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Zhang Y, Shen J, Su H, Lin C. Association between composite dietary antioxidant index and epilepsy in American population: a cross-sectional study from NHANES. BMC Public Health 2024; 24:2240. [PMID: 39154181 PMCID: PMC11330070 DOI: 10.1186/s12889-024-19794-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Epilepsy is a major global health challenge, affecting approximately 50 million people across the globe and resulting in significant economic impacts on individuals and society. Oxidative stress is implicated in the pathogenesis of epilepsy, highlighting the potential of antioxidant-rich dietary patterns in offering preventive and protective benefits by mitigating oxidative stress. The Composite Dietary Antioxidant Index (CDAI) provides a measure for assessing dietary antioxidant intake, yet its link to epilepsy remains unexplored. METHODS Our analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2013 to 2018, including 20,180 screened participants. Weighted logistic regression models were employed to examine the association between the CDAI and epilepsy prevalence. Non-linear associations were explored through restricted cubic splines (RCS), and the relationships between individual antioxidant components within the CDAI and epilepsy were also assessed. RESULTS After adjusting for potential confounders, a negative association between the CDAI and epilepsy was suggested (OR = 0.991; p = 0.087, 95% CI [0.819,1.014]). Stratification of CDAI into quartiles revealed a significantly reduced risk of epilepsy in higher CDAI quartiles (Q3 and Q4) compared to the lowest quartile (Q1) (Q3: OR = 0.419; p = 0.030, 95% CI [0.192, 0.914]; Q4: OR = 0.421; p = 0.004, 95% CI [0.239, 0.742]), with a significant trend observed across quartiles (p for trend = 0.013). RCS analysis suggested a nonlinear association between CDAI levels and epilepsy (non-linear p = 0.049), which, however, was not statistically significant after full adjustment (non-linear p = 0.103). Additionally, significant negative correlations with epilepsy were observed for vitamin A and zinc (Vitamin A: OR = 0.999; p = 0.012, 95% CI [0.998, 1.000]; Zinc: OR = 0.931; p = 0.042, 95% CI [0.869, 0.997]). CONCLUSIONS Our research indicates a correlation where higher CDAI levels correspond to a reduced risk of epilepsy. Therefore, embracing a diet rich in antioxidants could be beneficial in preventing epilepsy. This finding holds considerable potential for shaping future strategies in both epilepsy prevention and treatment.
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Affiliation(s)
- Yuhao Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Junyi Shen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Hao Su
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chunyan Lin
- Department of Teaching and Research Section of Internal Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Huang A, Huang W, Ye Y, Liu L, Wang H, Bian X, Qin Y, Guo Z, Chen W. High composite dietary antioxidant index is associated with reduced risk of kidney stones: a cross-sectional analysis of NHANES 2007-2020. Nutr Res 2024; 128:60-69. [PMID: 39059059 DOI: 10.1016/j.nutres.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/17/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024]
Abstract
The composite dietary antioxidant index (CDAI) is commonly utilized to assess antioxidant intake across diseases, but its association with kidney stones is unclear. We hypothesized that higher CDAI is associated with reduced kidney stone risk. Using National Health and Nutrition Examination Survey 2007-2020 data, we calculated CDAI based on vitamins A, C, E, selenium, zinc, and carotenoids intake in 29,280 adults. Stone formers had lower CDAI, with significant gender differences. Restricted cubic spline showed an L-shaped curve, with the steepest decline before CDAI of 1.449. In multivariate logistic regression, moderate and high CDAI tertiles were associated with reduced kidney stone odds compared to the lowest tertile (odds ratio [95% CI]): 0.85 [0.73, 0.99], P = .035 and 0.80 [0.66, 0.95], P = .014, respectively). Vitamin C had the highest negative correlation weight with kidney stones. Significant interactions were found for age and diabetes subgroups. In conclusion, higher CDAI may reduce kidney stone risk, especially with adequate vitamin C intake. Further cohort studies are warranted to confirm the causal association.
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Affiliation(s)
- Anwen Huang
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Weiyan Huang
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Yufei Ye
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Lulu Liu
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Haiyan Wang
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Xiaolu Bian
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Yingyi Qin
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Zhiyong Guo
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
| | - Wei Chen
- Department of Nephrology, First Affiliated Hospital of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China.
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Zhang L, Yin D, Zhu T, Geng L, Gan L, Ou S, Fan D. Composite dietary antioxidant index is associated with renal anemia: a cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04157-8. [PMID: 39044023 DOI: 10.1007/s11255-024-04157-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024]
Abstract
An increasing evidence suggested that chronic kidney disease (CKD) is closely related to oxidative stress, and dietary antioxidant intake can serve as a primary preventive measure for CKD. However, the relationship between composite dietary antioxidant index (CDAI) and renal anemia is not well understood. We postulated that elevated CDAI levels would be inversely related to a higher likelihood of renal anemia. The standardized calculation of CDAI was performed to investigate the relationship between them by a binary regression model. A non-linear relationship was examined through restricted cubic spline curves, and then pinpointed the inflection point. Subgroup analysis was then used to assess the robustness of the model. Finally 5880 participants were included in the study and a notable correlation between CDAI and renal anemia was found (P < 0.0001). In the multivariate linear regression model with adjustment for all confounding variables, the odds ratio (OR) and 95% confidence interval (CI) was 0.96 (0.94, 0.98; P < 0.0001), A non-linear relationship between CDAI and renal anemia was explored through restricted cubic splines, with a inflection at 6.005. Before the inflection point, for each unit rise in CDAI, the prevalence of renal anemia decreased by 5.7%. Subgroup analysis showed no statistically significant differences in interactions between any subgroups (P > 0.05). Our findings indicated a non-linear negative correlation between CDAI and renal anemia. The causal relationship still needs to be further clarified through large-scale prospective studies.
