血浆叶绿醌与高血压和高 BMI 中国成年人缺血性中风风险的负相关：巢式病例对照研究。

Inverse Association between Plasma Phylloquinone and Risk of Ischemic Stroke in Chinese Adults with Hypertension and High BMI: A Nested Case-Control Study.

机构信息

Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.

Graduate School at Shenzhen, Tsinghua University, Shenzhen, China.

出版信息

J Nutr. 2022 Aug 9;152(8):1927-1935. doi: 10.1093/jn/nxac131.

DOI:10.1093/jn/nxac131

PMID:35660920

Abstract

BACKGROUND

Evidence on the association between phylloquinone status and cardiovascular diseases is scarce and conflicting. These inconsistencies may be due to differences in individual characteristics of the study populations, which may modify the association.

OBJECTIVE

This study aimed to evaluate the association between plasma phylloquinone and the risk of first total stroke and its subtypes, and to examine potential effect modifications by BMI in patients with hypertension.

METHODS

We performed a nested case-control study including 604 first stroke cases and 604 matched controls. The mean age was 62.2 y (range, 45 to 75). Lower BMI was defined as <25 kg/m2 and higher BMI was defined as ≥25 kg/m2. The risks of the first stroke were estimated by ORs and 95% CIs using conditional logistic regression. The primary outcome was total stroke or ischemic stroke.

RESULTS

The relation between log-transformed phylloquinone concentration and stroke or ischemic stroke was modified by BMI. Higher phylloquinone concentrations were associated with lower stroke risk in those with a higher BMI. When plasma phylloquinone was assessed as tertiles, the adjusted ORs of first stroke and ischemic stroke for participants with a high BMI in tertile 2-3 were 0.70 (95% CI: 0.46, 1.08) and 0.57 (95% CI: 0.35, 0.92) compared with those in tertile 1, respectively. However, there was no significant association between plasma phylloquinone and risk of first total stroke or ischemic stroke for those with a lower BMI. Patients with a higher BMI and lower phylloquinone concentrations had the highest risk of ischemic stroke and showed a statistically significant difference compared with the reference group with a lower BMI and higher phylloquinone (OR = 1.80, 95% CI: 1.06, 3.10; P-interaction: 0.017).

CONCLUSIONS

In Chinese patients with hypertension, there was an inverse association between baseline plasma phylloquinone and risk of first ischemic stroke among those with a higher BMI. This trial was registered at clinicaltrials.gov as NCT00794885.

摘要

背景

叶醌状况与心血管疾病之间的关联证据有限且相互矛盾。这些不一致可能是由于研究人群个体特征的差异所致，这些差异可能会改变这种关联。

目的

本研究旨在评估血浆叶绿醌与首次总卒中及其亚型风险之间的关联，并检查高血压患者体重指数（BMI）对其的潜在修饰作用。

方法

我们进行了一项巢式病例对照研究，包括 604 例首发卒中病例和 604 例匹配对照。平均年龄为 62.2 岁（范围 45 至 75 岁）。较低的 BMI 定义为<25 kg/m2，较高的 BMI 定义为≥25 kg/m2。采用条件逻辑回归估计首次卒中的风险比（OR）和 95%置信区间（CI）。主要结局是总卒中或缺血性卒中。

结果

叶醌浓度的对数与卒中或缺血性卒中之间的关系受 BMI 修饰。较高的叶醌浓度与 BMI 较高者的卒中风险降低相关。当以三分位评估血浆叶醌时，与三分位 1 相比，BMI 较高者中三分位 2-3 的首次卒中及缺血性卒中的校正 OR 分别为 0.70（95%CI：0.46，1.08）和 0.57（95%CI：0.35，0.92）。然而，对于 BMI 较低者，血浆叶醌与首次总卒中或缺血性卒中的风险之间无显著关联。BMI 较高且叶醌浓度较低的患者发生缺血性卒中的风险最高，与参考组 BMI 较低且叶醌浓度较高的患者相比具有统计学显著性差异（OR=1.80，95%CI：1.06，3.10；P 交互作用=0.017）。