Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Eur J Nutr. 2024 Feb;63(1):209-220. doi: 10.1007/s00394-023-03251-4. Epub 2023 Oct 7.
Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study.
We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants.
After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing.
Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
先前报道的富含蛋白质的食物与中风亚型之间的关联引起了人们对评估个别氨基酸的兴趣。我们在 EPIC 研究中研究了饮食氨基酸与缺血性和出血性中风风险的关系。
我们分析了来自 7 个欧洲国家的 356142 名参与者的数据。使用经过验证的特定国家的饮食问卷评估了 19 种单一氨基酸的饮食摄入量，并使用额外的 24 小时饮食回忆进行了校准。使用多变量调整的 Cox 回归模型来估计与每种氨基酸摄入相关的缺血性和出血性中风的风险比（HR）和 95%置信区间（CI）。在 267642 名（75%）参与者中评估了血压作为潜在机制的作用。
中位随访 12.9 年后，4295 名参与者发生缺血性中风，1375 名参与者发生出血性中风。在多次测试校正后，脯氨酸（占总蛋白的百分比）摄入量较高与缺血性中风风险降低 12%相关（较高摄入量的 HR 为 0.88；95%CI 0.82，0.94）。在相互调整所有其他氨基酸、收缩压和舒张压后，这种关联仍然存在。亮氨酸、缬氨酸、苯丙氨酸、苏氨酸、色氨酸、酪氨酸与缺血性中风的负相关，在调整脯氨酸摄入量后，每个关联都减弱了。对于出血性中风，在经过多次测试校正后，连续分析中未观察到统计学上显著的关联。
较高的脯氨酸摄入量可能与缺血性中风的风险降低相关，与其他饮食氨基酸和血压无关。
