Tong Tammy Yn, Li Yanping, Rexrode Kathryn M, Willett Walter C, Sun Qi, Manson JoAnn E, Longo Valter D, Key Timothy J, Hu Frank B
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
J Nutr. 2025 May;155(5):1560-1569. doi: 10.1016/j.tjnut.2025.03.026. Epub 2025 Mar 22.
Differences in dietary protein have been associated with stroke risk, with possible heterogeneity in associations by stroke type or food sources of protein.
We examined the associations of individual dietary amino acids, as the constituents of dietary protein, with risks of ischemic, hemorrhagic, and total stroke.
We analyzed data from 73,830 females in the Nurses' Health Study (1984-2012), 92,333 females in the Nurses' Health Study II (1991-2013), and 43,268 males in the Health Professionals Follow-Up Study (1986-2016). Dietary intakes of 22 (20 standard and 2 nonstandard) amino acids were assessed using validated food frequency questionnaires, administered typically every 4 y. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischemic, hemorrhagic, and total stroke in relation to the energy-adjusted intakes of individual amino acids.
During a mean follow-up of 23.7 y, 3058 ischemic, 872 hemorrhagic, and 5997 total stroke cases were documented. After correction for multiple testing, lower risks of ischemic stroke were observed with higher intakes of glutamine (HR per 1 standard deviation higher: 0.94, 95% CI: 0.90, 0.98, P = 0.004) and proline (0.94, 0.90, 0.98, P = 0.005). The associations remained directionally consistent across sensitivity analyses but attenuated upon mutual adjustment. All other amino acids, including branched-chain amino acids, were not significantly associated with ischemic stroke. For hemorrhagic stroke, no significant associations were observed for any of the amino acids. For total stroke, inverse associations were also observed for both glutamine (0.94, 0.91-0.97, P < 0.001) and proline (0.96, 0.93-0.99, P = 0.004). In terms of dietary sources, glutamine was most strongly correlated with plant protein and whole grains, whereas proline was most strongly correlated with dairy protein and dairy products.
Higher intakes of glutamine and proline were associated with lower risks of ischemic and total stroke.
膳食蛋白质的差异与中风风险相关，不同类型中风或蛋白质食物来源的关联可能存在异质性。
我们研究了作为膳食蛋白质组成成分的个体膳食氨基酸与缺血性、出血性和总体中风风险的关联。
我们分析了护士健康研究（1984 - 2012年）中73830名女性、护士健康研究II（1991 - 2013年）中92333名女性以及健康专业人员随访研究（1986 - 2016年）中43268名男性的数据。使用经过验证的食物频率问卷评估22种（20种标准和2种非标准）氨基酸的膳食摄入量，通常每4年进行一次评估。多变量调整的Cox回归模型用于估计与个体氨基酸能量调整摄入量相关的缺血性、出血性和总体中风的风险比（HRs）及95%置信区间（CIs）。
在平均23.7年的随访期间，记录了3058例缺血性中风、872例出血性中风和5997例总体中风病例。在进行多重检验校正后，观察到谷氨酰胺摄入量较高时缺血性中风风险较低（每增加1个标准差的HR：0.94，95%CI：0.90，0.98，P = 0.004），脯氨酸摄入量较高时也有类似情况（0.94，0.90，0.98，P = 0.005）。在敏感性分析中，这些关联在方向上保持一致，但在相互调整后减弱。所有其他氨基酸，包括支链氨基酸，与缺血性中风均无显著关联。对于出血性中风，未观察到任何氨基酸与之有显著关联。对于总体中风，谷氨酰胺（0.94，0.91 - 0.97，P < 0.001）和脯氨酸（0.96，0.93 - 0.99，P = 0.004）也呈现负相关。在膳食来源方面，谷氨酰胺与植物蛋白和全谷物的相关性最强，而脯氨酸与乳制品蛋白和乳制品的相关性最强。
较高的谷氨酰胺和脯氨酸摄入量与较低的缺血性和总体中风风险相关。
