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Wen X, Fretts AM, Miao G, Malloy KM, Zhang Y, Umans JG, Cole SA, Best LG, Fiehn O, Zhao J. Plasma lipidomic markers of diet quality are associated with incident coronary heart disease in American Indian adults: the Strong Heart Family Study. Am J Clin Nutr 2024; 119:748-755. [PMID: 38160800 DOI: 10.1016/j.ajcnut.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Identifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet- coronary heart disease (CHD) association. OBJECTIVES This study aimed to identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. METHODS Using liquid chromatography-mass spectrometry, we measured 1542 lipid species from 1694 American Indian adults (aged 18-75 years, 62% female) in the Strong Heart Family Study. Participants were followed up for development of CHD through 2020. Information on the past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed-effects linear regression was used to identify individual lipids cross-sectionally associated with AHEI. In prospective analysis, Cox frailty model was used to estimate the hazard ratio (HR) of each AHEI-related lipid for incident CHD. All models were adjusted for age, sex, center, education, body mass index, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Multiple testing was controlled at a false discovery rate of <0.05. RESULTS Among 1542 lipid species measured, 71 lipid species (23 known), including acylcarnitine, cholesterol esters, glycerophospholipids, sphingomyelins and triacylglycerols, were associated with AHEI. Most of the identified lipids were associated with consumption of ω-3 (n-3) fatty acids. In total, 147 participants developed CHD during a mean follow-up of 17.8 years. Among the diet-related lipids, 10 lipids [5 known: cholesterol ester (CE)(22:5)B, phosphatidylcholine (PC)(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4)B, phosphatidylethanolamine (PE)(p-18:0/20:4)/PE(o-18:0/20:4), and sphingomyelin (d36:2)A] were associated with incident CHD. On average, each standard deviation increase in the baseline level of these 5 lipids was associated with 17%-23% increased risk of CHD (from HR: 1.17; 95% CI: 1, 1.36; to HR: 1.23; 95% CI: 1.05, 1.43). CONCLUSIONS In this study, lipidomic markers of diet quality in American Indian adults are found. Some diet-related lipids are associated with risk of CHD beyond established risk factors.
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Affiliation(s)
- Xiaoxiao Wen
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Guanhong Miao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States
| | - Kimberly M Malloy
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ying Zhang
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jason G Umans
- Biomarker, Biochemistry, and Biorepository Core, MedStar Health Research Institute, Hyattsville, MD, United States; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, United States
| | - Shelley A Cole
- Population Health, Texas Biomedical Research Institute, San Antonio, TX, United States
| | - Lyle G Best
- Missouri Breaks Industries Research, Timber Lake, SD, United States
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California-Davis, Davis, CA, United States
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States.
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