Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
Nutrients. 2024 Oct 19;16(20):3553. doi: 10.3390/nu16203553.
Although healthy lifestyle has been linked with a reduced risk of cardiovascular diseases (CVDs), the potential metabolic mechanism underlying this association remains unknown.
We included 161,018 CVD-free participants from the UK Biobank. Elastic net regression was utilized to generate a healthy lifestyle-related metabolic signature. The Cox proportional hazards model was applied to investigate associations of lifestyle-related metabolic signature with incident CVDs, and mediation analysis was conducted to evaluate the potential mediating role of metabolic profile on the healthy lifestyle-CVD association. Mendelian randomization (MR) analysis was conducted to detect the causality.
During 13 years of follow-up, 17,030 participants developed incident CVDs. A healthy lifestyle-related metabolic signature comprising 123 metabolites was established, and it was inversely associated with CVDs. The hazard ratio (HR) was 0.83 (95% confidence interval [CI]: 0.81, 0.84) for CVD, 0.83 (95% CI: 0.81, 0.84) for ischemic heart disease (IHD), 0.86 (95% CI: 0.83, 0.90) for stroke, 0.86 (95% CI: 0.82, 0.89) for myocardial infarction (MI), and 0.75 (95% CI: 0.72, 0.77) for heart failure (HF) per standard deviation increase in the metabolic signature. The metabolic signature accounted for 20% of the association between healthy lifestyle score and CVD. Moreover, MR showed a potential causal association between the metabolic signature and stroke.
Our study revealed a potential link between a healthy lifestyle, metabolic signatures, and CVD. This connection suggests that identifying an individual's metabolic status and implementing lifestyle modifications may provide novel insights into the prevention of CVD.
尽管健康的生活方式与心血管疾病 (CVD) 的风险降低有关，但这种关联的潜在代谢机制尚不清楚。
我们纳入了来自英国生物库的 161018 名无 CVD 参与者。利用弹性网络回归生成与健康生活方式相关的代谢特征。应用 Cox 比例风险模型研究生活方式相关代谢特征与 CVD 事件的相关性，并进行中介分析评估代谢特征在健康生活方式与 CVD 关联中的潜在中介作用。进行孟德尔随机化 (MR) 分析以检测因果关系。
在 13 年的随访期间，17030 名参与者发生了 CVD 事件。建立了一个由 123 种代谢物组成的与健康生活方式相关的代谢特征，该特征与 CVD 呈负相关。CVD 的风险比 (HR) 为 0.83（95%置信区间 [CI]：0.81，0.84），缺血性心脏病 (IHD) 为 0.83（95% CI：0.81，0.84），中风为 0.86（95% CI：0.83，0.90），心肌梗死 (MI) 为 0.86（95% CI：0.82，0.89），心力衰竭 (HF) 为 0.75（95% CI：0.72，0.77），代谢特征每增加一个标准差。代谢特征解释了健康生活方式评分与 CVD 之间关联的 20%。此外，MR 显示代谢特征与中风之间存在潜在的因果关系。
我们的研究揭示了健康生活方式、代谢特征和 CVD 之间的潜在联系。这种联系表明，确定个体的代谢状态并进行生活方式改变可能为 CVD 的预防提供新的思路。
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