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Affiliation(s)
- Liling Zhang
- Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Defeng Yin
- Department of Emergency, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Tingting Zhu
- Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Lei Geng
- Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Linwang Gan
- Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Santao Ou
- Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
| | - Di Fan
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
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Liu S, Zhu Z, Yu K, Zhang W, Pu J, Lv Y, Tang Z, Liu F, Sun Y. The association between composite dietary antioxidant index and diabetic retinopathy in type 2 diabetic patients: evidence from the NHANES. Front Nutr 2024; 11:1399763. [PMID: 39081679 PMCID: PMC11286554 DOI: 10.3389/fnut.2024.1399763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Background Although diabetic retinopathy (DR) is closely related to dietary patterns and oxidative stress, there is little research on the relationship between the compound dietary antioxidant index (CDAI) and DR. This study aims to fill this gap by analyzing data from the National Health and Nutrition Examination Survey (NHANES) to explore the association between CDAI and DR in patients with type 2 diabetes, in order to provide a basis for dietary guidance to prevent DR. Methods Data for this study was obtained from NHANES conducted between 1999 and 2020. Information regarding dietary intake was collected through 24 h dietary recall interviews. Multivariate logistic regression analyses and restricted cubic splines (RCS) were employed to explore the association between CDAI and DR. Furthermore, subgroup analyses were conducted to further examine the relationship. Results In this study, a total of 2,158 participants were included, with a mean age of 58.87 years. After adjusting for all potential confounding factors, multivariate logistic regression analyses consistently demonstrated a negative correlation between CDAI and DR (OR = 0.94, 95%CI: 0.90-0.98, p = 0.007). Specifically, individuals in the highest quartile of CDAI had a significantly reduced risk of DR compared to those in the lowest quartile (OR = 0.51, 95%CI: 0.34-0.75, p < 0.001). The RCS analyses further confirmed the linear negative correlation between CDAI and DR (non-linear p = 0.101). Additionally, subgroup analyses provided further evidence for the robustness of this association across different subpopulations. Conclusion Our study highlights the linear negative correlation between CDAI and DR in type 2 diabetic patients. Further prospective studies are still needed in the future to confirm the role of CDAI in the risk of developing DR.
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Affiliation(s)
- Shasha Liu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Zhanfang Zhu
- Department of Internal Medicine, Xi'an Jiaotong University Hospital, Xi'an, China
| | - Kai Yu
- Department of Cardiology, Pucheng County Hospital, Weinan, China
| | - Wei Zhang
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Jie Pu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Ying Lv
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Zhiguo Tang
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fuqiang Liu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yongqiang Sun
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China
- Department of Interventional Radiography, Shanxi Provincial People's Hospital, Xi'an, China
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Jin D, Lv T, Chen S, Chen Y, Zhang C, Wang X, Li J. Association between oxidative balance score and 10-year atherosclerotic cardiovascular disease risk: results from the NHANES database. Front Nutr 2024; 11:1422946. [PMID: 39077158 PMCID: PMC11284129 DOI: 10.3389/fnut.2024.1422946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction The oxidative balance score (OBS) is a holistic measure that represents the overall equilibrium between prooxidants and antioxidants in one's diet and lifestyle. Little research has been conducted on the correlation between OBS and 10-year atherosclerotic cardiovascular disease risk (ASCVD). Therefore, the objective of this investigation was to examine the potential correlation between OBS and 10-year risk. Methods A total of 11,936 participants from the NHANES conducted between 2001 and 2016 were chosen for the study and their dietary and lifestyle factors were used to assess the OBS score. Logistic regression and restricted cubic splines (RCS) were employed in the cross-sectional study to evaluate the correlation between OBS and the 10-year ASCVD risk. The cohort study utilized Cox proportional hazards models and RCS to assess the correlation between OBS and all-causes and cardiovascular disease (CVD) mortality in individuals with high ASCVD risk. Results The cross-sectional study found that the OBS (OR = 0.94, 95% CI = 0.93-0.98), as well as the dietary OBS (OR = 0.96, 95% CI = 0.92-0.96) and lifestyle OBS (OR = 0.74, 95% CI = 0.69-0.79), were inversely associated with the 10-year ASCVD risk. A significant linear relationship was observed between OBS, dietary OBS, lifestyle OBS, and the 10-year ASCVD risk. The cohort study found that the OBS was inversely associated with all-cause (aHRs = 0.97, 95% CI = 0.96-0.99) and CVD (aHRs = 0.95, 95% CI = 0.93-0.98) mortality in individuals with high ASCVD risk. A significant linear correlation was observed between OBS, dietary OBS, lifestyle OBS, and all-cause and CVD mortality in participants with high ASCVD risk. Conclusion The findings indicate that OBS, OBS related to diet, and OBS related to lifestyle were significantly inversely correlated with the 10-year ASCVD risk. Adopting a healthy eating plan and making positive lifestyle choices that result in increased OBS levels can help lower the likelihood of all-cause and CVD mortality in individuals with high ASCVD risk.
