Greater adherence to a mediterranean diet is associated with lower C-reactive protein (CRP) levels, but not to lower odds of having dry eye disease,The Ocular Surface

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Greater adherence to a mediterranean diet is associated with lower C-reactive protein (CRP) levels, but not to lower odds of having dry eye disease
The Ocular Surface ( IF 6.4 ) Pub Date : 2023-10-01 , DOI: 10.1016/j.jtos.2023.09.013
Morten Schjerven Magno ₁ , Emily Moschowits ₂ , Mathias Kaurstad Morthen ₃ , Marie Wangen Beining ₄ , Nomdo M Jansonius ₅ , Christopher J Hammond ₆ , Tor P Utheim ₇ , Jelle Vehof ₈

Affiliation

Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Stavanger University Hospital, Stavanger, Norway.
Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, London, United Kingdom.
Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK.
Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Dutch Dry Eye Clinic, Velp, the Netherlands; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.

Purpose

To investigate the hypothesis that a Mediterranean diet is associated with a lower risk of having dry eye disease (DED) in the general population.

Methods

DED was assessed using the Women's Health Study (WHS) dry eye questionnaire in 58,993 participants from the Dutch Lifelines Cohort with complete available dietary data (20–94 years, 60% female). Level of adherence to a traditional Mediterranean diet was assessed using the modified Mediterranean Diet Score (mMDS). High-sensitivity C-reactive Protein (hsCRP) was included as a marker of whole-body inflammation. Logistic regressions were used to examine the relationship between WHS-defined DED and mMDS, corrected for age, sex, BMI, education, income, and 48 potentially confounding comorbidities. The association between mMDS and hsCRP, and hsCRP and DED, was further explored in separate regressions.

Results

Of all participants, 9.1% had DED. In contrast to the hypothesis, higher mMDS levels were associated with greater odds of DED, corrected for demographics, smoking status, BMI, and comorbidities (OR 1.034, 95%CI: 1.015 to 1.055, P = 0.001). Moreover, there was a highly significant relationship between increasing mMDS and lower circulating hsCRP levels; however, there was no significant relationship between hsCRP and DED.

Conclusions

Stronger adherence to a Mediterranean diet does not appear to be associated with lower odds of having DED in the general population. Furthermore, there was no association between hsCRP and DED in this study. However, the previously described link between a Mediterranean diet and lower hsCRP was confirmed in this large population-based study.

中文翻译：

更坚持地中海饮食与降低 C 反应蛋白 (CRP) 水平相关，但不会降低患干眼病的几率

目的

调查地中海饮食与普通人群患干眼病 (DED) 风险较低相关的假设。

方法

使用女性健康研究 (WHS) 干眼问卷对来自荷兰生命线队列的 58,993 名参与者进行 DED 评估，并提供完整的可用饮食数据（20-94 岁，60% 女性）。使用改良的地中海饮食评分（mMDS）评估对传统地中海饮食的坚持程度。高敏 C 反应蛋白 (hsCRP) 被列为全身炎症的标志物。使用 Logistic 回归来检查 WHS 定义的 DED 和 mMDS 之间的关系，并针对年龄、性别、BMI、教育程度、收入和 48 种潜在的混杂合并症进行校正。mMDS 和 hsCRP 以及 hsCRP 和 DED 之间的关联在单独的回归中得到了进一步探讨。

结果

在所有参与者中，9.1% 患有 DED。与假设相反，较高的 mMDS 水平与较高的 DED 几率相关，并根据人口统计、吸烟状况、BMI 和合并症进行校正（OR 1.034，95%CI：1.015 至 1.055，P = 0.001）。此外，mMDS 升高与循环 hsCRP 水平降低之间存在高度显着的关系；然而，hsCRP 与 DED 之间没有显着相关性。