Hu Qin, Ma Xiangyu, Cai Tongjian, Li Yafei
Department of Epidemiology, Institute of Military Preventive Medicine, Army Medical University (Third Military Medical University), NO. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
Nutr Metab (Lond). 2025 Mar 18;22(1):24. doi: 10.1186/s12986-025-00913-4.
This study aimed to investigate the relationship between the dietary intake of total flavonoids and their six subclasses and the risk of atherosclerotic cardiovascular disease (ASCVD) in adults, and to evaluate the potential mediating effect of inflammation in this association.
Cross-sectional data from 3841 individuals participating in the National Health and Nutrition Examination Survey 2017-2018 were included in the analysis. Flavonoid intake was assessed using a 2-day dietary recall method, and ASCVD status was determined by extracting relevant information from the medical condition questionnaire. To determine the relationship between flavonoid intake and ASCVD risk, we employed logistic regression, subgroup, mediation, and restricted cubic spline analyses.
Intake of flavan-3-ols, flavones, flavonols, and total flavonoids was negatively correlated with ASCVD risk. Subgroup analysis revealed that the association between flavonoid intake and ASCVD risk exhibits sex-specific differences, with the relationship being more pronounced among women. The significant associations between increased flavonoid intake and reduced ASCVD risk were observed in smokers, non-alcohol consumers, physically inactive individuals, those with hypertension. A nonlinear relationship was observed between the intake of total flavonoids, flavan-3-ols and flavonols and ASCVD risk. Additionally, high-sensitivity C-reactive protein (hs-CRP) and the neutrophil-to-lymphocyte ratio (NLR), inflammatory markers relevant to ASCVD, were found to mediate the association between flavonoid intake and ASCVD risk. Flavonoids demonstrated a dose‒response relationship with reductions in the levels of hs-CRP and the NLR.
This study indicates the inverse association between flavonoid intake, particularly flavan-3-ols, flavones, and flavonols, and the risk of ASCVD. It highlights the mediating role of CRP and NLR in this relationship. Furthermore, the study emphasizes the importance of considering lifestyle factors and sex when evaluating the cardiovascular benefits of flavonoids.
本研究旨在探讨成年人总黄酮及其六个亚类的膳食摄入量与动脉粥样硬化性心血管疾病（ASCVD）风险之间的关系，并评估炎症在这种关联中的潜在中介作用。
分析纳入了3841名参与2017 - 2018年美国国家健康与营养检查调查的个体的横断面数据。使用2天膳食回顾法评估黄酮类化合物的摄入量，并通过从医疗状况问卷中提取相关信息来确定ASCVD状态。为了确定黄酮类化合物摄入量与ASCVD风险之间的关系，我们采用了逻辑回归、亚组分析、中介分析和受限立方样条分析。
黄烷 - 3 - 醇、黄酮、黄酮醇和总黄酮的摄入量与ASCVD风险呈负相关。亚组分析显示，黄酮类化合物摄入量与ASCVD风险之间的关联存在性别差异，这种关系在女性中更为明显。在吸烟者、不饮酒者、缺乏身体活动的个体、高血压患者中，观察到黄酮类化合物摄入量增加与ASCVD风险降低之间存在显著关联。总黄酮、黄烷 - 3 - 醇和黄酮醇的摄入量与ASCVD风险之间存在非线性关系。此外，发现与ASCVD相关的炎症标志物高敏C反应蛋白（hs - CRP）和中性粒细胞与淋巴细胞比值（NLR）介导了黄酮类化合物摄入量与ASCVD风险之间的关联。黄酮类化合物与hs - CRP和NLR水平的降低呈剂量反应关系。
本研究表明黄酮类化合物摄入量，特别是黄烷 - 3 - 醇、黄酮和黄酮醇，与ASCVD风险呈负相关。它强调了CRP和NLR在这种关系中的中介作用。此外，该研究强调在评估黄酮类化合物对心血管的益处时考虑生活方式因素和性别的重要性。
