論文No4153
Dietary Pattern, Sputum DNA Methylation, and Lung Health
An Epidemiological Study in People Who Ever Smoked
Yue Feng,Huining Kang,Akshay Sood,...Vernon Shane Pankratz,Steven A. Belinsky,Shuguang Leng
CHEST, Volume 167, Issue 5, p1333-1345, May 2025.
要約
本研究では、喀痰の遺伝子メチル化に基づいて、肺の健康に関連する新しい食事パターン（DiPHeaL）を特定しました。
DiPHeaLは、加工肉の低摂取と、濃い緑黄色野菜、茶、アルコール、果物ジュースの高摂取を特徴とします。
過去喫煙者において、DiPHeaLスコアが高いほど、肺機能、呼吸器関連の生活の質が改善し、心肺関連死亡リスクが低下しました。
特に気道閉塞のある過去喫煙者では、呼吸器関連の生活の質の改善効果がより顕著でした。
これらの関連性は、別の大規模コホート研究でも確認されました。
さらに、DiPHeaLスコアが高いことは、過去喫煙者における肺がん発生率の低下、および喫煙状況に関わらないCOPD発生率と肺がん死亡リスクの低下とも関連していました。
これらの結果から、過去喫煙者、特に気道閉塞のある人は、食事の改善によって肺の健康状態を改善できる可能性が示唆されました。
Take Home Message
過去に喫煙していた方は、加工肉を控え、濃い緑黄色野菜、茶、アルコール、果物ジュースを積極的に摂取する食事パターン（DiPHeaL）が、肺機能や生活の質を改善し、心肺関連疾患や肺がんのリスクを低下させる可能性があります。特に、気道閉塞のある過去喫煙者にとって、食事の改善はより大きな恩恵をもたらすかもしれません。
Background
We previously identified a sputum 12-gene methylation panel that predicts lung aging and risk for lung cancer.
Research Question
Can the sputum methylation panel be used as a readout to derive a dietary pattern beneficial for lung health? Is this dietary pattern associated with various subjective and objective lung health phenotypes? Does this relationship vary among people who currently smoke vs previously smoked?
Study Design and Methods
Using the Lovelace Smoker Cohort (LSC), we employed the least absolute shrinkage and selection operator regularized Poisson regression to define a dietary pattern for sputum. Associations of the dietary pattern with objective and subjective lung health measurements were examined using generalized linear and Cox models in the LSC and the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening trial.
Results
The Dietary Pattern for Healthy Lung (DiPHeaL) includes low consumption of processed meat, and high consumption of dark green vegetables, tea, alcohol, and fruit juice. In the LSC, a higher DiPHeaL score (1 SD) was associated with better FEV1 (by 96.1 mL/s), FEV1/FVC ratio (by 1.83%), and respiratory quality of life (by 4.9 for activity score), and decreased cardiopulmonary mortality (by 47%) in participants who previously smoked (all P values < .05), but not in participants who currently smoke. Moreover, effect sizes of the DiPHeaL score on respiratory quality of life measures were greater among participants who previously smoked with airway obstruction compared with those without. Associations with cardiovascular and respiratory mortality were replicated in PLCO participants who previously smoked . A higher DiPHeaL score was also associated with lower lung cancer incidence in participants who previously smoked, as well as reduced COPD incidence and lung cancer mortality regardless of smoking status in the PLCO.
Interpretation
We defined a novel dietary pattern for lung epigenetic aging, which linked to lung health measurements. Participants who previously smoked, especially those with airway obstruction, may benefit the most from nutritional modification.