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Affiliation(s)
- Dekui Jin
- Department of General Practice, The Third Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tian Lv
- Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang, China
| | - Shiqin Chen
- Yuhuan Second People’s Hospital, Yuhuan, China
- Department of Neurology, Second People's Hospital of Yuhuan, Yuhan, China
| | - Yiqiao Chen
- Department of Neurology, Qingtian People’s Hospital, Qingtian, Lishui, China
| | - Chengying Zhang
- Department of General Practice, The Third Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Wang
- Department of Neurology, Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Jie Li
- Department of Neurology, Lishui People's Hospital, Lishui, China
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Zhao M, Zhang D, Zhang Q, Lin Y, Cao H. Association between composite dietary antioxidant index and hyperlipidemia: a cross-sectional study from NHANES (2005-2020). Sci Rep 2024; 14:15935. [PMID: 38987566 PMCID: PMC11237065 DOI: 10.1038/s41598-024-66922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 07/05/2024] [Indexed: 07/12/2024] Open
Abstract
The association between the composite dietary antioxidant index (CDAI) and hyperlipidemia remains unclear. Therefore, this study aimed to investigate the relationship between CDAI and hyperlipidemia. The data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) dataset spanning from 2005 to 2020. Based on 24-h dietary recall interviews, the CDAI was calculated using the intake of six dietary antioxidants. Univariate and multivariate logistic regression models were employed to investigate the relationship between CDAI and the occurrence of hyperlipidemia. Additionally, restricted cubic spline (RCS) analysis was utilized to investigate potential non-linear relationships between the CDAI and risk of hyperlipidemia. The final analysis included 30,788 adults in the United States, among whom 25,525 (82.91%) were diagnosed with hyperlipidemia. A significant negative correlation was observed between the CDAI and hyperlipidemia in the unadjusted (Odds ratio [OR] 0.97 [95% CI 0.96, 0.98]) and multi-variable adjusted (OR 0.98 [95% CI 0.97, 0.99]) models. When the CDAI values were analyzed as a categorical variable, individuals in the highest quartile (OR 0.82 [95% CI 0.73, 0.92]) exhibited a nearly one fifth decreased risk of hyperlipidemia compared to those in the lowest quartile. Additionally, RCS analysis revealed a linear relationship between CDAI and hyperlipidemia (P for nonlinearity = 0.124). The results remained consistent across subgroups except for individuals under the age of 60 or those with diabetes mellitus. There was a significant negative correlation between the CDAI and risk of hyperlipidemia, indicating that maintaining an optimal CDAI level could effectively reduce the incidence of hyperlipidemia.
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Affiliation(s)
- Minli Zhao
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
| | - Danwei Zhang
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
| | - Qiuping Zhang
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
| | - Yuan Lin
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
| | - Hua Cao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Fujian Medical University, University Town, 1 Xue Yuan Road, Fuzhou, 350122, China.
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Cui A, Yan J, Zeng Y, Shi B, Cheng L, Deng H, Wei X, Zhuang Y. Association between composite dietary antioxidant and bone mineral density in children and adolescents aged 8-19 years: findings from NHANES. Sci Rep 2024; 14:15849. [PMID: 38982172 PMCID: PMC11233598 DOI: 10.1038/s41598-024-66859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 07/04/2024] [Indexed: 07/11/2024] Open
Abstract
Dietary antioxidants may have beneficial effects on bone health, but it remains uncertain in children and adolescents. This study investigates the association of composite dietary antioxidant index (CDAI) with bone mineral density (BMD) in children and adolescents aged 8-19 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. The study assessed the relationship between CDAI and BMD in 2994 individuals aged 8-19 years (average age 13.48 ± 3.32 years) from the NHANES 2007-2010. Multivariate linear regression analyses were utilized to detect the association between CDAI and total spine, femur neck, and total femur BMD, adjusting for confounders including age, race/ethnicity, sex, poverty income ratio (PIR), body mass index (BMI), serum phosphorus and calcium. Stratified analyses and interaction tests were performed to examine the stability of the results. The weighted characteristics showed that subjects in the fourth CDAI quartile were more likely to be older, men, and Non-Hispanic White. They have higher values of serum total calcium and phosphorus. After adjusting all confounders, CDAI was positively associated with the total spine (β = 0.0031 95% CI 0.0021-0.0040), total femur (β = 0.0039 95% CI 0.0028-0.0049), and femur neck BMD (β = 0.0031 95% CI 0.0021-0.0040) in children and adolescents. Furthermore, we found no interaction effects between different race/ethnicity, age, and sex groups. Our findings suggest that dietary intake of multiple antioxidants was positively associated with BMD in children and adolescents. These findings provide valuable evidence for improving bone health in the early stages of life. However, more prospective studies are required to validate our findings and their causal relationship.
