1999 - 2004年美国成年人中植物性饮食与亚临床心血管疾病的关联
Association of plant-based diets with subclinical cardiovascular disease in U.S. adults, 1999-2004.
作者信息
Ting Audrey, Wallace Amelia S, Rooney Mary R, Kim Hyunju, Sullivan Valerie K, Selvin Elizabeth, Rebholz Casey M
机构信息
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore 21205, MD, USA.
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, 2024 E. Monument Street, Baltimore 21205, MD, USA.
出版信息
Am J Prev Cardiol. 2025 Jun 9;23:101029. doi: 10.1016/j.ajpc.2025.101029. eCollection 2025 Sep.
BACKGROUND
Dietary patterns currently recommended for cardiovascular health often emphasize the consumption of plant foods.
METHODS
We included 7,708 participants from the National Health and Nutrition Examination Survey 1999-2004 aged ≥20 years who were not pregnant and did not have a self-reported history of cardiovascular disease. Dietary intake was assessed using a 24-hour dietary recall. All plant-based dietary indices [overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI)] were analyzed by quartiles and cardiac biomarkers [cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] were categorized as elevated versus non-elevated using clinical cutpoints. We used logistic regression models progressively adjusted for confounders to study the associations between each plant-based diet index and elevated cardiac biomarkers. All analyses used appropriate survey weights to account for the complex study design.
RESULTS
Mean age was 45 years old, 46 % were male, and 74 % were non-Hispanic White. After adjustment for sociodemographic characteristics, lifestyle behaviors, and measures of health status, there was an inverse association between adherence to hPDI (quartile 4 vs. quartile 1) and elevated cTnI (OR: 0.52, 95 % CI: 0.30, 0.90; p-trend <0.01) and a positive association between uPDI and elevated cTnI (OR for quartile 4 vs. 1: 1.65, 95 % CI: 1.10, 2.46; p-trend=0.04). There were no significant associations between plant-based diet indices and elevated cTnT or NT-proBNP.
CONCLUSION
Higher adherence to a healthy plant-based diet was inversely associated with elevated cTnI and higher adherence to an unhealthy plant-based diet was positively associated with elevated cTnI in a nationally representative sample of U.S. adults. Supporting access to and adoption of healthy plant-based diets may be a useful strategy for promoting population-level cardiovascular health.
背景
目前推荐的对心血管健康有益的饮食模式通常强调植物性食物的摄入。
方法
我们纳入了1999 - 2004年美国国家健康与营养检查调查中年龄≥20岁、未怀孕且无心血管疾病自我报告病史的7708名参与者。采用24小时饮食回顾法评估饮食摄入量。所有基于植物的饮食指数[总体基于植物的饮食指数（PDI）、健康PDI（hPDI）和不健康PDI（uPDI）]按四分位数进行分析，心脏生物标志物[心肌肌钙蛋白T（cTnT）、心肌肌钙蛋白I（cTnI）和N末端B型利钠肽原（NT-proBNP）]根据临床切点分为升高与未升高两类。我们使用逐步调整混杂因素的逻辑回归模型来研究每个基于植物的饮食指数与升高的心脏生物标志物之间的关联。所有分析均使用适当的调查权重以考虑复杂的研究设计。
结果
平均年龄为45岁，46%为男性，74%为非西班牙裔白人。在对社会人口学特征、生活方式行为和健康状况指标进行调整后，坚持hPDI（四分位数4与四分位数1相比）与cTnI升高之间存在负相关（比值比：0.52，95%置信区间：0.30，0.90；p趋势<0.01），uPDI与cTnI升高之间存在正相关（四分位数4与1相比的比值比：1.65，95%置信区间：1.10，2.46；p趋势 = 0.04）。基于植物的饮食指数与cTnT或NT-proBNP升高之间无显著关联。
结论
在美国成年人的全国代表性样本中，更高程度地坚持健康的植物性饮食与cTnI升高呈负相关，而更高程度地坚持不健康的植物性饮食与cTnI升高呈正相关。支持获取和采用健康的植物性饮食可能是促进人群心血管健康的一项有用策略。
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