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Article(id=1322590066992595753, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322589954702688372, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407335, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1721491200000, receivedDateStr=2024-07-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793259644506, onlineDateStr=2026-10-29, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793259644506, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793259644506, creator=13701087609, updateTime=1793259644506, updator=13701087609, issue=Issue{id=1322589954702688372, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793259617734, creator='13701087609', updateTime=1793260023378, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322591656147276425, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322589954702688372, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322591656147276426, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322589954702688372, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=138, endPage=143, ext={EN=ArticleExt(id=1322590067256836906, articleId=1322590066992595753, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Impact of lifestyle inflammation score on the risk of inflammatory bowel disease, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effect of the Lifestyle Inflammation Score (LIS) on the risk of developing inflammatory bowel disease.

Methods

Utilizing data from the prospective cohort study of the UK Biobank (UKB), the Lifestyle Inflammation Score was calculated, and participants were categorized into three groups based on their tertiles: LIS1 (<-0.18), LIS2 (-0.18 to 0.50), and LIS3 (>0.50). The cumulative incidence of IBD and its subtypes was calculated using the Kaplan-Meier method, and inter-group comparisons were conducted using the Log-rank test. Cox regression models were employed to analyze the hazard ratios (HR) and 95% confidence intervals (95%CI) for the occurrence of IBD, ulcerative colitis (UC), and Crohn’s disease (CD) across different LIS groups.

Results

A total of 365 343 participants were included in the study, with a median follow-up period of 12.62 years. The incidence counts for IBD, UC, and CD were 2 784, 1 969, and 993, respectively. The Log-rank test revealed a statistically significant difference in the cumulative incidence of IBD among the three groups (χ2=7.973, P<0.05). Using the occurrence of IBD as the dependent variable and LIS grouping as the independent variable, after adjusting for confounding factors such as age, gender, history of breastfeeding, and appendectomy, the risk of developing IBD was found to increase in the LIS3 group compared to LIS1 group (HR=1.155, 95%CI: 1.041-1.281). In subgroup analyses, the risk of developing UC was also elevated in the LIS3 group compared to LIS1 (HR=1.150, 95%CI:1.015-1.304), while no significant trend was observed in the CD subgroup.

Conclusion

The Lifestyle Inflammation Score is positively correlated with the risk of IBD and UC, but does not significantly increase the risk of CD.

, authors=Wang-dong FAN1, Wen-qian YU2, authorsList=Wang-dong FAN, Wen-qian YU, authorCompany=null, correspAuthors=Wen-qian YU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322590067697238829, articleId=1322590066992595753, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=生活方式炎症分数对炎性肠病发病风险的影响, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

探讨生活方式炎症分数（lifestyle inflammation score，LIS）对炎性肠病（inflammatory bowel disease, IBD）发病风险的影响。

方法

基于英国生物银行（UK Biobank, UKB）的前瞻性队列研究数据，计算生活方式炎症分数，并将研究对象按照其三分位数划分为LIS1组（<-0.18），LIS2组（-0.18～0.50）和LIS3组（>0.50）。采用K-M法计算IBD及其疾病亚型累积发病风险并绘制发病曲线，组间比较采用Log -rank检验。Cox回归模型用于分析不同LIS组之间的炎性肠病、溃疡性结肠炎（ulcerative colitis，UC）及克劳恩病（Crohn disease，CD）发生风险（HR）和95%置信区间（95%CI）。

结果

共365 343位研究对象纳入研究，中位随访时间为12.62年，IBD、UC及CD发病例数分别为2 784、1 969和993例。Log-rank检验结果显示，三组间IBD累积发病率差异有统计学意义（χ2=7.973，P<0.05）。以是否发生IBD为因变量，LIS分组为自变量，调整年龄、性别、母乳喂养史和阑尾切除术史等混杂因素后，与LIS1组相比，LIS3组发生IBD的风险增加（HR=1.155，95%CI：1.041～1.281）。在疾病亚组分析中，与LIS1组相比，LIS3组发生UC的风险增加（HR= 1.150，95%CI：1.015～1.304），在CD亚组中未观察到显著的趋势。

结论

LIS与IBD及UC的发病风险呈正相关，不能显著增加CD的发病风险。

, authors=樊王冬1, 于文倩2, authorsList=樊王冬, 于文倩, authorCompany=null, correspAuthors=于文倩, authorNote=

樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

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于文倩，E-mail:
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樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

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樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

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Practical Preventive Medicine, 2024, 31(7):856-859.(In Chinese), articleTitle=Risk factors and cluster analysis of Crohn's disease in Qingdao area, refAbstract=null), Reference(id=1322590076190704496, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, doi=null, pmid=null, pmcid=null, year=2023, volume=61, issue=8, pageStart=135, pageEnd=137, 145, url=null, language=null, rfNumber=[28], rfOrder=30, authorNames=郑瑞雪, 黄晓玲, journalName=中国现代医生, refType=null, unstructuredReference=郑瑞雪，黄晓玲. 生命早期饮食与炎性肠病的关系[J]. 中国现代医生，2023，61（8）：135-137, 145., articleTitle=生命早期饮食与炎性肠病的关系, refAbstract=null), Reference(id=1322590076274590577, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, doi=null, pmid=null, pmcid=null, year=2023, volume=61, issue=8, pageStart=135, pageEnd=137,145, url=null, language=null, rfNumber=[28], rfOrder=31, authorNames=Zheng RX, Huang XL, journalName=China Modern Doctor, refType=null, unstructuredReference=Zheng RX, Huang XL. The relationship between diet and inflammatory bowel disease early in life[J]. China Modern Doctor, 2023, 61(8): 135-137,145.(In Chinese), articleTitle=The relationship between diet and inflammatory bowel disease early in life, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322590067885982510, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, xref=1., ext=[AuthorCompanyExt(id=1322590067894371119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, companyId=1322590067885982510, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Clinical Pharmacy/Pharmacy, West China Fourth Hospital, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1322590067906954032, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, companyId=1322590067885982510, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院，临床药学部/药剂科，四川 成都 610041)]), AuthorCompany(id=1322590067969868593, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, xref=2., ext=[AuthorCompanyExt(id=1322590067978257202, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, companyId=1322590067969868593, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西公共卫生学院/华西第四医院，流行病与卫生统计学系，四川 成都 610041)])], figs=[ArticleFig(id=1322590069249131335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=EN, label=Figure 1, caption=The cumulative risk of IBD, UC and CD between different LIS groups, figureFileSmall=7MCQ1cpXMf2A5aC9FjZIwQ==, figureFileBig=JQgUHjCHN3hpe4VrZ2pb8Q==, tableContent=null), ArticleFig(id=1322590069307851592, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=CN, label=图1, caption=不同LIS分组的累积发病风险图

注：图A炎性肠病；图B溃疡性结肠炎；图C克罗恩病。

, figureFileSmall=7MCQ1cpXMf2A5aC9FjZIwQ==, figureFileBig=JQgUHjCHN3hpe4VrZ2pb8Q==, tableContent=null), ArticleFig(id=1322590071144956745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=EN, label=Table 1, caption=

Components of life inflammatory score and weight

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值权重
饮酒
不饮酒00
轻度饮酒1-0.66
重度饮酒10.3
体力活动
几乎没有00
适度体力活动1-0.18
剧烈体力活动1-0.41
吸烟
未吸烟者00
现在吸烟者10.5
BMI(kg/m2)
<2500
25～3010.89
>3011.57
), ArticleFig(id=1322590071228842826, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=CN, label=表1, caption=

生活方式炎症分数各变量赋值表

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值权重
饮酒
不饮酒00
轻度饮酒1-0.66
重度饮酒10.3
体力活动
几乎没有00
适度体力活动1-0.18
剧烈体力活动1-0.41
吸烟
未吸烟者00
现在吸烟者10.5
BMI(kg/m2)
<2500
25～3010.89
>3011.57
), ArticleFig(id=1322590071295951691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=EN, label=Table 2, caption=