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Affiliation(s)
- Aiyong Cui
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China
| | - Juan Yan
- Department of Medical Services Section, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shen'zhen, 518107, China
| | - Yuan Zeng
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China
| | - Baoqiang Shi
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China
| | - Long Cheng
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China
| | - Hongli Deng
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
| | - Xing Wei
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
| | - Yan Zhuang
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
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Kong X, Wang W. Associations between the composite dietary antioxidant index and abdominal aortic calcification among United States adults: A cross-sectional study. JPEN J Parenter Enteral Nutr 2024; 48:571-579. [PMID: 38734926 DOI: 10.1002/jpen.2638] [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: 12/04/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Oxidative stress has previously been shown to play a pivotal role in the pathogenesis of vascular calcification. In the present study, we aimed to investigate the association between the composite dietary antioxidant index (CDAI) and abdominal aortic calcification (AAC). METHODS We conducted a cross-sectional study of United States adults using data from the 2013-2014 National Health and Nutrition Examination Survey. The CDAI was calculated from vitamins A, C, E, selenium, zinc, and caretenoid through two rounds of 24-h dietary recall interviews. AAC was assessed by a lateral dual-energy x-ray absorptiometry scan of the thoraco-lumbar spine. The association between CDAI and AAC was evaluated with weighted multivariable logistic regression. RESULTS Overall, an unweighted 1081 participants were analyzed, including 110 with AAC and 971 without AAC. In the multivariable fully adjusted logistic regression model, CDAI was significantly associated with AAC (odds ratio = 0.89, 95% CI 0.81-0.98; P = 0.02). Compared with the lowest quartile, the highest quartile of CDAI was related to a 0.33-fold risk of AAC (95% CI 0.12-0.90; P = 0.03). Subgroup analysis showed that the significant association between CDAI and AAC was only observed in participants without hypertension (P for interaction = 0.002). CONCLUSION A higher CDAI was associated with a lower prevalence of AAC among adults without hypertension in the US. Further large-scale prospective studies are required to analyze the protective role of the CDAI in AAC progression.
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Affiliation(s)
- Xiufang Kong
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Wang
- Department of Nephrology, Shanghai Tenth People's Hospital, Shanghai, China
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Wang R, Tao W, Cheng X. Association of composite dietary antioxidant index with cardiovascular disease in adults: results from 2011 to 2020 NHANES. Front Cardiovasc Med 2024; 11:1379871. [PMID: 39006166 PMCID: PMC11239507 DOI: 10.3389/fcvm.2024.1379871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/13/2024] [Indexed: 07/16/2024] Open
Abstract
Background Oxidative stress is a known pathogenic mechanism in cardiovascular disease (CVD), yet the association between dietary antioxidants and CVD in the general population remains underexplored. This study leverages data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association of a composite dietary antioxidant index with CVD in US adults. Methods Analyzing data from 25,997 adults (2011-2020 NHANES), we employed weighted generalized linear models, subgroup analysis, threshold effect analyses, and sensitivity analysis to assess the association between dietary antioxidants and CVD. Nonlinear associations were explored through a restricted cubic spline, with gender-specific stratification and threshold effect analysis to identify critical inflection points. Results Increasing levels of the composite dietary antioxidant index corresponded with decreased CVD prevalence (P < 0.001). In all models, weighted generalized linear models revealed a consistent negative association between CVD prevalence. And in Model 3, Quartile 4 had a 29% lower CVD prevalence than Quartile 1[0.71 (0.59, 0.85), P < 0.001]. Meanwhile, the findings of the unweighted logistic regression model demonstrated stability. Various characteristics such as sex, age, race, PIR, education, BMI, alcohol consumption, hypertension, hyperlipidemia, and diabetes did not influence this inverse association (P for interaction >0.05). Notably a nonlinear association was observed, with a significant inflection point at 3.05 among women. Conclusion This study demonstrates a strong negative association between the composite dietary antioxidant index and CVD prevalence, suggesting the potential protective role of dietary antioxidants. These findings underscore the need for prospective studies to further understand the impact of oxidative stress on cardiovascular health.
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Affiliation(s)
| | | | - Xiaobing Cheng
- Department of Cardiology, The Third People’s Hospital of Hefei, Hefei, Anhui, China
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10
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Zhu H, Chen Y, Feng Y, Chen H. Association between the composite dietary antioxidant index and the prevalence and recurrence of kidney stones: results of a nationwide survey. Front Nutr 2024; 11:1413937. [PMID: 38962435 PMCID: PMC11220257 DOI: 10.3389/fnut.2024.1413937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Aim This study aims to evaluate the relationship between the Composite Dietary Antioxidant Index (CDAI) and the prevalence and recurrence of kidney stones. Methods Data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2014 were used in this cross-sectional analysis. The CDAI was derived by standardizing the intake of dietary antioxidants from 24 h dietary recalls. The study assessed the prevalence and recurrence of kidney stones based on questionnaire responses. The association between the CDAI and both the prevalence and recurrence of kidney stones was investigated using multivariable logistic regression. Subgroup analyses and interaction tests further evaluated the robustness of this relationship. Results The study included 20,743 participants, and the reported incidence and recurrence rates of kidney stones were 9.09 and 2.90%, respectively. After stratifying the CDAI into tertiles, an inverse trend was observed in both kidney stones' prevalence and recurrence probabilities with increasing CDAI levels. Adjusting for confounding factors, individuals in the top tertile had a 23% lower prevalence of kidney stones (OR = 0.77, 95% CI: 0.66, 0.90, p = 0.0011) and a 39% lower recurrence rate (OR = 0.61, 95% CI: 0.47, 0.80, p = 0.0003) than those in the bottom tertile. In addition, interaction tests showed that age, gender, body mass index, hypertension, and diabetes did not significantly affect the relationship between CDAI levels and kidney stone prevalence and recurrence rates. Conclusion Our study suggests that increased levels of CDAI are associated with reduced incidence and recurrence rates of kidney stones. Therefore, increasing the intake of dietary antioxidants may be an effective strategy for preventing kidney stones and their recurrence.
