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

• Published in: BMC public health Vol. 24; no. 1; pp. 1449 - 15
• Main Authors: Liu, ShiJian, Yang, Ruiming, Zuo, Yingdong, Qiao, Conghui, Jiang, Wenbo, Cheng, Weilun, Wei, Wei, Liu, Zijie, Geng, Yiding, Dong, Ying
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30-05-2024; BMC
• Subjects: Adult; Aged; Biological Specimen Banks; Biomarkers - blood; C-reactive protein; C-Reactive Protein - analysis; Circulating systemic inflammation; Cohort; Complications and side effects; Diet therapy; Diet, Mediterranean - statistics & numerical data; Female; Health aspects; Hospitalization - statistics & numerical data; Humans; Inflammation; Inflammation - blood; Leukocytes; Male; Measurement; Mediterranean diet; Middle Aged; Mortality, Premature; Physiological aspects; Premature death; Prospective Studies; UK Biobank; United Kingdom - epidemiology; United Kingdom; Premature death; Cohort; UK biobank; Circulating systemic inflammation; Mediterranean diet
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18888-x

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.
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.
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(HR
=1.19; 95%:1.17-1.21; HR
=1.17; 95%:1.15-1.19; HR
=1.18; 95%:1.16-1.20; HR
=1.19; 95%:1.17-1.21) and premature death(HR
=1.68; 95%:1.61-1.75; HR
=1.23; 95%:1.18-1.27; HR
=1.45; 95%:1.40-1.50; HR
=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(HR
=1.07; 95%:0.99-1.16;HR
=1.19; 95%:0.96-1.47).
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.