Baseline characteristics of research subjects ［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群LIS分组χ2/H值P值
LIS1组LIS2组LIS3组
总人数365 343127 741127 527110 075
随访时间（年）12.62(11.90, 13.32)12.62(11.91, 13.31)12.62(11.91, 13.32)12.63(11.90, 13.33)4.840.089
性别23.16<0.001
女性191 349(54.4)66 267(51.9)66 906(52.5)58 176(52.9)
男性173 994(47.6)61 474(48.1)60 621(47.5)51 899(47.1)
年龄（岁）58.00(50.00, 63.00)58.00(50.00, 63.00)58.00(50.00, 63.00)58.00(50.00, 63.00)46.48<0.001
BMI（kg/m2）198 718.28<0.001
≤25122 089(33.4)91 129(71.3)28 105(22.0)2 855(2.6)
25～30155 031(42.4)36 612(28.7)77 116(60.5)41 303(37.5)
>3088 223(24.1)0(0.0)22 306(17.5)65 917(59.9)
吸烟史19 696.35<0.001
无326 628(89.4)121 145(94.8)119 005(93.3)86 478(78.6)
有38 715(10.6)6 596(5.2)8 522(6.7)23 597(21.4)
饮酒史75 559.95<0.001
无28 876(7.9)11 924(9.3)10 025(7.9)6 927(6.3)
轻度饮酒261 389(71.5)115 817(90.7)92 599(72.6)52 973(48.1)
重度饮酒75 078(20.6)0(0.0)24 903(19.5)50 175(45.6)
体力活动39 427.69<0.001
0<MET≤1 095121 942(33.4)28 060(22.0)47 844(37.5)46 038(41.8)
1 095<MET≤2 811121 625(33.3)31 420(24.6)44 260(34.7)45 945(41.7)
2 811<MET121 776(33.3)68 261(53.4)35 423(27.8)18 092(16.4)
母乳喂养史133.98<0.001
无77 289(27.6)28 920(28.9)26 503(27.3)21 866(26.5)
有202 541(72.4)71 287(71.1)70 613(72.7)60 641(73.5)
阑尾切除术史140.86<0.001
无322 725(88.3)113 878(89.1)112 395(88.1)96 452(87.6)
有42 618(11.7)13 863(10.9)15 132(11.9)13 623(12.4)
), ArticleFig(id=1322590071379837772, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=CN, label=表2, caption=

研究对象基线特征表［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群LIS分组χ2/H值P值
LIS1组LIS2组LIS3组
总人数365 343127 741127 527110 075
随访时间（年）12.62(11.90, 13.32)12.62(11.91, 13.31)12.62(11.91, 13.32)12.63(11.90, 13.33)4.840.089
性别23.16<0.001
女性191 349(54.4)66 267(51.9)66 906(52.5)58 176(52.9)
男性173 994(47.6)61 474(48.1)60 621(47.5)51 899(47.1)
年龄（岁）58.00(50.00, 63.00)58.00(50.00, 63.00)58.00(50.00, 63.00)58.00(50.00, 63.00)46.48<0.001
BMI（kg/m2）198 718.28<0.001
≤25122 089(33.4)91 129(71.3)28 105(22.0)2 855(2.6)
25～30155 031(42.4)36 612(28.7)77 116(60.5)41 303(37.5)
>3088 223(24.1)0(0.0)22 306(17.5)65 917(59.9)
吸烟史19 696.35<0.001
无326 628(89.4)121 145(94.8)119 005(93.3)86 478(78.6)
有38 715(10.6)6 596(5.2)8 522(6.7)23 597(21.4)
饮酒史75 559.95<0.001
无28 876(7.9)11 924(9.3)10 025(7.9)6 927(6.3)
轻度饮酒261 389(71.5)115 817(90.7)92 599(72.6)52 973(48.1)
重度饮酒75 078(20.6)0(0.0)24 903(19.5)50 175(45.6)
体力活动39 427.69<0.001
0<MET≤1 095121 942(33.4)28 060(22.0)47 844(37.5)46 038(41.8)
1 095<MET≤2 811121 625(33.3)31 420(24.6)44 260(34.7)45 945(41.7)
2 811<MET121 776(33.3)68 261(53.4)35 423(27.8)18 092(16.4)
母乳喂养史133.98<0.001
无77 289(27.6)28 920(28.9)26 503(27.3)21 866(26.5)
有202 541(72.4)71 287(71.1)70 613(72.7)60 641(73.5)
阑尾切除术史140.86<0.001
无322 725(88.3)113 878(89.1)112 395(88.1)96 452(87.6)
有42 618(11.7)13 863(10.9)15 132(11.9)13 623(12.4)
), ArticleFig(id=1322590071459529549, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=EN, label=Table 3, caption=

