TABLE 2.
Hazard ratios (95% CIs) of CVD incidence according to dietary glutamine and glutamate consumption after diabetes diagnosis
| Dietary glutamine intake | ||||||
|---|---|---|---|---|---|---|
| Q1 (Low) | Q2 | Q3 | Q4 | Q5 (High) | P-trend | |
| CVD | ||||||
| No. of case/person-y | 654/39,102 | 531/39,455 | 590/39,375 | 551/39,513 | 601/39,413 | |
| Model 1 | 1 | 0.83 (0.74, 0.94) | 0.91 (0.81, 1.02) | 0.82 (0.73, 0.93) | 0.84 (0.75, 0.95) | 0.003 |
| Model 2 | 1 | 0.87 (0.77, 0.98) | 0.94 (0.84, 1.06) | 0.87 (0.77, 0.99) | 0.88 (0.77, 0.99) | 0.04 |
| CHD | ||||||
| No. of case/person-y | 511/39,102 | 418/39,455 | 449/39,375 | 423/39,513 | 474/39,413 | |
| Model 1 | 1 | 0.83 (0.73, 0.95) | 0.87 (0.76, 0.99) | 0.79 (0.69, 0.91) | 0.83 (0.73, 0.95) | 0.003 |
| Model 2 | 1 | 0.87 (0.76, 1.00) | 0.90 (0.79, 1.03) | 0.84 (0.73, 0.97) | 0.87 (0.75, 1.00) | 0.04 |
| Stroke | ||||||
| No. of case/person-y | 143/39,102 | 113/39,455 | 141/39,375 | 128/39,513 | 127/39,413 | |
| Model 1 | 1 | 0.84 (0.65, 1.09) | 1.07 (0.83, 1.36) | 0.95 (0.74, 1.22) | 0.89 (0.69, 1.15) | 0.46 |
| Model 2 |
1 |
0.87 (0.67, 1.13) |
1.11 (0.86, 1.42) |
0.98 (0.76, 1.27) |
0.93 (0.71, 1.22) |
0.71 |
| Dietary glutamate intake | ||||||
| Q1 (Low) |
Q2 |
Q3 |
Q4 |
Q5 (High) |
P-trend |
|
| CVD | ||||||
| No. of case/person-y | 557/39,286 | 550/39,516 | 535/39,552 | 562/39,504 | 723/39,000 | |
| Model 1 | 1 | 1.06 (0.94, 1.20) | 1.07 (0.94, 1.21) | 1.15 (1.01, 1.30) | 1.44 (1.28, 1.61) | <0.0001 |
| Model 2 | 1 | 1.07 (0.95, 1.21) | 1.05 (0.92, 1.18) | 1.11 (0.98, 1.26) | 1.30 (1.15, 1.46) | <0.0001 |
| CHD | ||||||
| No. of case/person-years | 424/39,286 | 421/39,516 | 407/39,552 | 447/39,504 | 576/39,000 | |
| Model 1 | 1 | 1.07 (0.93, 1.22) | 1.06 (0.92, 1.23) | 1.21 (1.05, 1.39) | 1.50 (1.31, 1.71) | <0.0001 |
| Model 2 | 1 | 1.07 (0.93, 1.23) | 1.03 (0.90, 1.19) | 1.16 (1.00, 1.33) | 1.32 (1.15, 1.51) | <0.0001 |
| Stroke | ||||||
| No. of case/person-years | 133/39,286 | 129/39,516 | 128/39,552 | 115/39,504 | 147/39,000 | |
| Model 1 | 1 | 1.06 (0.82, 1.35) | 1.07 (0.83, 1.37) | 0.96 (0.74, 1.25) | 1.22 (0.96, 1.56) | 0.12 |
| Model 2 |
1 |
1.07 (0.84, 1.38) |
1.07 (0.83, 1.38) |
0.96 (0.74, 1.25) |
1.20 (0.93, 1.55) |
0.22 |
| Dietary glutamine-to-glutamate ratio | ||||||
| Q1 (Low) |
Q2 |
Q3 |
Q4 |
Q5 (High) |
P-trend |
|
| CVD | ||||||
| No. of case/person-years | 659/39,065 | 579/39,420 | 528/39,582 | 604/39,418 | 557/39,374 | |
| Model 1 | 1 | 0.87 (0.77, 0.97) | 0.78 (0.69, 0.87) | 0.87 (0.78, 0.97) | 0.77 (0.69, 0.86) | <0.0001 |
| Model 2 | 1 | 0.94 (0.84, 1.05) | 0.86 (0.77, 0.97) | 0.96 (0.86, 1.07) | 0.84 (0.75, 0.95) | 0.01 |
| CHD | ||||||
| No. of case/person-years | 510/39,065 | 444/39,420 | 421/39,582 | 462/39,418 | 438/39,374 | |
| Model 1 | 1 | 0.85 (0.75, 0.97) | 0.79 (0.70, 0.90) | 0.86 (0.75, 0.97) | 0.78 (0.69, 0.89) | 0.0008 |
| Model 2 | 1 | 0.94 (0.83, 1.07) | 0.91 (0.79, 1.03) | 0.96 (0.84, 1.09) | 0.87 (0.76, 1.00) | 0.07 |
| Stroke | ||||||
| No. of case/person-years | 149/39,065 | 135/39,420 | 107/39,582 | 142/39,418 | 119/39,374 | |
| Model 1 | 19 | 0.92 (0.73, 1.16) | 0.71 (0.55, 0.92) | 0.93 (0.74, 1.18) | 0.72 (0.57, 0.92) | 0.03 |
| Model 2 | 1 | 0.95 (0.75, 1.20) | 0.74 (0.58, 0.96) | 0.97 (0.76, 1.22) | 0.75 (0.58, 0.96) | 0.05 |
Model 1: Age, sex (men/women), and race (Caucasian/others).
Model 2: Model 1+ diabetes duration (years), BMI at diabetes diagnosis (<23.0, 23.0–24.9, 25.0–29.9, 30.0–34.9, or ≥35.0 kg/m2), physical activity (<3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, or ≥27.0 MET-h/wk), smoking status (never, past, current 1–14 cigarettes/d, or current ≥15 cigarettes/d), alcohol consumption (0, 0.1–4.9, 5.0–14.9, or ≥15.0 g/d), family history of MI (yes/no), family history of cancer (yes/no), family history of diabetes (yes/no), menopausal status and use of postmenopausal hormones (premenopausal, postmenopausal never users, postmenopausal past users, or postmenopausal current users, only for women), current aspirin use (yes/no), multivitamin use (yes/no), presence of hypertension (yes/no), use of lipid-lowering medication (yes/no), diabetes medication use (insulin, oral medication, or others), intake of total energy (quintiles), and healthy plant-based diet index (quintiles). Mutual adjustment was conducted for dietary glutamine and glutamate. CVD, cardiovascular disease
Abbreviations: MET, metabolic equivalent; MI, myocardial infarction.