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Affiliation(s)
| | | | - Yue Feng
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hui Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
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11
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Min X, Kong X, Wang W. L-Shaped Associations Between Composite Dietary Antioxidant Index and Hearing Loss: A Cross-Sectional Study From the National Health and Nutrition Examination Survey. Biol Res Nurs 2024:10998004241261400. [PMID: 38869482 DOI: 10.1177/10998004241261400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Oxidative stress has been implicated in the pathogenesis of hearing loss (HL). Dietary intake is a modifiable factor that could influence the oxidant and antioxidant capacity. We hypothesized that a higher composite dietary antioxidant index (CDAI) is associated with a reduced odds for HL. METHODS Adult participants from the 2001-2012 & 2015-2018 National Health and Nutrition Examination Study were included in this cross-sectional study. The CDAI was calculated from vitamins A, C, E, selenium, zinc, and caretenoid through 24-h dietary recall. Outcomes were HL, speech frequency HL (SFHL), and high frequency HL (HFHL). The associations between CDAI and HL, SFHL, and HFHL were evaluated by weighted multivariable logistic regression. RESULTS CDAI was associated with lower odds of HL (OR = 0.98, 95%CI 0.95-1.00, p = .043) and SFHL (OR = 0.97, 95%CI 0.95-1.00, p = .041), but not HFHL (OR = 0.98, 95%CI 0.96-1.00, p = .118) after adjustment for confounders. The multivariable-adjusted model showed a significant trend toward decreased risk of HL, SFHL, and HFHL with increasing CDAI quartile (all p for trend < 0.05). Restricted cubic spline analysis suggested that the associations between CDAI and HL, SFHL, and HFHL were L-shaped, with inflection points of CDAI at -0.61, 2.33, and 4.32, respectively. Subgroup analysis showed that participants with exposure to loud noise benefited from a higher CDAI for SFHL (p for interaction = 0.039). CONCLUSION Higher CDAI is associated with reduced odds of HL and SFHL in the U.S. adult population and serves as a promising intervention target to be further explored in prospective longitudinal studies in the future.
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Affiliation(s)
- Xinting Min
- Department of Otolaryngology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xiufang Kong
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Wang
- Department of Nephrology, Shanghai Tenth People's Hospital, Shanghai, China
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Li X, Hu X, You C. Interactive effects of Composite Dietary Antioxidant Index with Body Mass Index for the risk of stroke among U.S. adults: insight from NHANES 2001-2018. Front Nutr 2024; 11:1378479. [PMID: 38912299 PMCID: PMC11190190 DOI: 10.3389/fnut.2024.1378479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/28/2024] [Indexed: 06/25/2024] Open
Abstract
Background This cross-sectional study aims to explore the interactive effects of the Composite Dietary Antioxidant Index (CDAI) and Body Mass Index (BMI) on stroke risk among U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018. Methods The analysis involved 42,042 participants from a representative sample of non-institutionalized U.S. civilians, selected through a stratified, multistage probability sampling method. Dietary intake data were collected over two 24-h periods using the Automated Multiple-Pass Method. The study calculated a modified CDAI to assess dietary antioxidant intake, excluding supplements and water sources. Statistical methods included multivariable logistic regression and Generalized Additive Models (GAM) to evaluate the interaction between CDAI scores and BMI in relation to stroke risk, adjusting for a wide range of demographic, lifestyle, and health covariates. Results The research identified a significant interaction between CDAI scores and BMI categories in stroke risk assessment. While a negative correlation was observed between CDAI scores and stroke risk across the total population (OR 0.97, 95% CI 0.96-0.99), this relationship varied notably across different BMI groups. In participants with a BMI ≥25, a statistically significant negative association persisted, displaying a non-linear pattern. The study also revealed an inflection point in the CDAI score, indicating a shift in the relationship between dietary antioxidants and stroke risk. Conclusion This study underscores the complex interaction between dietary antioxidant intake and BMI in determining stroke risk among U.S. adults. The findings suggest that individuals with higher BMI may experience more pronounced benefits from dietary antioxidants in stroke prevention. These insights could inform targeted dietary recommendations and public health strategies aimed at reducing stroke risk, particularly in populations with higher BMI. Further research is needed to fully understand these interactions and their implications for stroke prevention guidelines.