Cox regression analysis of the impact of LIS on the risk of IBD

, figureFileSmall=null, figureFileBig=null, tableContent=
Cox回归模型
模型1模型2模型3
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P 值
LIS1组1(reference)1(reference)1(reference)
LIS2组1.037(0.947,1.134)0.4321.038(0.948, 1.136)0.4230.995(0.897, 1.804)0.931
LIS3组1.137(1.037,1.246)0.0061.138(1.038, 1.247)0.0061.155(1.041, 1.281)0.007
性别——1.069(0.993, 1.152)0.0791.058(0.970, 1.153)0.202
年龄——1.003(0.999,1.007)0.2471.002(0.996, 1.008)0.461
有阑尾切除术史————0.803(0.694, 0.928)0.003
有母乳喂养史————1.062(0.965, 1.169)0.228
), ArticleFig(id=1322590071539221326, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=CN, label=表3, caption=

LIS对IBD发病影响的多因素Cox回归模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
Cox回归模型
模型1模型2模型3
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P 值
LIS1组1(reference)1(reference)1(reference)
LIS2组1.037(0.947,1.134)0.4321.038(0.948, 1.136)0.4230.995(0.897, 1.804)0.931
LIS3组1.137(1.037,1.246)0.0061.138(1.038, 1.247)0.0061.155(1.041, 1.281)0.007
性别——1.069(0.993, 1.152)0.0791.058(0.970, 1.153)0.202
年龄——1.003(0.999,1.007)0.2471.002(0.996, 1.008)0.461
有阑尾切除术史————0.803(0.694, 0.928)0.003
有母乳喂养史————1.062(0.965, 1.169)0.228
), ArticleFig(id=1322590071614718799, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=EN, label=Table 4, caption=

Cox regression analysis of the impact of LIS on the risk of UC and CD

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P值
UC
LIS1组1(reference)1(reference)1(reference)
LIS2组1.078(0.968, 1.201)0.1691.079(0.969, 1.202)0.1651.020(0.902, 1.154)0.750
LIS3组1.124(1.007, 1.255)0.0371.125(1.008, 1.256)0.0351.150(1.015, 1.304)0.027
性别——1.117(1.023, 1.220)0.0141.096(0.990, 1.214)0.077
年龄——1.000(0.994, 1.006)0.8841.000(0.994, 1.006)0.957
有阑尾切除术史————0.660(0.547, 0.797)<0.001
有母乳喂养史————1.134(1.008, 1.276)0.034
CD
LIS1组1(reference)1(reference)1(reference)
LIS2组0.990(0.850, 1.154)0.8980.991(0.851, 1.155)0.9080.993(0.834, 1.182)0.936
LIS3组1.155(0.991, 1.346)0.0641.156(0.992, 1.347)0.0611.184(0.995, 1.410)0.056
性别——0.968(0.853, 1.097)0.6060.977(0.847, 1.128)0.753
年龄——1.008(1.000, 1.016)0.0371.008(0.998, 1.018)0.098
有阑尾切除术史————1.076(0.867, 1.335)0.511
有母乳喂养史————0.962(0.821, 1.127)0.627
), ArticleFig(id=1322590071677633360, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322590066992595753, language=CN, label=表4, caption=

LIS对UC及CD发病影响的多因素Cox回归模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P值
UC
LIS1组1(reference)1(reference)1(reference)
LIS2组1.078(0.968, 1.201)0.1691.079(0.969, 1.202)0.1651.020(0.902, 1.154)0.750
LIS3组1.124(1.007, 1.255)0.0371.125(1.008, 1.256)0.0351.150(1.015, 1.304)0.027
性别——1.117(1.023, 1.220)0.0141.096(0.990, 1.214)0.077
年龄——1.000(0.994, 1.006)0.8841.000(0.994, 1.006)0.957
有阑尾切除术史————0.660(0.547, 0.797)<0.001
有母乳喂养史————1.134(1.008, 1.276)0.034
CD
LIS1组1(reference)1(reference)1(reference)
LIS2组0.990(0.850, 1.154)0.8980.991(0.851, 1.155)0.9080.993(0.834, 1.182)0.936
LIS3组1.155(0.991, 1.346)0.0641.156(0.992, 1.347)0.0611.184(0.995, 1.410)0.056
性别——0.968(0.853, 1.097)0.6060.977(0.847, 1.128)0.753
年龄——1.008(1.000, 1.016)0.0371.008(0.998, 1.018)0.098
有阑尾切除术史————1.076(0.867, 1.335)0.511
有母乳喂养史————0.962(0.821, 1.127)0.627
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生活方式炎症分数对炎性肠病发病风险的影响
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樊王冬 1 , 于文倩 2
现代预防医学 | 健康与社会行为 2025,52(1): 138-143
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现代预防医学 |健康与社会行为 2025 , 52 (1) : 138 -143
生活方式炎症分数对炎性肠病发病风险的影响
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樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

