Zhang Yajie, Liu Yingying, Qiao Huiquan, Ma Qiongqiong, Zhao Bing, Wu Qian, Li Hongyu
Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Biomedical Sciences, Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Front Nutr. 2025 Apr 23;12:1574876. doi: 10.3389/fnut.2025.1574876. eCollection 2025.
This research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.
A cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan-Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators-specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR- in the connection between CDAI and mortality.
The mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92-0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93-0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.
A higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.
本研究调查了复合膳食抗氧化指数（CDAI）与老年高血压患者心血管疾病（CVD）发生风险及死亡率之间的关系。利用美国国家健康与营养检查调查（NHANES）的数据，研究甘油三酯-葡萄糖（TyG）指数在这些关系中的潜在中介作用。
从NHANES数据库中提取了5276名年龄在65岁及以上且被诊断为高血压的参与者组成队列。主要观察指标为CVD发生风险及死亡率，数据来自美国国家卫生统计中心（NCHS）。采用多变量逻辑回归模型评估CDAI与CVD之间的关系。采用Cox比例风险回归模型和Kaplan-Meier生存曲线分析CDAI与死亡率之间的关系。进行中介分析，以评估TyG相关指标（具体为TyG、TyG-BMI、TyG-WC和TyG-WHtR）在CDAI与死亡率之间关系中的潜在中介作用。
研究参与者的平均CDAI为1.88±3.90，平均年龄为74.15±5.96岁。在平均109.51个月的随访期间，观察到4712例CVD病例和725例死亡记录。在完全调整模型中，CDAI与CVD（比值比[OR]=0.94，95%置信区间[CI]=0.92-0.97）和死亡率（风险比[HR]=0.95，95%CI=0.93-0.97）均呈负相关。中介分析表明，TyG-BMI、TyG-WC和TyG-WHtR指数分别占CDAI与死亡率之间关系的33.1%、34.3%和19.1%。
较高的CDAI与老年高血压患者的CVD及死亡率呈负相关。这种关系部分由TyG相关指数介导，表明增加抗氧化剂摄入量可能改善该人群的健康结局并降低不良预后风险。
