膳食糖摄入量与成年人群中胆石症患病风险的关联性分析

Association between Dietary Sugar Intake and the Risk of Gallstone Disease in Adults

摘要: 目的：基于美国国家健康与营养检查调查(NHANES)数据库，探讨成年人群胆石症患病风险与膳食糖摄入量的关系。方法：采用NHANES 2017~2020年的数据进行横断面研究。通过24小时饮食回顾评估膳食糖摄入量，胆石症则依据自我报告判定。运用加权Logistic回归模型调整混杂因素分析关联强度，并使用广义相加模型(GAM)探索非线性关系，通过两步递归法计算拐点。结果：共纳入7087名参与者，膳食糖摄入量的中位数为88.00克(IQR：54.45~131.59克)，胆石症的报告率为11.10%。校正混杂因素后，膳食总糖摄入量每增加10克，胆石症患病风险升高4.5% [OR: 1.045 (95% CI: 1.013~1.078), P = 0.011]。GAM提示存在非线性关联，然而对数似然比检验未检测到统计学上显著的阈值效应(P = 0.067)。结论：成年人群中胆石症患病风险与膳食糖摄入量呈连续、非线性的正相关关系，提示较高的膳食糖摄入量与胆石病患病率上升有关。

Abstract: Objective: To investigate the association between total dietary sugar intake and the risk of gallstone disease in adults based on the National Health and Nutrition Examination Survey (NHANES). Methods: A cross-sectional study was conducted using NHANES 2017~2020 data. Total dietary sugar intake was assessed by 24-hour dietary recall, and gallstone disease was defined by self-report. Weighted Logistic regression models were used to adjust for potential confounders, and generalized additive models (GAM) were applied to examine non-linear relationships, with the inflection point calculated by a two-step recursive method. Results: Among 7087 participants, the median total sugar intake was 88.00 g (IQR: 54.45~131.59 g), and 11.10% reported gallstone disease. After adjusting for confounders, each 10 g increase in total dietary sugar intake was associated with a 4.5% increase in gallstone disease prevalence [OR = 1.045 (95% CI: 1.013~1.078), P = 0.011]. GAM indicated a non-linear relationship. However, the log-likelihood ratio test did not detect a statistically significant threshold effect (P = 0.067). Conclusion: There is a continuous, non-linear positive correlation between the risk of gallstone disease and total dietary sugar intake in adults, suggesting that higher levels of sugar consumption are associated with increased gallstone disease prevalence.