TABLE 2.
Geometric mean or odds ratios for select cardiovascular disease risk markers across quintiles (Q) of an a priori—defined Healthy Dietary Pattern in the Multi-Ethnic Study of Atherosclerosis1
| Q1 (n = 1065) | Q2 (n = 978) | Q3 (n = 907) | Q4 (n = 1151) | Q5 (n = 941) | P for trend2 | |
|---|---|---|---|---|---|---|
| Inflammatory markers3 | ||||||
| CRP (mg/dL) | ||||||
| Model 14 | 2.03 (1.90, 2.18) | 1.87 (1.75, 2.00) | 1.87 (1.74, 2.01) | 1.77 (1.66, 1.88) | 1.47 (1.36, 1.58) | <0.001 |
| Model 25 | 1.92 (1.79, 2.05) | 1.85 (1.72, 1.98) | 1.87 (1.75, 2.01) | 1.81 (1.69, 1.93) | 1.54 (1.43, 1.66) | <0.001 |
| Model 36 | 1.85 (1.73, 1.98) | 1.80 (1.68, 1.92) | 1.86 (1.74, 1.99) | 1.84 (1.73, 1.96) | 1.63 (1.52, 1.75) | 0.04 |
| IL-6 (mg/dL) | ||||||
| Model 14 | 1.28 (1.23, 1.33) | 1.21 (1.16, 1.26) | 1.17 (1.13, 1.22) | 1.13 (1.08, 1.17) | 1.05 (1.01, 1.09) | <0.001 |
| Model 25 | 1.23 (1.18, 1.28) | 1.20 (1.16, 1.25) | 1.18 (1.13, 1.22) | 1.14 (1.10, 1.19) | 1.09 (1.04, 1.13) | <0.001 |
| Model 36 | 1.21 (1.16, 1.25) | 1.18 (1.14, 1.23) | 1.17 (1.13, 1.22) | 1.16 (1.12, 1.20) | 1.12 (1.07, 1.17) | 0.01 |
| Homocysteine (μmol/L) | ||||||
| Model 14 | 9.1 (9.0, 9.3) | 8.9 (8.7, 9.0) | 8.6 (8.5, 8.8) | 8.6 (8.5, 8.8) | 8.5 (8.3, 8.6) | <0.001 |
| Model 25 | 9.0 (8.9, 9.2) | 8.9 (8.7, 9.0) | 8.6 (8.5, 8.8) | 8.7 (8.6, 8.8) | 8.6 (8.4, 8.7) | <0.001 |
| Model 36 | 9.0 (8.9, 9.2) | 8.8 (8.7, 9.0) | 8.6 (8.5, 8.8) | 8.7 (8.6, 8.8) | 8.6 (8.4, 8.7) | 0.002 |
| Fibrinogen (mg/dL) | ||||||
| Model 14 | 339 (335, 343) | 335 (331, 339) | 335 (331, 339) | 333 (329, 336) | 328 (324, 332) | <0.001 |
| Model 25 | 337 (332, 341) | 335 (330, 339) | 335 (331, 339) | 333 (330, 337) | 330 (326, 335) | 0.05 |
| Model 36 | 335 (331, 339) | 333 (329, 337) | 335 (331, 339) | 334 (330, 338) | 332 (328, 337) | 0.54 |
| Markers of subclinical atherosclerosis | ||||||
| CC-IMT (mm)3 | ||||||
| Model 14 | 0.85 (0.84, 0.86) | 0.84 (0.83, 0.85) | 0.84 (0.83, .85) | 0.83 (0.82, 0.84) | 0.83 (.82, 0.84) | <0.001 |
| Model 25 | 0.85 (0.84, 0.86) | 0.84 (0.83, 0.85) | 0.84 (0.83, 0.85) | 0.83 (0.83, 0.84) | 0.83 (0.82, 0.84) | 0.007 |
| Model 36 | 0.84 (0.83, 0.85) | 0.84 (0.83, 0.85) | 0.84 (0.83, 0.85) | 0.84 (0.83, 0.84) | 0.84 (0.83, 0.85) | 0.09 |
| IC-IMT (mm)3 | ||||||
| Model 14 | 0.93 (0.91, 0.96) | 0.92 (0.89, 0.94) | 0.94 (0.91, 0.96) | 0.92 (0.90, 0.95) | 0.91 (0.89, 0.94) | 0.05 |
| Model 25 | 0.91 (0.89, 0.94) | 0.91 (0.89, 0.94) | 0.94 (0.92, 0.97) | 0.93 (0.91, 0.95) | 0.92 (0.90, 0.95) | 0.83 |
| Model 36 | 0.91 (0.89, 0.93) | 0.91 (0.89, 0.94) | 0.94 (0.91, 0.97) | 0.93 (0.91, 0.95) | 0.93 (0.90, 0.95) | 0.86 |
| Carotid plaque7 | ||||||
| Model 14 | 1.00 | 0.89 (0.74, 1.08) | 0.90 (0.74, 1.10) | 0.87 (0.72, 1.05) | 0.78 (0.63, 0.96) | 0.01 |
| Model 25 | 1.00 | 0.96 (0.79, 1.17) | 1.01 (0.82, 1.24) | 0.99 (0.81, 1.21) | 0.90 (0.71, 1.11) | 0.33 |
