Jabbari Masoumeh, Eini-Zinab Hassan, Kalhori Ali, Barati Meisam, Zayeri Farid, Poustchi Hossein, Pourshams Akram, Hekmatdoost Azita, Malekzadeh Reza
Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Food Science and Technology, Nutritional Science, The Ohio State University, Columbus, OH USA.
J Diabetes Metab Disord. 2024 Jul 8;23(2):2043-2054. doi: 10.1007/s40200-024-01463-x. eCollection 2024 Dec.
Evaluation of the added value of Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diet scores on the prediction model of the World Health Organization (WHO) to predict 10-year cardiovascular disease (CVD) mortality using the Golestan Cohort Study data.
A total of 44,648 participants (25,268 women and 18,531 men) were included in the final analysis. To assess the external validity of the non-laboratory risk model of WHO, the Area Under the Curve (AUC) and calibration plot methods were used. The multivariate Cox proportional hazards regression analysis was used to evaluate the association of 10-year CVD mortality risk with DASH and Mediterranean scores and their components. The added value of each significant variables was evaluated by the concordance C-statistic and integrated discrimination improvement (IDI). Statistical significance was defined as < 0.05.
DASH and Mediterranean diet scores were not significant predictors of 10-year CVD mortality in both genders ( > 0.05). However, sodium and total vegetable in both genders and added sugar in women were significant predictors for 10-year stroke mortality ( < 0.05). Sodium intake in women and monounsaturated fatty acid (MUFA) to saturated fatty acid (SFA) ratio in men had significant associations with 10-year mortality of myocardial infarction/coronary heart disease (MI/CHD). Calculation of IDI showed that none of the evaluated nutritional indices/variables could significantly improve the WHO model performance and predictive ability.
Inclusion of DASH and Mediterranean diet scores and their components did not improve WHO risk prediction model performance and predictive ability to predict 10-year CVD mortality.
The online version contains supplementary material available at 10.1007/s40200-024-01463-x.
利用戈勒斯坦队列研究数据，评估终止高血压膳食疗法（DASH）和地中海饮食评分在世界卫生组织（WHO）预测10年心血管疾病（CVD）死亡率的预测模型中的附加价值。
最终分析纳入了总共44648名参与者（25268名女性和18531名男性）。为评估WHO非实验室风险模型的外部有效性，采用了曲线下面积（AUC）和校准图方法。多变量Cox比例风险回归分析用于评估10年CVD死亡风险与DASH和地中海评分及其组成成分之间的关联。通过一致性C统计量和综合判别改善（IDI）评估每个显著变量的附加价值。统计学显著性定义为<0.05。
DASH和地中海饮食评分在两性中均不是10年CVD死亡率的显著预测因素（>0.05）。然而，两性中的钠和总蔬菜量以及女性中的添加糖是10年中风死亡率的显著预测因素（<0.05）。女性的钠摄入量和男性的单不饱和脂肪酸（MUFA）与饱和脂肪酸（SFA）的比例与10年心肌梗死/冠心病（MI/CHD）死亡率有显著关联。IDI计算表明，所评估的营养指标/变量均不能显著改善WHO模型的性能和预测能力。
纳入DASH和地中海饮食评分及其组成成分并不能改善WHO风险预测模型预测10年CVD死亡率的性能和预测能力。
在线版本包含可在10.1007/s40200-024-01463-x获取的补充材料。
