Yang Chan, Yang Qiangfei, Peng Xi, Li Xinqiong, Rao Guocheng
Division of Endocrinology and Metabolism, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, Sichuan, China.
Jianyang City People's Hospital, Chengdu, 610040, Sichuan, China.
Diabetol Metab Syndr. 2023 Jun 20;15(1):131. doi: 10.1186/s13098-023-01109-7.
To investigate the associations of composite dietary antioxidant index (CDAI) with risk of cardiovascular disease (CVD) mortality among individuals with type 2 diabetes (T2D). This prospective cohort study included 7551 patients with T2D who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2018. Death statistics were gathered by connecting the cohort database to the National Death Index through December 31, 2019. Multivariable Cox proportional hazards regression models were utilized to calculate hazard ratios and 95% CIs for the relationship of CDAI with risks of CVD and all-cause mortality. Three multivariable models were built. Restricted cubic spline analyses were utilized to explore the nonlinear association of CDAI with CVD mortality, and nonlinearity was tested by the likelihood ratio test. This cohort study included data from 7551 participants with T2D (mean [SE] age, 61.4 (0.2) years; 3811 male [weighted, 50.5%] and 3740 female [weighted, 49.5%]; median CDAI level, - 2.19 [IQR, - 2.19 ~ - 0.22]). A total of 2227 all-cause deaths and 746 CVD deaths were identified during an average of 98 months of follow-up. Nonlinear associations were observed for CDAI (P < 0.05 for nonlinearity) with risk of CVD mortality among patients with T2D. Compared with participants in the first quartile of CDAI levels (< - 2.19), the hazard ratios for CVD mortality were 0.47 (95% CI 0.30-0.75) for participants in the highest CDAI level quartile. This cohort study found that higher CDAI levels were significantly associated with lower risk of CVD mortality among individuals with T2D.
为了研究复合膳食抗氧化指数（CDAI）与2型糖尿病（T2D）患者心血管疾病（CVD）死亡风险之间的关联。这项前瞻性队列研究纳入了1999年至2018年参加美国国家健康与营养检查调查（NHANES）的7551例T2D患者。通过将队列数据库与截至2019年12月31日的国家死亡指数相连来收集死亡统计数据。使用多变量Cox比例风险回归模型来计算CDAI与CVD风险和全因死亡率之间关系的风险比及95%置信区间。构建了三个多变量模型。采用受限立方样条分析来探讨CDAI与CVD死亡率之间的非线性关联，并通过似然比检验来检验非线性。这项队列研究纳入了7551例T2D参与者的数据（平均[标准差]年龄为61.4（0.2）岁；3811例男性[加权，50.5%]和3740例女性[加权，49.5%]；CDAI水平中位数为-2.19[四分位间距，-2.19~-0.22]）。在平均98个月的随访期间，共确定了2227例全因死亡和746例CVD死亡。观察到CDAI与T2D患者的CVD死亡风险之间存在非线性关联（非线性P<0.05）。与CDAI水平处于第一四分位数（<-2.19）的参与者相比，CDAI水平处于最高四分位数的参与者CVD死亡的风险比为0.47（95%置信区间0.30-0.75）。这项队列研究发现，较高的CDAI水平与T2D患者较低的CVD死亡风险显著相关。
