BMC Public Health (May 2024)

The association of circulating systemic inflammation with premature death and the protective role of the Mediterranean diet: a large prospective cohort study of UK biobank

  • ShiJian Liu,
  • Ruiming Yang,
  • Yingdong Zuo,
  • Conghui Qiao,
  • Wenbo Jiang,
  • Weilun Cheng,
  • Wei Wei,
  • Zijie Liu,
  • Yiding Geng,
  • Ying Dong

DOI
https://doi.org/10.1186/s12889-024-18888-x
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 15

Abstract

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Abstract Background Although previous studies have identified specific circulating inflammatory markers associated with the risk of mortality, they have often overlooked the broader impact of a comprehensive inflammatory response on health outcomes. This study aims to assess the association between circulating systemic inflammation and age-related hospitalization and premature death, as well as explore the potential mediating effects of various dietary patterns on these associations. Methods A total of 448,574 participants enrolled in the UK Biobank study were included. Circulating C-reactive protein(CRP), white blood cell count(WBC), platelet count(Plt), and neutrophil/lymphocyte ratio(NLR) were measured, which were used to establish a weighted systemic inflammatory index of inflammation index(INFLA-Score). Dietary intake information was documented through 24-hour dietary recalls, and dietary pattern scores including Dietary Approaches to Stop Hypertension(DASH), Mediterranean(MED), and Healthy Eating Index-2020(HEI-2020) were calculated. Cox proportional hazards regression models were performed to assess the associations between INFLA-Score and age-related disease hospitalization, cause-specific and all-cause premature death. Results During a median follow-up of 12.65 years, 23,784 premature deaths were documented. After adjusting for multiple covariates, higher levels of CRP, WBC, NLR, and INFLA-Score were significantly associated with increased risks of age-related disease hospitalization(HRCRP=1.19; 95%:1.17–1.21; HRWBC=1.17; 95%:1.15–1.19; HRNLR=1.18; 95%:1.16–1.20; HRINFLA−Score=1.19; 95%:1.17–1.21) and premature death(HRCRP=1.68; 95%:1.61–1.75; HRWBC=1.23; 95%:1.18–1.27; HRNLR=1.45; 95%:1.40–1.50; HRINFLA−Score=1.58; 95%:1.52–1.64). Compared to the lowest INFLA-Score group, the highest INFLA-Score group was associated with increased values of whole-body and organ-specific biological age, and had a shortened life expectancy of 2.96 (95% CI 2.53–3.41) and 4.14 (95% CI 3.75–4.56) years at the age of 60 years in women and men, respectively. Additionally, we observed no significant association of the INFLA-Score with aging-related hospitalization and premature death among participants who were more adhering to the Mediterranean (MED) dietary pattern(HRAging−related hospitalization=1.07; 95%:0.99–1.16;HRPremature death=1.19; 95%:0.96–1.47). Conclusion A higher INFLA-Score was correlated with an increased risk of age-related hospitalization and premature death. Nevertheless, adherence to a Mediterranean (MED) diet may mitigate these associations.

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