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Affiliation(s)
- Xi Li
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Hu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chao You
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Najar M, Khalili P, Ayoobi F, Rezaei Poor M, Vatankhah H, Pourmirzaei Olyaei H, Vazirinejad R, Jamali Z. Dietary antioxidants and hypertension among menopausal women in Rafsanjan Cohort Study. Sci Rep 2024; 14:12703. [PMID: 38830913 PMCID: PMC11148154 DOI: 10.1038/s41598-024-63401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
Studies on the beneficial role of dietary antioxidants in preventing or managing hypertension in postmenopausal women are infrequent. The present cross-sectional study aimed to assess the association between dietary antioxidants and hypertension among menopausal women in Rafsanjan, a city located in the southeast of Iran. This study was based on data from the Rafsanjan Cohort Study (RCS), as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Among 2359 postmenopausal women, finally, 1936 women were included in this study. Participants were grouped as having normal blood pressure (BP), elevated BP, stage 1 hypertension, or stage 2 hypertension as defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline. A food frequency questionnaire (FFQ), was utilized to ascertain the levels of various nutrients and dietary antioxidants in the diet. The association between dietary intakes of antioxidants and blood pressure groups was evaluated by crude and adjusted models in the multinominal logistics regression analysis. Normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension were observed in 35.69%, 3.62%, 10.59%, and 50.10% of postmenopausal women respectively. In the adjusted model, in subjects with higher consumption of β-carotene, the odds ratios of elevated BP in the 3rd quartile was about 2 times (OR: 2.04 (1.06-3.93) higher than 1st quartile. Also, in subjects with medium quality of DAQS, the odds ratios of elevated BP and stage 1 blood pressure were about 2 times (OR: 2.09 (1.05-4.17) and 1.69 times (OR: 1.69 (1.09-2.63) higher than subjects with low quality respectively. Furthermore, we did not find any statistically significant association between increased intake of dietary antioxidants and decreased odds of hypertension. After controlling the effects of confounding variables, increased dietary intake of selenium, carotenoids, vitamin A, vitamin C, and vitamin E did not decrease the odds of hypertension in postmenopausal women. Accordingly, it is suggested that this association be further investigated in the follow-up phase of this prospective study.
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Affiliation(s)
- Marzieh Najar
- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohadese Rezaei Poor
- Clinical Research Development Unit (CRDU), Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hajar Vatankhah
- Department of Obstetrics and Gynecology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Reza Vazirinejad
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Li X, Chen Y, Liu B, Ye M, Liu B, Lu L, Guo R. Associations Between Estimated Pulse Wave Velocity and Five-Year All-Cause Mortality in Patients with Atherosclerotic Cardiovascular Disease with and without Standard Modifiable Risk Factors: Evidence From NHANES 1999-2016. Clin Epidemiol 2024; 16:367-377. [PMID: 38827433 PMCID: PMC11144008 DOI: 10.2147/clep.s457054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024] Open
Abstract
Aim The study aimed to analyze the associations between estimated pulse wave velocity (ePWV) and 5-year mortality in atherosclerotic cardiovascular disease (ASCVD) patients with and without standard modifiable risk factors (SMuRFs), which included smoking status, hypertension, diabetes, and hypercholesterolemia. Methods The present retrospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016. Patients with ASCVD who completed both the questionnaire survey and serum testing were included. Patients were categorized into the ≥1 SMuRF group if they had at least one SMuRF, while those without any SMuRFs were classified into the SMuRF-less group. The ePWV, which was calculated using the age and mean blood pressure, was evenly divided into three categories: low (Q1), medium (Q2), and high (Q3). Multivariable weighted Cox proportional-hazard regression analyses were utilized to explore the risk factors associated with 5-year mortality in patients with and without SMuRFs. And restricted cubic spline curve (RCS) was used to assess their nonlinear correlation. Results A total of 1901 patients with ASCVD were included in the study. For the patients in ≥1 SMuRF group, the Q3 group included patients who were older, with a higher proportion of males, more comorbidities, and a lower body mass index than the Q1 group (P<0.05). The Cox proportional-hazard regression model results revealed, the Q3 group had a higher risk of 5-year mortality than the Q1 group [hazard ratio (HR) 4.30, 95% confidence interval (CI) (2.66, 6.95), P<0.001]. RCS demonstrated a linear trend between high level of ePWV and decreased risks of mortality. Similar results were observed in the SMuRF-less group [HR 10.62, 95% CI (1.22, 92.06), P=0.032]. Conclusion A high level of ePWV signified a higher risk of 5-year mortality in ASCVD patients with and without SMuRFs.