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樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

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樊王冬1, 于文倩2
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院，临床药学部/药剂科，四川 成都 610041
  • 2.四川大学华西公共卫生学院/华西第四医院，流行病与卫生统计学系，四川 成都 610041
通讯作者:
于文倩，E-mail:
作者简介:

樊王冬（1987—），男，硕士，主管药师，研究方向：卫生政策、药物不良反应、数据挖掘分析

Impact of lifestyle inflammation score on the risk of inflammatory bowel disease
Wang-dong FAN1, Wen-qian YU2
Affiliations
  • Department of Clinical Pharmacy/Pharmacy, West China Fourth Hospital, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2025-01-10 doi: 10.20043/j.cnki.MPM.202407335
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摘要
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目的

探讨生活方式炎症分数（lifestyle inflammation score，LIS）对炎性肠病（inflammatory bowel disease, IBD）发病风险的影响。

方法

基于英国生物银行（UK Biobank, UKB）的前瞻性队列研究数据，计算生活方式炎症分数，并将研究对象按照其三分位数划分为LIS1组（<-0.18），LIS2组（-0.18～0.50）和LIS3组（>0.50）。采用K-M法计算IBD及其疾病亚型累积发病风险并绘制发病曲线，组间比较采用Log -rank检验。Cox回归模型用于分析不同LIS组之间的炎性肠病、溃疡性结肠炎（ulcerative colitis，UC）及克劳恩病（Crohn disease，CD）发生风险（HR）和95%置信区间（95%CI）。

结果

共365 343位研究对象纳入研究，中位随访时间为12.62年，IBD、UC及CD发病例数分别为2 784、1 969和993例。Log-rank检验结果显示，三组间IBD累积发病率差异有统计学意义（χ2=7.973，P<0.05）。以是否发生IBD为因变量，LIS分组为自变量，调整年龄、性别、母乳喂养史和阑尾切除术史等混杂因素后，与LIS1组相比，LIS3组发生IBD的风险增加（HR=1.155，95%CI：1.041～1.281）。在疾病亚组分析中，与LIS1组相比，LIS3组发生UC的风险增加（HR= 1.150，95%CI：1.015～1.304），在CD亚组中未观察到显著的趋势。

结论

LIS与IBD及UC的发病风险呈正相关，不能显著增加CD的发病风险。

生活方式  /  炎性肠病  /  溃疡性结肠炎  /  克劳恩病  /  风险因素
Objective

To investigate the effect of the Lifestyle Inflammation Score (LIS) on the risk of developing inflammatory bowel disease.

Methods

Utilizing data from the prospective cohort study of the UK Biobank (UKB), the Lifestyle Inflammation Score was calculated, and participants were categorized into three groups based on their tertiles: LIS1 (<-0.18), LIS2 (-0.18 to 0.50), and LIS3 (>0.50). The cumulative incidence of IBD and its subtypes was calculated using the Kaplan-Meier method, and inter-group comparisons were conducted using the Log-rank test. Cox regression models were employed to analyze the hazard ratios (HR) and 95% confidence intervals (95%CI) for the occurrence of IBD, ulcerative colitis (UC), and Crohn’s disease (CD) across different LIS groups.

Results

A total of 365 343 participants were included in the study, with a median follow-up period of 12.62 years. The incidence counts for IBD, UC, and CD were 2 784, 1 969, and 993, respectively. The Log-rank test revealed a statistically significant difference in the cumulative incidence of IBD among the three groups (χ2=7.973, P<0.05). Using the occurrence of IBD as the dependent variable and LIS grouping as the independent variable, after adjusting for confounding factors such as age, gender, history of breastfeeding, and appendectomy, the risk of developing IBD was found to increase in the LIS3 group compared to LIS1 group (HR=1.155, 95%CI: 1.041-1.281). In subgroup analyses, the risk of developing UC was also elevated in the LIS3 group compared to LIS1 (HR=1.150, 95%CI:1.015-1.304), while no significant trend was observed in the CD subgroup.

