膳食微量营养素摄入与过敏性鼻炎的关联：基于2005~2006年美国国家健康与营养检查调查(NHANES)的横断面分析

Association of Dietary Micronutrient Intake with Allergic Rhinitis: A Cross-Sectional Analysis of NHANES 2005~2006

摘要: 背景：过敏性鼻炎已成为全球性公共卫生负担，患病率持续上升，膳食微量营养素与过敏性鼻炎患病的关联尚存争议，既往研究结论尚不统一。方法：本研究采用2005~2006年美国国家健康与营养检查调查(NHANES)的全国代表性数据，对具有完整膳食摄入数据与19种血清特异性免疫球蛋白E检测结果的6336名美国受试者开展横断面分析。研究共评估15种维生素与矿物质，采用基于膳食营养素参考摄入量(DRIs)的生理摄入量分级标准，通过限制性立方样条模型分析变量间的非线性剂量–反应关系。结果：经多变量调整后发现，较高的膳食维生素K摄入水平，与过敏性鼻炎较高患病率呈横断面关联；维生素C与过敏性鼻炎患病存在非线性剂量–反应关联模式。未观察到维生素A、维生素E、B族维生素、钙、镁、锌、硒与过敏性鼻炎存在具有统计学意义的关联。结论：维生素K和维生素C的摄入与过敏性鼻炎的关联并非单一的统一保护性关联，二者关联模式更为复杂。后续仍需开展前瞻性研究，以明确因果时序、验证上述关联并排除反向因果偏倚。

Abstract: Background: Allergic rhinitis (AR) represents a growing global public health burden, with its prevalence rising steadily. The association between dietary micronutrients and AR development remains controversial, and findings from previous studies are inconsistent. Methods: Using nationally representative data from the 2005~2006 US National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional analysis of 6,336 US participants with complete data on dietary intake and 19 serum specific immunoglobulin E (sIgE) allergen measurements. A total of 15 vitamins and minerals were evaluated. We applied physiological intake grading criteria based on the Dietary Reference Intakes (DRIs), and adopted restricted cubic spline (RCS) models to explore non-linear dose-response relationships between the variables. Results: After multivariable adjustment, higher dietary vitamin K intake was cross-sectionally associated with higher odds of allergic rhinitis. A non-linear dose-response association pattern was identified between vitamin C intake and AR. No statistically significant associations were observed for vitamin A, vitamin E, B vitamins, calcium, magnesium, zinc, or selenium with allergic rhinitis. Conclusions: Vitamin K and vitamin C intake do not show a single uniform protective association with allergic rhinitis; rather, their underlying association patterns with the disease are more complex. Further prospective studies are warranted to clarify the temporal sequence of causality, verify the above associations, and rule out reverse causation bias.