Table 3.
Hazard ratios (95% CIs) of incident CVD, CHD, and stroke by quintile and continuous total protein intake in MESA (n = 5879).
| HR (95% CI) | |||||||
|---|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | For 20 g/Day Increment | ||
| Total Protein Intake (Grams/Day) | |||||||
| CVD | |||||||
| Mean (min, max) | 32.0 (11.1, 39.9) | 46.3 (39.9, 53.1) | 60.1 (53.1, 67.2) | 76.2 (67.2, 87.9) | 116.0 (87.9, 261.6) | ||
| Cases | 206 | 211 | 224 | 205 | 199 | ||
| Model 1 | Reference | 1.00 (0.82, 1.22) | 1.14 (0.92, 1.41) | 1.08 (0.84, 1.38) | 1.16 (0.83, 1.61) | 0.36 | 1.10 (1.00, 1.20) |
| Model 2 | Reference | 1.01 (0.83, 1.24) | 1.12 (0.90, 1.38) | 1.03 (0.80, 1.32) | 1.06 (0.76, 1.48) | 0.76 | 1.04 (0.95, 1.14) |
| Model 2-BMI, diabetes | Reference | 1.02 (0.84, 1.25) | 1.17 (0.95, 1.45) | 1.11 (0.87, 1.43) | 1.18 (0.84, 1.65) | 0.32 | 1.10 (1.00, 1.20) |
| Model 3a | Reference | 1.02 (0.84, 1.25) | 1.12 (0.90, 1.40) | 1.04 (0.81, 1.34) | 1.07 (0.75, 1.51) | 0.75 | 1.05 (0.95, 1.16) |
| Model 3b | Reference | 1.04 (0.85, 1.26) | 1.14 (0.92, 1.41) | 1.03 (0.81, 1.32) | 1.11 (0.79, 1.55) | 0.61 | 1.06 (0.97, 1.16) |
| CHD | |||||||
| Mean (min, max) | 32.0 (11.1, 39.9) | 46.3 (39.9, 53.1) | 60.1 (53.1, 67.2) | 76.2 (67.2, 87.9) | 116.0 (87.9, 261.6) | ||
| Cases | 133 | 123 | 145 | 140 | 127 | ||
| Model 1 | Reference | 0.87 (0.68, 1.12) | 1.04 (0.80, 1.35) | 1.00 (0.74, 1.36) | 0.95 (0.63, 1.43) | 0.96 | 1.07 (0.96, 1.19) |
| Model 2 | Reference | 0.87 (0.67, 1.12) | 1.00 (0.77, 1.30) | 0.95 (0.70, 1.28) | 0.86 (0.57, 1.30) | 0.63 | 1.01 (0.90, 1.13) |
| Model 2-BMI, diabetes | Reference | 0.88 (0.68, 1.13) | 1.06 (0.81, 1.38) | 1.03 (0.76, 1.40) | 0.96 (0.63, 1.46) | 0.91 | 1.07 (0.96, 1.20) |
| Model 3a | Reference | 0.87 (0.67, 1.12) | 0.99 (0.75, 1.30) | 0.93 (0.68, 1.28) | 0.84 (0.54, 1.30) | 0.57 | 1.01 (0.89, 1.14) |
| Model 3b | Reference | 0.89 (0.69, 1.14) | 1.03 (0.79, 1.34) | 0.95 (0.70, 1.28) | 0.89 (0.59, 1.36) | 0.74 | 1.02 (0.91, 1.15) |
| Stroke | |||||||
| Mean (min, max) | 32.0 (11.1, 39.9) | 46.3 (39.9, 53.1) | 60.1 (53.1, 67.2) | 76.2 (67.2, 87.9) | 116.0 (87.9, 261.6) | ||
| Cases | 70 | 77 | 72 | 56 | 57 | ||
| Model 1 | Reference | 1.17 (0.84, 1.64) | 1.27 (0.87, 1.85) | 1.07 (0.68, 1.69) | 1.35 (0.74, 2.47) | 0.46 | 1.13 (0.96, 1.33) |
| Model 2 | Reference | 1.17 (0.84, 1.64) | 1.24 (0.85, 1.81) | 1.01 (0.65, 1.60) | 1.21 (0.66, 2.23) | 0.73 | 1.07 (0.91, 1.27) |
| Model 2-BMI, diabetes | Reference | 1.19 (0.85, 1.67) | 1.29 (0.88, 1.88) | 1.09 (0.69, 1.71) | 1.33 (0.72, 2.44) | 0.51 | 1.12 (0.95, 1.33) |
| Model 3a | Reference | 1.18 (0.84, 1.66) | 1.26 (0.86, 1.85) | 1.03 (0.65, 1.64) | 1.21 (0.64, 2.26) | 0.75 | 1.07 (0.89, 1.28) |
| Model 3b | Reference | 1.21 (0.87, 1.70) | 1.28 (0.87, 1.86) | 1.03 (0.66, 1.62) | 1.27 (0.69, 2.35) | 0.64 | 1.10 (0.93, 1.30) |
HR indicates hazard ratio; CI, confidence interval; Q1, first quintile; Q2, second quintile; Q3, third quintile; Q4, fourth quintile; Q5, fifth quintile; CVD, cardiovascular disease; CHD, coronary heart disease; BMI, body mass index. HRs were obtained for quintiles of protein intake, with Q1 as the reference, and continuously for each 20 g/day increment in protein intake in relation to CVD risk. Linear trends were assessed by assigning the median value in each quintile and evaluating it on a continuous scale. Model 1 is adjusted for age (years), sex, race/ethnicity (White, Chinese, Black, Hispanic), field center, and total energy intake (kcal); Model 2 is adjusted for all variables in Model 1 plus education (<high school, high school, >high school), income (<$20,000, $20,000–$49,999, >$49,999), smoking status (current, former, never) and pack-years of cigarette smoking, dietary supplement use one per week or more (yes/no), alcohol use (g/day), physical activity (moderate and vigorous physical activity total, metabolic equivalents per min/week), prevalent diabetes (yes/no), and body max index (kg/m2); Model 2-BMI, diabetes is adjusted for all variables in Model 2 excluding BMI (kg/m2) and prevalent diabetes; Model 3a is adjusted for all variables in Model 2 plus intakes of total dietary fiber (g/day), trans fats (% of energy), saturated fatty acids (% of energy), poly-unsaturated fatty acids (% of energy), monounsaturated fatty acids (% of energy), and vitamin E (IU/day); Model 3b is adjusted for all variables in Model 2 plus systolic blood pressure (mmHg), diastolic blood pressure (mmHg), triglycerides (mg/dL), HDL cholesterol (mg/dL), LDL cholesterol (mg/dL), C-reactive protein (mg/L), and interleukin-6 (pg/mL).