Conclusion

The Lifestyle Inflammation Score is positively correlated with the risk of IBD and UC, but does not significantly increase the risk of CD.

Lifestyle  /  Inflammatory bowel disease  /  Ulcerative colitis  /  Crohn’s disease  /  Risk factors
樊王冬, 于文倩. 生活方式炎症分数对炎性肠病发病风险的影响. 现代预防医学, 2025 , 52 (1) : 138 -143 . DOI: 10.20043/j.cnki.MPM.202407335
Wang-dong FAN, Wen-qian YU. Impact of lifestyle inflammation score on the risk of inflammatory bowel disease[J]. Modern Preventive Medicine, 2025 , 52 (1) : 138 -143 . DOI: 10.20043/j.cnki.MPM.202407335
正文
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炎性肠病（inflammatory bowel disease, IBD）是一种多复发的慢性肠道疾病，其主要亚型为溃疡性结肠炎（ulcerative colitis，UC）和克劳恩病（Crohn disease，CD）[1]。据2020年一项研究报道[2]，IBD患者人均直接医疗年支出约为2 000～3 500欧元，约有0.2%的欧洲人口正承受着IBD带来的经济负担，而在中国，1990—2019年间IBD标化发病率从1.47/10万上升到了3.01/10万[3]。随着全球工业化进展和西方饮食和生活方式的普及，IBD已逐渐成为全球性疾病[2]。IBD的机制尚不清楚，但包括微生物、生活饮食方式及生命早期抗生素暴露等环境因素在其发生发展过程中发挥着重要的作用[4]。一项孟德尔随机化研究结果显示[5]，除结肠癌外，IBD还与口腔癌及乳腺癌存在着因果关联。因此，预防IBD的发生不仅可减轻该疾病本身给社会带来的医疗负担，还能降低患其他疾病的风险。
既往研究表明，各种生活方式因素，包括饮食、体力活动、肥胖、压力、睡眠和吸烟等，可能会改变IBD的风险[6]。既往许多指标如饮食炎症指数（dietary inflammatory index，DII）和经验性饮食炎症模式（empirical dietary inflammatory pattern，EDIP）主要集中于建立饮食与机体炎症之间的关系，而忽略了生活方式特征对炎症的贡献[7-8]。生活方式炎症分数（lifestyle inflammation score，LIS）是由BYRD等研究者于2019年提出的首次衡量生活方式对人体炎症影响的算法，主要包括了吸烟、饮酒、身体质量指数（body mass index, BMI）和体力活动四个部分，计算该指标所需信息在日常调查中便于收集，同时各指标权重的生物学合理性也得到了良好的解释[9]。不健康的生活方式会诱导机体发生慢性炎症，而慢性炎症的浸润又将给IBD的发生发展提供良好的环境[10-11]。因此，本研究基于英国生物银行（UK Biobank，UKB）的前瞻性队列数据，结合LIS，首次综合考虑炎症相关生活方式与IBD发病风险之间的关联，期望能从炎症相关生活方式入手，为IBD的早期风险识别及预防提供参考。
1　对象与方法
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1.1　研究对象
本研究的研究对象均为UKB于2006—2010年招募的40～69岁的参与者。排除了基线调查之前即患有IBD的研究对象（n=3 284），以及用于计算LIS的吸烟史、饮酒史、体力活动及BMI等信息缺失（n=94 276）的研究对象后，共计365 343位参与者纳入本研究。
1.2　暴露与结局定义
