Background/objectives

Previous studies consistently report that diet quality is inversely associated with risk of cardiovascular disease (CVD) and type 2 diabetes. However, few studies have assessed the association of diet quality with serum lipoproteins, an intermediate marker of cardio-metabolic health, or assessed whether type 2 diabetes modifies these associations. This study assessed associations of diet quality (evaluated using the Alternative Healthy Eating Index (AHEI)), and the interaction of diet quality with diabetes, on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), apolipoprotein A (apoA1), and apolipoprotein B (apoB) among American Indians (AIs).

Subjects/methods

Participants comprised AIs who participated in the Strong Heart Family Study (SHFS)—a study of CVD and its risk factors in 12 AI communities. Generalized estimated equations (GEEs) were used to examine the following associations: (1) the cross-sectional associations of diet quality (as determined by AHEI) with serum lipoproteins (n = 2200); and (2) the prospective associations of the AHEI measured at baseline with serum lipoproteins (n = 1899).

Results

In cross-sectional analyses, associations of AHEI with TC (p < 0.0001) LDL-C (p = 0.005), and ApoB (p = 0.002) differed according to diabetes status. In prospective analysis, AHEI was associated with more favorable levels of TC (p = 0.029) and LDL-C (p = 0.008) among participants with diabetes independent of other demographic, behavioral, and health factors; associations of diet quality with TC, LDL-C, and ApoB were much weaker among participants without diabetes. There was no association of diet quality with TG, HDL-C, or ApoA.

Conclusions

The associations of diet quality with TC, LDL-C, and ApoB differ according to diabetes status.

中文翻译：

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糖尿病高危人群饮食质量与血清脂蛋白水平的关联：强心家族研究。

 背景/目标

此前的研究一致表明，饮食质量与心血管疾病 (CVD) 和 2 型糖尿病的风险呈负相关。然而，很少有研究评估饮食质量与血清脂蛋白（心脏代谢健康的中间标志物）之间的关联，或评估 2 型糖尿病是否会改变这些关联。本研究评估了饮食质量（使用替代健康饮食指数 (AHEI) 进行评估）的关联，以及饮食质量与糖尿病之间的相互作用，包括总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL-C)美洲印第安人 (AI) 中的高密度脂蛋白 (HDL-C)、载脂蛋白 A (apoA1) 和载脂蛋白 B (apoB)。

 主题/方法

参与者包括参加强心脏家族研究 (SHFS) 的人工智能，该研究是一项针对 12 个人工智能社区的 CVD 及其危险因素的研究。广义估计方程（GEE）用于检查以下关联：（1）饮食质量（由 AHEI 确定）与血清脂蛋白的横截面关联（ n = 2200）； (2) 基线时测量的 AHEI 与血清脂蛋白的前瞻性关联 ( n = 1899)。

 结果

在横断面分析中，AHEI 与 TC ( p < 0.0001)、LDL-C ( p = 0.005) 和 ApoB ( p = 0.002) 的关联因糖尿病状态而异。在前瞻性分析中，AHEI 与糖尿病参与者中更有利的 TC ( p = 0.029) 和 LDL-C ( p = 0.008) 水平相关，与其他人口、行为和健康因素无关；在没有糖尿病的参与者中，饮食质量与 TC、LDL-C 和 ApoB 的关联要弱得多。饮食质量与 TG、HDL-C 或 ApoA 没有关联。

 结论

饮食质量与 TC、LDL-C 和 ApoB 的关联因糖尿病状况而异。