基于全球疾病负担2021数据分析膳食因素与甲状腺癌发病率的相关性OA
Ecological analysis of the association between dietary factors and thyroid carcinoma incidence based on GBD 2021 data
目的:探讨膳食因素与甲状腺癌发病率的相关性.方法:提取全球疾病负担(GBD)2021数据库中1990-2021年194个国家/地区甲状腺癌发病数据及15种膳食因子的人均摄入量数据.在膳食因子层面,首先进行共线性诊断,随后对膳食暴露变量进行Z-score标化并以甲状腺癌年龄标化发病率为结局变量,构建采用伽马分布和对数连接函数的贝叶斯广义线性混合模型,估计各膳食因子的后验回归系数及相对变化倍数.在膳食模式层面,采用主成分分析提取膳食模式,计算并标化膳食模式得分后评估不同膳食模式与甲状腺癌年龄标化发病率之间的统计学关联强度.同时,结合社会人口学指数(SDI)、性别和年龄分层分析,评估不同发展水平和人群特征关联强度的异质性.结果:全球甲状腺癌年龄标化发病率1990-2021年呈上升趋势且存在显著的地区差异,女性发病率持续高于男性,发病率随年龄增长而上升.膳食暴露分析显示,膳食纤维、豆类和坚果摄入量呈全球性增长趋势,反式脂肪酸摄入量普遍下降,含糖饮料和动物源性食物的摄入模式呈现显著的SDI分层特征.贝叶斯广义线性混合模型识别出11种与甲状腺癌发病显著相关的膳食因子,其中豆类、水果、含糖饮料、红肉、反式脂肪酸和钠与甲状腺癌年龄标化发病率呈正相关,坚果、膳食纤维、加工肉类、牛奶和蔬菜则呈负相关.共识别出三种膳食模式,膳食模式1(红肉、加工肉类、含糖饮料和牛奶高载荷)以及膳食模式2(水果、豆类、蔬菜和多不饱和脂肪酸载荷较高,并伴含糖饮料中度载荷)的得分与甲状腺癌年龄标化发病率呈正相关,膳食模式3(坚果、ω-3脂肪酸高载荷)的得分与甲状腺癌年龄标化发病率呈负相关.结论:甲状腺癌发病率全球上升与膳食结构变化可能存在关联,经历营养转型的部分中等发展水平国家/地区表现得更为突出.
Objective:To examine the association between dietary factors and thyroid carcinoma incidence.Methods:Data on thyroid carcinoma incidence and per capita intake of 15 dietary factors in 194 countries and territories from 1990 to 2021 were extracted from the Global Burden of Disease(GBD)2021 database.At the dietary factor level,collinearity diagnostics were first performed,continuous dietary exposure variables were standardized using Z-scores before model fitting,and Bayesian generalized linear mixed models with a gamma distribution and log link function were fitted using the age-standardized incidence rate of thyroid carcinoma as the outcome to estimate posterior regression coefficients and rate ratios(per one-standard-deviation increase in each dietary exposure).At the dietary pattern level,principal component analysis was used to derive dietary patterns.After calculating and standardizing the dietary pattern scores,the statistical strength of the association between different dietary patterns and the age-standardized incidence rate of thyroid carcinoma was evaluated.Heterogeneity in the associations was further assessed by stratified analyses according to the sociodemographic index(SDI),sex,and age.Results:From 1990 to 2021,the global age-standardized incidence rate of thyroid carcinoma increased and showed marked regional variation.Incidence remained consistently higher in females than in males,and the age-specific incidence rates increased with age.Analysis of dietary exposure indicated that intake of dietary fiber,legumes,and nuts increased globally,whereas trans fat intake generally declined.Intake patterns of sugar-sweetened beverages and animal-source foods showed pronounced SDI-related differences.Bayesian generalized linear mixed model identified 11 factors significantly associated with the age-standardized incidence rate of thyroid carcinoma.Intake of legumes,fruits,sugar-sweetened beverages,red meat,trans fats,and sodium was positively associated with thyroid carcinoma incidence,whereas intake of nuts,dietary fiber,processed meat,milk,and vegetables was negatively associated with thyroid carcinoma incidence.Three dietary patterns were identified,scores for pattern 1(characterized by high loadings of red meat,processed meat,sugar-sweetened beverages,and milk)and pattern 2(characterized by high loadings of fruits,legumes,vegetables,and polyunsaturated fatty acids,accompanied by a moderate loading of sugar-sweetened beverages)were positively associated with thyroid carcinoma incidence.In contrast,the score for dietary pattern 3(characterized by high loadings of nuts and omega-3 fatty acids)was negatively associated with thyroid carcinoma incidence.Conclusion:The global increase in thyroid carcinoma incidence may be associated with changes in dietary structure,especially in medium-development countries undergoing nutritional transition.
陈科宇;段艳婷;徐加杰
浙江中医药大学第二临床医学院,浙江 杭州 310053||杭州医学院附属人民医院 浙江省人民医院耳鼻咽喉-头颈外科中心头颈外科,浙江 杭州 310014全省头颈肿瘤精准医学研究重点实验室,浙江 杭州 310014||浙江省头颈部恶性肿瘤临床医学研究中心,浙江 杭州 310014浙江中医药大学第二临床医学院,浙江 杭州 310053||杭州医学院附属人民医院 浙江省人民医院耳鼻咽喉-头颈外科中心头颈外科,浙江 杭州 310014||全省头颈肿瘤精准医学研究重点实验室,浙江 杭州 310014||浙江省头颈部恶性肿瘤临床医学研究中心,浙江 杭州 310014
医药卫生
甲状腺癌膳食暴露评估全球疾病负担研究贝叶斯广义线性混合模型社会人口学指数
Thyroid cancerDietary exposure assessmentGlobal Burden of DiseaseBayesian generalized linear mixed modelSociodemographic index
《浙江大学学报(医学版)》 2026 (6)
540-550,11
浙江省"尖兵领雁+X"科技计划(2025C02056)This study was supported by"Pioneer"and"Leading Goose"R&D Program of Zhejiang(2025C02056)
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