LIS由BYRD等人[9]依据吸烟、饮酒、体力活动及BMI不同的权重进行计分，该分数与膳食炎症分数共同应用于多种代谢性疾病的研究中[12]，用以代替炎症相关生化指标。本研究中，吸烟划分为现在吸烟者和未吸烟者（包括既往吸烟者）；饮酒划分为轻度饮酒和重度饮酒；BMI划分为低于25 kg/m2、25～30 kg/m2和高于30 kg/m2；体力活动按照国际体力活动问卷（physical activity questionnaire, IPAQ）计算所得的MET当量三分位数进行划分。其中，UKB对于饮酒史的划分中，“从不”“极少数在特殊场合”“每月1～3次”“每周1～2次”“每周2～3次”的归为轻度饮酒，“几乎每天”归为重度饮酒。具体变量的权重赋值见表1，赋值为负代表具有抗炎作用，赋值为正代表具有促炎作用，所有变量赋值相加即为LIS总分。研究对象按照基线资料计算的LIS三分位数进行分组，LIS<-0.18为LIS1组，LIS介于-0.18与0.50之间为LIS2组，LIS>0.50为LIS3组。结局定义为随访过程中确诊IBD/UC/CD，根据国际疾病分类( ICD- 9,、ICD-10)进行评估。以确诊IBD/UC/CD时间、死亡时间、失访时间或随访结束时间（2021年9月30日）为随访终点。
1.3　统计方法
本研究中所有连续性变量均不满足正态分布，因此采用中位数（P25，P75）进行描述，分类变量采用例数与构成比描述。不同LIS分组之间定量资料的差异采用K-W秩和检验进行分析,分类资料构成比的差异利用χ2检验比较。此外，由于体力活动及BMI分类为等级资料，故其组间差异采用K-W秩和检验进行分析。采用K-M法分别计算IBD、UC及CD累积发病率并绘制发病曲线，组间比较采用Log -rank检验。Cox回归模型用于分析不同LIS分组对IBD发病风险的影响，效应值为风险比（Hazard ratio，HR）及其95%置信区间（Confidential Interval，CI）其中，模型一未调整混杂，模型二调整了性别与年龄，模型三在模型二的基础上，进一步调整了生命早期母乳喂养情况及阑尾切除术史。亚组分析将IBD分为UC与CD，再次采用Cox回归分析LIS对不同疾病亚型的发病影响。双侧检验水准α=0.05，log-rank检验进行组间比较时，采用α分割法进行校正，新的双侧检验水准为α/3≈0.017，P<0.017可认为两组间差异有统计学意义。所有的统计分析均在软件SPSS 26.0中进行。
2　结果
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2.1　研究对象基线特征
365 343位资料完整且满足条件的研究对象最终被纳入本研究进行分析，其中女性占比54.4%，研究对象年龄中位数为58岁，中位随访时间为12.62年。将所有研究对象按照LIS的三分位数分组，其中LIS1组有127 741人，LIS2组有1 275 27人，LIS3组有110 075人。组间差异分析结果显示，性别构成比、年龄、BMI、吸烟史、饮酒史、体力活动、母乳喂养史及阑尾切除术史在各组之间的差异均有统计学意义（P<0.05），而随访时间在不同的LIS分组里差异没有统计学意义。见表2。
2.2　LIS对炎性肠病发病的影响
随访期间，分别发生IBD 2 784例，UC 1 969例以及CD 993例，发病密度分别为6.04 /万人年、4.27 /万人年和2.15 /万人年。采用K-M法计算各疾病累积发病率并绘制累积风险曲线，随着随访时间的增加，LIS越高各疾病的累积发病风险越高，见图1。Log-rank检验结果显示不同LIS分组间的IBD累积发病风险差异有统计学意义（χ2=7.973，P<0.05），而不同LIS分组之间的UC及CD累积发病风险差异无统计学意义。进一步，两两比较结果显示，LIS各组之间的IBD累积发病风险差异经校正后无统计学意义（P>0.017）。
以随访期间是否发生IBD为因变量（是=1，否=0），LIS分组为自变量，在校正年龄、性别、母乳喂养史和阑尾切除术史等混杂因素后，LIS3组发生IBD的风险是LIS1组的1.155倍（95%CI：1.041～1.281）。见表3。
2.3　亚组分析
本研究进一步将IBD分为UC与CD进行亚组分析。分别以是否发生UC或CD为因变量（是=1，否=0），LIS分组为自变量，校正混杂因素后开展Cox风险回归分析，UC结果与IBD一致，而LIS的增加并不会显著地影响CD的发病风险。见表4。
3　讨论
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LIS作为综合了多种炎症相关生活方式的指标，在既往的研究中被发现与多种疾病相关[13-15]。GAO等[15]学者的一项探讨生活方式和膳食炎症评分与女性结直肠癌发病率的关联研究发现，无论生活方式炎症分数单独使用或与膳食炎症分数相结合，均与更高的结肠癌风险相关。此外，在一项基于美国国立卫生研究院和美国退休人员协会数据库的饮食与健康研究中也发现，促炎饮食和生活方式的聚集暴露可能与结直肠癌的高风险相关[13]。但仅有CHUN-HAN等[16]学者基于3个大型前瞻性队列分析发现膳食炎症分数与CD风险增加有关，而与UC风险无关。目前尚无生活方式炎症指数与IBD相关的研究报道。本研究基于UKB的前瞻性队列数据，首次探讨了LIS与IBD及其亚型发病风险之间的关系，研究结果显示，高水平的LIS会显著增加IBD及UC的发病风险，而在CD亚组中并未发现一致的结果。