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Affiliation(s)
- Xicong Li
- Department of Cardiovascular, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Department of Cardiovascular, 920th Hospital of Joint Logistics Support Force, Chinese People’s Liberation Army (PLA), Kunming, Yunnan, People’s Republic of China
| | - Yubiao Chen
- Department of Respiratory Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Baiyun Liu
- Department of Respiratory Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Mingyuan Ye
- Department of Otolaryngology, Zhuhai Maternity and Child Health Hospital, Zhuhai, Guangdong, People’s Republic of China
| | - Bei Liu
- Department of Cardiovascular, 920th Hospital of Joint Logistics Support Force, Chinese People’s Liberation Army (PLA), Kunming, Yunnan, People’s Republic of China
| | - Lifei Lu
- Department of Respiratory Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Ruiwei Guo
- Department of Cardiovascular, 920th Hospital of Joint Logistics Support Force, Chinese People’s Liberation Army (PLA), Kunming, Yunnan, People’s Republic of China
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15
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Qiao Q, Liu X, Xue W, Chen L, Hou X. Analysis of the association between high antioxidant diet and lifestyle habits and diabetic retinopathy based on NHANES cross-sectional study. Sci Rep 2024; 14:11868. [PMID: 38789523 PMCID: PMC11126608 DOI: 10.1038/s41598-024-62707-7] [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: 01/10/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
Oxidative stress plays a crucial role in increasing the risk of developing diabetic retinopathy (DR). The oxidative balance score (OBS) and the composite dietary antioxidant index (CDAI) are two tools for assessing the effects of diet and lifestyle on oxidative stress. The aim of this study was to investigate the association between OBS, CDAI and the occurrence of DR. After controlling for potential confounders, OBS was negatively associated with DR with an odds ratio (OR) of 0.976 and a 95% confidence interval (CI) of 0.956-0.996, suggesting that for every unit increase in OBS, the risk of DR was reduced by 2.4%. In contrast, the relationship between OBS and CDAI was not significant (P > 0.05), suggesting that it was OBS, not CDAI, that contributed to the reduced risk of diabetic retinopathy. After adjusting for potential confounders, OBS was negatively associated with DR (OR: 0.976; 95% CI 0.956-0.996), but this association was not found in CDAI (P > 0.05), suggesting that for every one-unit increase in OBS, there was a 2.4% reduction in the risk of developing DR. This study suggests that a diet and lifestyle high in OBS reduces the risk of developing DR, which provides a rationale for nutritional interventions to prevent DR.
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Affiliation(s)
- Qincheng Qiao
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
- The First Clinical Medical College, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xingjian Liu
- The First Clinical Medical College, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wen Xue
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Li Chen
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine and Health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Xinguo Hou
- Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China.
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, China.
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine and Health, Jinan, China.
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China.
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Yang M, Miao S, Hu W, Yan J. Association between the dietary inflammatory index and all-cause and cardiovascular mortality in patients with atherosclerotic cardiovascular disease. Nutr Metab Cardiovasc Dis 2024; 34:1046-1053. [PMID: 38218715 DOI: 10.1016/j.numecd.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/04/2023] [Accepted: 11/24/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide. Inflammation is pivotal in atherosclerosis development. The dietary inflammatory index (DII) is a tool to quantify the overall inflammatory potential of diet. The association between DII and all-cause and cardiovascular mortality in ASCVD patients remains undetermined. METHODS AND RESULTS Participants included individuals with ASCVD from the National Health and Nutrition Examination Survey from 1999 to 2018. A total of 5006 participants were included, during a median of 6.6 years of follow-up, of which 2220 (44.4 %) were dead. The Cox proportional hazard model evaluated the association between DII and all-cause and cardiovascular mortality. Participants in the higher DII quartile exhibited a higher mortality of ASCVD. Compared with the patients in quartile 1, those in quartile 4 had a 34 % increased risk for all-cause mortality (HR = 1.34, 95 % CI = 1.21-1.61, p = 0.001). Cardiovascular mortality showed a similar trend, however the correlation is not significant. The restricted cubic spline (RCS) showed that the relationship between DII and all-cause and cardiovascular mortality was linear. Subgroup analysis revealed a persistently positive association between DII and all-causemortality across population subgroups. However, an interaction was detected between DII and alcohol history in relation to cardiovascular mortality. CONCLUSION DII was positively correlated with the all-cause mortality of ASCVD patients. The intake of a pro-inflammatory diet may increase mortality in ASCVD patients.
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Affiliation(s)
- Mingkun Yang
- Department of Second Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, Zhejiang, China
| | - Shenhui Miao
- Department of Critical Care Medicine, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, YiWu 322000, China
| | - Weihang Hu
- Department of Critical Care Medicine, Zhejiang Hospital, Lingyin Road 12, Hangzhou 310013, Zhejiang, China
| | - Jing Yan
- Department of Critical Care Medicine, Zhejiang Hospital, Lingyin Road 12, Hangzhou 310013, Zhejiang, China.
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Wang R, Gao K, Wang L, Gong X, Wu Y, Zheng L, Han S, Li L, Xue M. A cross-sectional study exploring the relationship between oxidative balance score and 10-year atherosclerotic cardiovascular disease risk based on the National Health and Nutrition Examination Survey (2011-2020). Diab Vasc Dis Res 2024; 21:14791641241244658. [PMID: 38597578 PMCID: PMC11008352 DOI: 10.1177/14791641241244658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The intricate interaction between oxidative stress and atherosclerotic cardiovascular disease (ASCVD) is an essential area of research because of the potential role of oxidative homeostasis in regulating ASCVD risk. This study aimed to investigate the relationship between the oxidative balance score (OBS) and the 10-years risk of ASCVD to gain insight into how oxidative balance affects cardiovascular health. METHODS This cross-sectional study analyzed National Health and Nutrition Examination Survey (NHANES) 2011-2020 data (40-79 age group), exploring OBS's link to 10-years ASCVD risk. OBS categorized dietary and lifestyle factors. Multivariate logistic regression controlled for age, sex, race, and demographics. A restricted cubic spline examined linear relationships; robustness was ensured through subgroup analyses. RESULTS Analysis of 4955 participants reveals a negative association between OBS and 10-years ASCVD risk. Continuous OBS adjusted OR: 0.97 (95% CI: 0.95∼0.99, p < .001). Quartile analysis shows reduced risk in Q2 0.88 (95% CI: 0.63∼1.22, p = .43), Q3 0.92 (95% CI: 0.66∼1.28, p = .614), and Q4 0.59 (95% CI: 0.42∼0.83, p = .002) compare Q1. Quartile analysis indicated decreasing risk in higher OBS quartiles. Lifestyle OBS and Dietary OBS demonstrated similar trends. Stratified analyses highlight race and hypertension as effect modifiers (p < .05). CONCLUSION Our study suggests an association between higher OBS and a reduced 10-years ASCVD risk. However, causation should not be inferred, and in the future, more extensive clinical and fundamental research is required to delve deeper into this association.
