摘要
目的基于公开数据库中的大样本信息,探究日常咖啡摄入与不同类型疼痛之间的相关性。方法提取美国国家卫生和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中1999—2000年、2001—2002年、2003—2004年3个周期受试者的咖啡摄入、疼痛及11个协变量(包括年龄、性别、种族、受教育程度等)数据,采用无序多分类Logistic回归法构建3种模型评估日常咖啡摄入与疼痛之间的相关性。结果共入选符合纳入与排除标准的受试者13428名,其平均年龄为(49.79±19.06)岁,男女比例为0.9∶1。每日咖啡摄入情况:无咖啡摄入7794名(58.0%),>0~2杯咖啡摄入2077名(15.5%),>2杯咖啡摄入3557名(26.5%);每日咖啡因摄入情况:无咖啡因摄入7794名(58.0%),>0~200 mg咖啡因摄入3152名(23.5%),>200 mg咖啡因摄入2482名(18.5%)。疼痛情况:无疼痛或疼痛持续时间<24 h 10202名(76.0%),急性疼痛910名(6.8%),亚急性疼痛369名(2.7%),慢性疼痛1947名(14.5%)。经权重估算,13428名受试者预计可代表1.9亿(190709157名)年龄≥20岁的美国公民,该期间美国人群急性疼痛、亚急性疼痛、慢性疼痛总体患病率分别为8%、3%、16%。Logistic回归分析显示,在未对任何协变量进行校正时,相较于每日无咖啡/咖啡因摄入者,每日咖啡摄入>2杯(OR=1.354,95%CI:1.187~1.544)或咖啡因摄入>200 mg(OR=1.372,95%CI:1.185~1.587)人群出现慢性疼痛的风险增加;当校正年龄、性别、种族的影响后,可得到相近结果,OR值分别为1.243(95%CI:1.083~1.427)和1.249(95%CI:1.072~1.456);当对11个协变量均进行校正时,未发现每日咖啡摄入杯数及咖啡因摄入量与慢性疼痛具有明显相关性。3种模型均未发现每日咖啡摄入杯数、咖啡因摄入量与急性疼痛、亚急性疼痛存在相关性。结论与不摄入咖啡者相比,每日大量摄入咖啡者出现慢性疼痛的风险增高,但此种相关性受多种因素的影响;尚未发现日常咖啡摄入与急性疼痛、亚急性疼痛存在明显相关性。仍需开展基础研究和前瞻性临床试验进一步明确咖啡摄入与慢性疼痛之间的因果关系及其确切作用机制。
Objective To elucidate whether coffee consumption and caffeine intake was associated with various subtypes of pain based on extensive data from publicly accessible databases.Methods The information was extracted from three cycles of the American National Health and Nutrition Examination Survey(1999-2000,2001-2002,2003-2004),encompassing data on coffee consumption,pain information,and 11 cova⁃riates(including age,gender,race,etc.).Multinomial logistic regression in three models were utilized for analysis.Results A total of 13428 participants were included in this study,with a mean age of(49.79±19.06)years and a male⁃to⁃female ratio of 0.9∶1.Daily coffee intake:non⁃drinker 7794(58.0%),>0-2 cups 2077(15.5%),>2 cups 3557(26.5%);daily caffeine intake:without intake 7794(58.0%),>0-200 mg 3152(23.5%),>200 mg 2482(18.5%);pain situation:no pain or pain duration<24 h 10202(76.0%),acute pain 910(6.8%),subacute pain 369(2.7%),chronic pain 1947(14.5%).After weighting,13428 participants were expected to represent 190 million(190709157)U.S.citizens aged≥20 years,and the overall prevalence of acute,subacute,and chronic pain in the U.S.population during that period was estimated to be 8%,3%,and 16%,respectively.Without adjusting for covariates,individuals who consumed more than 2 cups of coffee or 200 mg of caffeine per day exhibited an elevated risk of chronic pain compared to non⁃coffee/caffeine drinkers,with an odds ratio of 1.354(95%CI:1.187-1.544)and 1.372(95%CI:1.185-1.587),respectively.After adjusting for partial covariates including age,sex,and race,individuals who consumed more than 2 cups of coffee or more than 200 mg of caffeine per day still demon⁃strated an increased risk of chronic pain with an odds ratio of 1.243(95%CI:1.083-1.427)and 1.249(95%CI:1.072-1.456),respectively.However,after all covariates were adjusted,there was no significant association between coffee/caffeine consumption and chronic pain.Furthermore,the number of cups of coffee consumed or caffeine intake showed no significant correlation with acute and subacute pain.Conclusions Compared with nondrinkers,heavy daily coffee drinkers may be more likely to have chronic pain,but it is af⁃fected by multiple factors.Basic research and prospective clinical studies are needed to further determine the causality in this association.
作者
闻蓓
朱贺
许力
黄宇光
WEN Bei;ZHU He;XU Li;HUANG Yuguang(Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《协和医学杂志》
CSCD
北大核心
2024年第2期351-358,共8页
Medical Journal of Peking Union Medical College Hospital
基金
国家自然科学基金(82271262)。