既往已有研究探讨LIS不同组分与IBD之间的关联。在西方国家，吸烟被发现与CD的风险增加有关，而持续吸烟、戒烟和尼古丁替代都可能会不同程度地影响IBD患者的预后[17]。然而，在一项纳入16例队列研究的meta分析中，UC的风险在吸烟者和非吸烟者中没有显著差异[18]。吸烟对于IBD两种亚型的影响不一致，在其他研究中也有体现。一项高剂量经皮注射尼古丁（0.15 mg/d）的早期临床试验表明，与注射安慰剂的对照组相比，尼古丁能诱导UC患者临床症状的缓解，但却无法维持该缓解状态[6]。吸烟与IBD之间的关系通常被解释为抗炎途径受抑制、单核细胞功能失调以及小肠通透性的改变。吸烟者肠道菌群的物种多样性下降和抗炎菌门（例如厚壁菌门）减少也可能与IBD的风险增加有关[19]。
由于既往关于饮酒与IBD关联的研究结论不一致，饮酒目前并未被确定为IBD的风险因素。部分学者发现适当饮酒不但不会增加IBD的风险，还会起到保护作用[6]。而DI NARZO等人[20]通过研究饮酒的多基因风险评分与IBD风险之间的关联，发现饮酒量与IBD的发病风险成正相关，尽管该研究并未前瞻性地观察到饮酒与IBD发病之间的关联。这提示我们饮酒虽然并未增加IBD的发病风险，但作为IBD患者不良预后的风险因素也同样值得关注和重视。
体力活动在促进免疫反应和减少促炎细胞因子方面的作用是显而易见的。一项台湾儿童青少年体质与炎症性肠病风险研究结果显示，心肺耐力与儿童和青少年IBD发病风险呈负相关[21]。相比于体力活动对于IBD发病风险的影响，更多的研究结果聚焦于体力活动对IBD患者的预后带来的益处[22-23]。运动可以抑制局部促炎反应，减少炎症细胞因子和凋亡蛋白的表达，此外，运动还可以增加有益微生物物种的数量，丰富微生物群落的多样性，通过肠道微生物群控制氧化应激和炎症反应[24]。
肥胖和IBD的患病率在世界范围内均呈上升趋势，多两种疾病之间可能通过共同的环境风险因素相互关联，并通过肠道微生物群的改变而介导。脂肪组织产生的脂肪因子具有促炎作用，可驱动包括IBD在内的免疫介导疾病患者的疾病活动[25]。既往有研究表明，BMI每增加1 kg/m2，IBD换着住院和手术的风险分别增加了3.4%和5%[25]。
尽管本研究基于UKB数据库首次开展了LIS与IBD发病风险之间的研究，仍存在部分局限性。一是研究人群的局限性。UKB的研究对象年龄多在40～69岁之间，而现有研究表明，生命早期的风险暴露对IBD的发病风险至关重要[26-28]，儿童的IBD发病率在全球范围内逐年上升，本研究得出的结论无法外推至全年龄人群。二是研究所获取的自我报告的生活方式和其他协变量数据容易出现回忆偏倚，尤其是协变量母乳喂养，暴露时间与资料收集时间跨度太大。
综上所述，本研究基于UKB的前瞻性队列，从炎症相关生活方式入手，首次探讨了LIS与IBD发病风险之间的关联，发现较高的LIS与IBD及UC的发病风险呈正相关，却不能显著增加CD的发病风险。

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doi: 10.20043/j.cnki.MPM.202407335
  • 接收时间：2024-07-21
  • 首发时间：2026-10-29
  • 出版时间：2025-01-10
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    1.四川大学华西公共卫生学院/华西第四医院，临床药学部/药剂科，四川 成都 610041
    2.四川大学华西公共卫生学院/华西第四医院，流行病与卫生统计学系，四川 成都 610041

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Number of
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Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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