一名研究員為其做肺功能測試，另一名研究員做問卷調查，問卷內容包括吸煙習慣、飲食習慣、職業暴露史、室內空氣污染物暴露、家族史、呼吸病病歷和病徵。食物問卷由NCI已經驗證的DHQI修改而成。《資料分析》按每月進食的總量將所有研究對象分為三組，運用非條件邏輯回歸模型擬合，控制了混雜因素後，計算出各類食物的總進食量對慢性阻塞性肺病的比值比及其95%致信區間。運用多元線回歸模型，控制了混雜因素後，分析各類食物的每月總進食量與肺功能指數的關係。《結果》控制了混雜因素後，總水果進食量與慢性阻塞性肺病成負相關，與第一分位組比較，第三位組的比值比(95%致信區間)為0.618(0.41-0.931)，第一分位組的總水果進食量解釋了14.6%慢性阻塞性肺病的危險性。控制了混雜因素後，總十字科蔬菜進食量與慢性阻塞性肺病成負相關，與第一分位組比較，第三位組的比值比(95%致信區間)為0.596 (0.398-0.893)，第一分位組的總十字科蔬菜進食量解釋了17.7%慢性阻塞性肺病的危險性。肺功能方面，控制了混雜因素後，總十字科蔬菜進食量與FVC成負相關《結論》進食水果和十字科蔬菜可能降低患上慢性阻塞性肺病的危險性。後者未曾在以往的研究發表過，值得進一步進行研究。慢性阻塞性肺病的預防措施應包括鼓勵進食這兩類食物。ObjectivesTo investigate the relationship between dietary factors and risk of chronic obstructive pulmonary disease (COPD) as well as lung function in a middle-aged to older Chinese population.MethodsThis was an unmatched community-based case–control study. A total of 252 incident cases of COPD diagnosed by spirometry (FEV1/FVC ratio of < 70%) and 360 eligible controls were recruited.Each participant received a health examination including spirometry and anthropometric measurement. A food frequency questionnaire, modified from the validated Diet History Questionnaire I designed by the National Cancer Institute, was administered to assess the habitual consumption of various dietary items. Information on confounding factors, including smoking, environmental tobacco exposure, biomass exposure, occupational exposure, family history, and respiratory health, was collected using a modified American Thoracic Society (ATS) respiratory questionnaire.Unconditional logistic regression model was used to analyse the relationship between COPD and the dietary variables, while linear regression model was used to analyse the relationship between the dietary variables and lung function indices, adjustingCumulative total fruit intake was negatively associated with the risk of COPD. Compared with participants with the lowest tertile of cumulative total fruit intake, participants with the highest tertile had an adjusted OR of 0.618 (95% CI: 0.41-0.931)Cumulative cruciferous vegetable intake was also negatively associated with the risk of COPD. Compared with participants with the lowest tertile of cumulative cruciferous vegetable intake, participants with the highest tertile had an adjusted OR of 0.Regarding the relationships between dietary factors and lung function, positive associations were observed between cumulative total fruit intake and FEF25-75 (Beta=0.085). Higher intake of citrus fruit was also associated higher FEF25-75 (Beta=0.082).ConclusionOur results suggest that high consumption of fruit and cruciferous vegetable may protect against the development of COPD in middle-aged to elderly Chinese. COPD prevention strategy should encourage people to consume more fruit and cruciferous vegetablLing, Sai On.Thesis Ph.D. Chinese University of Hong Kong 2016.Includes bibliographical references (leaves ).Abstracts also in Chinese.Title from PDF title page (viewed on …).Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only.Detailed summary in vernacular field only