Objective

Smoking is a strong risk factor for the development of abdominal aortic aneurysm (AAA). It was hypothesised that a Mediterranean diet via its anti-oxidative properties would decrease the risk of AAA, particularly among smokers.

Methods

The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 632 women), aged 45 – 83 years at baseline. A modified Mediterranean Diet (mMED) score, including eight food groups, was calculated based on a food frequency questionnaire. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

During 17.5 years of follow up (1 427 841 person-years), 1 781 AAA cases (1 496 in men, 285 in women; 1 497 non-ruptured, 284 ruptured) were ascertained via Swedish registers. The mMED score was inversely associated with AAA incidence in men (per each one point increment in mMED score HR 0.96, 95% CI 0.93 – 1.00) and in women (HR 0.83, 95% CI 0.77 – 0.90), for non-ruptured (HR 0.95, 95% CI 0.92 – 0.99; in men with infrarenal aortic diameter ≥ 30 mm HR 0.90, 95% CI 0.81 – 1.00) and for ruptured AAA (HR 0.81, 95% CI 0.70 – 0.93). In current and ex-smokers with low (< 20) and moderate (20 – 39.9) pack-years of smoking, a statistically significant inverse association was observed. HRs for each one point increment in the mMED score in current smokers were 0.83 (95% CI 0.75 – 0.91) and 0.90 (95% CI 0.84 – 0.97), respectively; in ex-smokers 0.89 (95% CI 0.81 – 0.97) and 0.93 (95% CI 0.85 – 1.01), respectively. No association was observed among current or ex-smokers with ≥ 40 pack-years; HRs 1.02 (95% CI 0.91 – 1.13) and 0.95 (95% CI 0.83 – 1.10), respectively.

Conclusion

Adherence to the Mediterranean diet was associated with a reduced AAA risk in current and ex-smokers with low pack-years of smoking.

中文翻译：

---

地中海饮食与吸烟者腹主动脉瘤风险降低有关：两项前瞻性队列研究的结果

客观的

吸烟是腹主动脉瘤 (AAA) 发展的重要危险因素。据推测，地中海饮食通过其抗氧化特性会降低 AAA 的风险，尤其是在吸烟者中。

方法

研究人群包括瑞典男性队列（45072 名男性）和瑞典乳房 X 光检查队列（36632 名女性），基线年龄为 45-83 岁。根据食物频率调查问卷计算出改良的地中海饮食 (mMED) 评分，包括八个食物组。Cox 比例风险模型用于估计具有 95% 置信区间 (CI) 的风险比 (HR)。

结果

在 17.5 年的随访期间（1 427 841 人年），通过瑞典登记确定了 1 781 例 AAA 病例（男性 1 496 例，女性 285 例；未破裂 1 497 例，破裂 284 例）。mMED 评分与男性的 AAA 发病率呈负相关（mMED 评分每增加 1 分，HR 0.96，95% CI 0.93 – 1.00）和女性（HR 0.83，95% CI 0.77 – 0.90），对于未破裂（ HR 0.95, 95% CI 0.92 – 0.99；对于肾下主动脉直径 ≥ 30 mm HR 0.90, 95% CI 0.81 – 1.00) 和破裂的 AAA (HR 0.81, 95% CI 0.70 – 0.93)。在低（< 20）和中度（20 – 39.9）包年吸烟的当前和戒烟者中，观察到了统计学上显着的负相关。当前吸烟者 mMED 评分每增加 1 分的 HR 分别为 0.83 (95% CI 0.75 – 0.91) 和 0.90 (95% CI 0.84 – 0.97)；在前吸烟者中 0. 分别为 89 (95% CI 0.81 – 0.97) 和 0.93 (95% CI 0.85 – 1.01)。在≥ 40 包年的当前或曾经吸烟者中未观察到相关性；HR 分别为 1.02 (95% CI 0.91 – 1.13) 和 0.95 (95% CI 0.83 – 1.10)。

结论

坚持地中海饮食与吸烟年数较低的当前和戒烟者的 AAA 风险降低有关。