Jancsura McKenzie K, Wirth Michael D, Helsabeck Nathan P, Mercer Brian M, Haas David M, Greenland Philip, McNeil Rebecca, Levine Lisa D, Silver Robert M, Yee Lynn M, Saade George R, Khan Sadiya S, Chung Judith H, Grobman William A
College of Nursing The Ohio State University Columbus OH USA.
Department of Biobehavioral Health and Nursing Science, College of Nursing University of South Carolina Columbia SC USA.
J Am Heart Assoc. 2024 Dec 17;13(24):e035391. doi: 10.1161/JAHA.124.035391. Epub 2024 Dec 10.
Inflammatory diets may influence risk of cardiovascular disease. Subsequent cardiovascular disease is also influenced by adverse pregnancy outcomes (APOs) such as preterm birth, small-for-gestational-age birth, gestational diabetes, and hypertensive disorders of pregnancy. However, the associations between inflammatory diet, APOs, and cardiometabolic health remain unclear.
We used data from the nuMoM2b (Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-Be) HHS (Heart Health Study) to assess the relationship between dietary quality and cardiometabolic health. We calculated Energy-Adjusted Dietary Inflammatory Index scores representing the inflammatory burden in a person's diet. We used linear regression to determine the association between Energy-Adjusted Dietary Inflammatory Index score and cardiometabolic outcomes. We performed stratified analyses for outcomes with a significant interaction between Energy-Adjusted Dietary Inflammatory Index and APO. Data were available from 3249 participants at a median of 3.1 years after delivery. Higher Energy-Adjusted Dietary Inflammatory Index scores were associated with higher body mass index (B=0.29 kg/m [95% CI, 0.16-0.42]), waist circumference (0.66 cm [95% CI, 0.39-0.93]), diastolic blood pressure (0.26 mm Hg [95% CI, 0.09-0.44]), mean arterial pressure (0.23 mm Hg [95% CI, 0.06-0.40]), triglycerides (2.11 mg/dL [95% CI, 1.05-3.18]), creatinine (2.78 mg/dL [95% CI, 1.13-4.44]), insulin (exp[B]=1.04 [95% CI, 1.03-1.05]) and C-reactive protein (exp[B]=1.07 [95% CI, 1.04-1.10]), and lower high-density lipoprotein cholesterol (-0.41 mg/dL [95% CI, -0.66 to -0.37]) (all <0.01). Significant interactions with APO (<0.05) were identified for body mass index and waist circumference, with stratified analysis revealing stronger associations for individuals with APOs.
A more proinflammatory diet was associated with worse cardiometabolic health measures, and these relationships differed by a person's APO history. Further investigation should establish how dietary modifications after pregnancy may potentially mitigate cardiovascular disease risk.
炎性饮食可能会影响心血管疾病风险。后续的心血管疾病还会受到不良妊娠结局（如早产、小于胎龄儿出生、妊娠期糖尿病和妊娠高血压疾病）的影响。然而，炎性饮食、不良妊娠结局与心脏代谢健康之间的关联仍不明确。
我们使用了来自nuMoM2b（未生育孕妇妊娠结局研究监测准妈妈）心脏健康研究（HHS）的数据，以评估饮食质量与心脏代谢健康之间的关系。我们计算了能量调整饮食炎症指数得分，该得分代表了一个人饮食中的炎症负担。我们使用线性回归来确定能量调整饮食炎症指数得分与心脏代谢结局之间的关联。对于能量调整饮食炎症指数与不良妊娠结局之间存在显著交互作用的结局，我们进行了分层分析。在分娩后3.1年的中位数时间点，有3249名参与者的数据可供使用。较高的能量调整饮食炎症指数得分与较高的体重指数（B = 0.29 kg/m² [95%置信区间，0.16 - 0.42]）、腰围（0.66 cm [95%置信区间，0.39 - 0.93]）、舒张压（0.26 mmHg [95%置信区间，0.09 - 0.44]）、平均动脉压（0.23 mmHg [95%置信区间，0.06 - 0.40]）、甘油三酯（2.11 mg/dL [95%置信区间, 1.05 - 3.18]）、肌酐（2.78 mg/dL [95%置信区间, 1.13 - 4.44]）、胰岛素（exp[B] = 1.04 [95%置信区间, 1.03 - 1.05]）和C反应蛋白（exp[B] = 1.07 [95%置信区间, 1.04 - 1.10]）相关，而与较低的高密度脂蛋白胆固醇（-0.41 mg/dL [95%置信区间, -0.66至-0.37]）相关（所有P均<0.01）。对于体重指数和腰围，我们发现与不良妊娠结局存在显著交互作用（P<0.05），分层分析显示不良妊娠结局个体的关联更强。
炎症性更强的饮食与更差的心脏代谢健康指标相关，并且这些关系因个人的不良妊娠结局病史而异。进一步的研究应确定妊娠后的饮食调整如何可能降低心血管疾病风险。
