Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, PR China.
Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, PR China.
Nutrition. 2024 Aug;124:112469. doi: 10.1016/j.nut.2024.112469. Epub 2024 Apr 15.
To our knowledge, no evidence exists to link dietary inflammatory potential to cardiovascular disease (CVD) in China. Furthermore, the precise mechanisms underlying the link between a pro-inflammatory diet and CVD remain incompletely understood.
We aimed to investigate the relationship between dietary inflammatory potential and nonfatal CVD in the Chinese population and to explore the mediating role of insulin resistance.
A total of 4822 adults who participated in the China Health and Nutrition Survey (CHNS) were included in this analysis. The dietary inflammatory index (DII) was used to assess dietary inflammatory potential. Cox proportional hazards models and restricted cubic spline were applied to assess the longitudinal associations. The triglyceride-glucose (TyG) index was calculated to measure insulin resistance. Mediation analysis using a two-stage regression method for survival data was employed to explore the mediating effects of the TyG index on the association between DII score and nonfatal CVD.
During a median follow-up of 18 y, 234 incident cases of nonfatal CVD, including 136 strokes and 114 myocardial infarctions (MIs), were observed. For each standard deviation of the DII score, nonfatal CVD incidence increased by 15% (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01-1.31), and stroke incidence increased by 22% (HR = 1.22, 95% CI: 1.03-1.45). DII score displayed a linear association with nonfatal CVD and stroke (P for nonlinearity = 0.250 and 0.238, respectively). No significant association was found between the DII score and MI. Mediation analyses showed that the TyG index mediated 5.90% and 9.35% of the total association between DII score and nonfatal CVD and stroke, respectively.
This study provides evidence that dietary inflammatory potential is positively associated with nonfatal CVD and stroke in Chinese adults, and the association was partly mediated by insulin resistance.
据我们所知，目前尚无证据表明饮食炎症潜能与中国的心血管疾病（CVD）之间存在关联。此外，炎症饮食与 CVD 之间的关联的确切机制仍不完全清楚。
本研究旨在调查中国人群饮食炎症潜能与非致死性 CVD 之间的关系，并探讨胰岛素抵抗的中介作用。
本研究共纳入了 4822 名参加中国健康与营养调查（CHNS）的成年人。采用饮食炎症指数（DII）评估饮食炎症潜能。应用 Cox 比例风险模型和限制性立方样条分析评估纵向关联。计算三酰甘油-葡萄糖（TyG）指数以衡量胰岛素抵抗。采用生存数据两阶段回归法进行中介分析，以探讨 TyG 指数对 DII 评分与非致死性 CVD 之间关联的中介作用。
在中位随访 18 年期间，观察到 234 例非致死性 CVD 事件，包括 136 例卒中和 114 例心肌梗死（MI）。DII 评分每增加一个标准差，非致死性 CVD 发生率增加 15%（风险比 [HR]：1.15，95%置信区间 [CI]：1.01-1.31），卒中和 MI 发生率分别增加 22%（HR = 1.22，95% CI：1.03-1.45）。DII 评分与非致死性 CVD 和卒中有线性关联（非线性 P 值分别为 0.250 和 0.238）。DII 评分与 MI 之间无显著关联。中介分析显示，TyG 指数分别介导了 DII 评分与非致死性 CVD 和卒中的总关联的 5.90%和 9.35%。
本研究提供了证据表明，饮食炎症潜能与中国成年人的非致死性 CVD 和卒中有正相关，这种关联部分是由胰岛素抵抗介导的。