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Affiliation(s)
- Rumeng Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kun Gao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lianhua Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao Gong
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanyan Wu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liying Zheng
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Senfu Han
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lizhi Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mei Xue
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Mao J, Zhao Y, Hu H, Zhou M, Yang X. An L-shaped association between composite dietary antioxidant index and stroke: Evidence from NHANES 2011-2020. J Stroke Cerebrovasc Dis 2024; 33:107578. [PMID: 38232583 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES Antioxidant diets are considered to be protective factors against stroke. However, comprehensive measurement and evaluation of antioxidant diets are lacking. This study aimed to investigate the correlation between the Composite Dietary Antioxidant Index (CDAI) and stroke in adults. MATERIALS AND METHODS In this study, based on the National Health and Nutrition Examination Survey (NHANES) 2011-2020 data, multivariate logistic regression, smoothing curve fitting, and threshold effect analysis were used to explore the relationship between CDAI and stroke. Subgroup analyses and interaction tests were conducted to assess the stability of this association within the population. RESULTS Among 12,922 U.S. adults, there was a significant negative correlation between CDAI and the prevalence of stroke. In the fully adjusted model, the risk of stroke was reduced by 4 % for each 1-unit increase in CDAI (OR [95% CI] = 0.96 [0.93, 0.99]). Participants in the highest quartile of the CDAI had a 37 % lower risk of stroke than those in the lowest quartile (OR [95% CI] = 0.63 [0.47, 0.84]). This negative correlation remained stable across subgroups. Furthermore, the study revealed an L-shaped association between CDAI and stroke through smoothing curve fitting. The threshold effect analysis further identified the inflection point as -1.55. CONCLUSIONS This study revealed an L-shaped relationship between CDAI and stroke. Keeping CDAI in the proper range may help prevent stroke in the general population.
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Affiliation(s)
- Jiesheng Mao
- Postgraduate Training Base Alliance of Wenzhou Medical University (Wenzhou People's Hospital), China
| | - Yunhan Zhao
- Postgraduate Training Base Alliance of Wenzhou Medical University (Wenzhou People's Hospital), China
| | - Haoxiang Hu
- Postgraduate Training Base Alliance of Wenzhou Medical University (Wenzhou People's Hospital), China
| | - Mi Zhou
- Third Affiliated Hospital, School of Medicine, Shanghai University, Shanghai 200444, China
| | - Xiaokai Yang
- Postgraduate Training Base Alliance of Wenzhou Medical University (Wenzhou People's Hospital), China.
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Mao J, Hu H, Zhao Y, Zhou M, Yang X. Association Between Composite Dietary Antioxidant Index and Cognitive Function Among Aging Americans from NHANES 2011-2014. J Alzheimers Dis 2024; 98:1377-1389. [PMID: 38578890 DOI: 10.3233/jad-231189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Background Antioxidant diets are considered to be protective factors for cognitive function. However, comprehensive measures of antioxidant diets are lacking. Objective To examine the association between the Composite Dietary Antioxidant Index (CDAI) and cognitive function in the elderly. Methods This cross-sectional study included a total of 2,456 participants (≥60 years old) from NHANES 2011-2014. Calculation of CDAI based on 6 minerals and vitamins (manganese, selenium, zinc, vitamins A, C, and E). Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning sub-test, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). We also created a composite cognitive z-score to represent global cognition. The statistical analyses we used included multiple linear regression analyses, subgroup analyses, curve-fitting analyses, and threshold effects analyses. Results After controlling for demographic characteristics, lifestyle factors, and disease history, multivariate linear regression analyses showed that increased CDAI was positively associated with scores on global cognitive function and each cognitive domain (p < 0.05), with subgroup analyses suggesting that this association was more pronounced in stroke patients (p for interaction < 0.05). Curve-fitting analyses and threshold effect analyses showed saturation effects between CDAI and CREAD Test, AFT, and composite Z-score, and an inverted U-shaped relationship with DSST, with inflection points of -1.89, 0.79, 1.13, and 1.77, respectively. Conclusions Our findings support that higher levels of CDAI are correlated with significantly elevated cognitive function. Maintaining CDAI in an appropriate range may contribute to cognitive health in elderly.
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Affiliation(s)
- Jiesheng Mao
- Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Zhejiang, China
| | - Haoxiang Hu
- Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Zhejiang, China
| | - Yunhan Zhao
- Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Zhejiang, China
| | - Mi Zhou
- Third Affiliated Hospital, School of Medicine, Shanghai University, Shanghai, China
| | - Xiaokai Yang
- Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Zhejiang, China
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