背景:EAT-Lancet委员会提出的坚持行星健康饮食(PHD)对心血管疾病(CVD)的影响尚无定论。此外,对CVD的遗传易感性是否能改变PHD与CVD的相关性尚不清楚.
目的:我们旨在调查PHD依从性与CVD之间的关系,并评估PHD与CVD遗传易感性之间的相互作用。
方法:这项研究包括114,165名参与者,他们完成了至少两次24小时饮食回顾,并且最初没有来自英国生物库的心血管疾病。计算PHD评分以评估对PHD的依从性。使用多基因风险评分评估遗传风险。总CVD发生率,缺血性心脏病(IHD),心房颤动(AF),心力衰竭(HF),中风是通过电子健康记录识别的。Cox比例风险回归模型用于估计风险比(HR)和95%置信区间(CI)。
结果:在9.9年的中位随访中,记录了10,071例(8.8%)CVD事件。与PHD依从性最低的参与者相比,总CVD的HR(95%CI),IHD,AF,HF,依从性最高的患者中的卒中为0.79(0.74,0.84),0.73(0.67,0.79),0.90(0.82,0.99),0.69(0.59,0.82),和0.88(0.75,1.04),分别。在CVD和PHD的遗传风险之间没有观察到显著的相互作用。具有高遗传风险和低PHD评分的参与者,与低遗传风险和高PHD评分的人群相比,有48%(95%CI,40%,56%)发生CVD的风险较高。对PHD依从性差的心血管疾病的人群归因风险(95%CI)范围为8.79%(5.36%,12.51%)至14.00%(9.00%,18.88%)。
结论:这些研究结果表明,较高的PHD依从性与较低的总CVD风险相关。IHD,AF,和HF在所有遗传风险类别的人群中。
BACKGROUND: The influence of adherence to a planetary health diet (PHD) proposed by the EAT-Lancet Commission on cardiovascular disease (
CVD) is inconclusive. Besides, whether genetic susceptibility to
CVD can modify the association of PHD with
CVD remains unknown.
OBJECTIVE: We aimed to investigate the association between adherence to PHD and
CVD, and to evaluate the interaction between PHD and genetic predisposition to
CVD.
METHODS: This study included 114,165 participants who completed at least two 24-hour dietary recalls and were initially free of cardiovascular disease from the UK biobank. PHD score was calculated to assess adherence to PHD. Genetic risk was evaluated using the polygenic risk score. Incidence of total CVD, ischemic heart disease (IHD), atrial fibrillation (AF), heart failure (HF), and stroke were identified via electronic health records. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: During a median follow-up of 9.9 years, 10,071 (8.8%) incident CVD cases were documented. Compared to participants with the lowest adherence to PHD, HRs (95% CIs) for total CVD, IHD, AF, HF, and stroke among those with the highest adherence were 0.79 (0.74, 0.84), 0.73 (0.67, 0.79), 0.90 (0.82, 0.99), 0.69 (0.59, 0.82), and 0.88 (0.75, 1.04), respectively. No significant interaction between genetic risk of
CVD and PHD was observed. Participants with high genetic risk and low PHD score, as compared with those with low genetic risk and high PHD score, had a 48% (95% CI, 40%, 56%) higher risk of CVD. The population-attributable risk (95% CI) of CVD for poor adherence to PHD ranged from 8.79% (5.36%, 12.51%) to 14.00% (9.00%, 18.88%).
CONCLUSIONS: These findings suggest that higher adherence to PHD was associated with lower risks of total CVD, IHD, AF, and HF in populations across all genetic risk categories.