| Model 36 | 1.00 | 0.90 (0.72, 1.13) | 1.00 (0.82, 1.22) | 1.01 (0.83, 1.25) | 0.96 (0.79, 1.17) | 0.43 |
| CAC (Agatston >0)7 | ||||||
| Model 14 | 1.00 | 0.81 (0.66, 0.99) | 1.11 (0.90, 1.37) | 0.94 (0.77, 1.15) | 0.96 (0.77, 1.20) | 0.93 |
| Model 25 | 1.00 | 0.86 (0.70, 1.06) | 1.32 (0.98, 1.50) | 1.00 (0.81, 1.23) | 1.03 (0.82, 1.30) | 0.46 |
| Model 36 | 1.00 | 0.86 (0.70, 1.06) | 1.23 (0.99, 1.52) | 1.03 (0.84, 1.27) | 1.09 (0.86, 1.37) | 0.20 |
| CAC (Agatston score)3,8 | ||||||
| Model 14 | 76.7 (66.1, 89.1) | 72.7 (63.1, 84.9) | 74.1 (64.0, 85.8) | 71.9 (62.7, 82.4) | 80.2 (68.9, 93.3) | 0.82 |
| Model 25 | 74.5 (63.9, 86.9) | 72.1 (61.6, 84.3) | 75.8 (63.4, 87.7) | 72.7 (63.3, 83.4) | 79.1 (67.9, 92.2) | 0.66 |
| Model 36 | 74.0 (63.4, 86.2) | 74.1 (61.0, 83.5) | 73.1 (65.0, 87.1) | 71.6 (63.5, 83.7) | 80.8 (68.9, 93.7) | 0.49 |
| ABI (<0.9)7 | ||||||
| Model 14 | 1.00 | 0.81 (0.49, 1.33) | 0.91 (0.55, 1.50) | 0.76 (0.46, 1.28) | 0.48 (0.25, 0.92) | 0.01 |
| Model 25 | 1.00 | 1.01 (0.60, 1.70) | 1.18 (0.70, 1.99) | 1.15 (0.67, 1.98) | 0.78 (0.29, 1.53) | 0.65 |
| Model 36 | 1.00 | 1.02 (0.61, 1.71) | 1.19 (0.70, 2.00) | 1.13 (0.66, 1.96) | 0.76 (0.38, 1.49) | 0.60 |
| Markers of vascular integrity3 | ||||||
| LAE (mL/mm Hg × 10) | ||||||
| Model 14 | 12.4 (12.1, 12.6) | 12.5 (12.2, 12.7) | 12.4 (12.1, 12.7) | 12.7 (12.4, 12.9) | 12.8 (12.5, 13.1) | 0.006 |
| Model 25 | 12.4 (12.2, 12.6) | 12.6 (12.4, 12.8) | 12.6 (12.3, 12.8) | 12.7 (12.4, 12.9) | 12.6 (12.3, 12.8) | 0.14 |
| Model 36 | 12.4 (12.2, 12.6) | 12.6 (12.4, 12.8) | 12.6 (12.3, 12.8) | 12.7 (12.4, 12.9) | 12.6 (12.4, 12.9) | 0.11 |
| SAE (mL/mm Hg × 100) | ||||||
| Model 14 | 3.75 (3.63, 3.87) | 3.81 (3.69, 3.93) | 3.87 (3.75, 4.00) | 3.82 (3.71, 3.94) | 4.00 (3.86, 4.14) | 0.01 |
| Model 25 | 3.78 (3.67, 3.90) | 3.80 (3.68, 3.91) | 3.89 (3.77, 4.01) | 3.81 (3.70, 3.91) | 3.96 (3.84, 4.09) | 0.10 |
| Model 36 | 3.79 (3.67, 3.91) | 3.80 (3.69, 3.92) | 3.89 (3.77, 4.01) | 3.80 (3.70, 3.91) | 3.96 (3.83, 4.09) | 0.13 |
| ACR | ||||||
| Model 14 | 7.3 (6.9, 7.7) | 7.1 (6.7, 7.5) | 6.9 (6.5, 7.3) | 6.7 (6.4, 7.1) | 6.4 (6.1, 6.8) | <0.001 |
| Model 25 | 7.1 (6.7, 7.5) | 7.1 (6.7, 7.5) | 6.9 (6.5, 7.3) | 6.8 (6.5, 7.1) | 6.6 (6.2, 6.9) | 0.005 |
| Model 36 | 7.1 (6.7, 7.5) | 7.0 (6.7, 7.4) | 6.9 (6.5, 7.3) | 6.8 (6.5, 7.2) | 6.6 (6.3, 7.0) | 0.02 |
| Lipids3 | ||||||
| HDL cholesterol (mg/dL) | ||||||
| Model 14 | 50.1 ± 0.4 | 51.3 ± 0.4 | 51.8 ± 0.5 | 52.3 ± 0.4 | 53.5 ± 0.5 | <0.001 |
| Model 25 | 50.6 ± 0.4 | 51.5 ± 0.4 | 51.8 ± 0.5 | 52.1 ± 0.4 | 53.0 ± 0.5 | 0.002 |
| Model 36 | 51.0 ± 0.4 | 51.8 ± 0.4 | 51.9 ± 0.4 | 51.9 ± 0.4 | 52.4 ± 0.5 | 0.20 |
| LDL cholesterol (mg/dL) | ||||||
| Model 14 | 119.2 ± 1.0 | 117.5 ± 1.0 | 118.0 ± 1.0 | 118.2 ± 0.9 | 116.8 ± 1.1 | 0.13 |
| Model 25 | 119.0 ± 1.0 | 117.4 ± 1.0 | 118.0 ± 1.0 | 118.3 ± 0.9 | 117.1 ± 1.1 | 0.34 |
| Model 36 | 118.8 ± 1.0 | 117.3 ± 1.0 | 117.9 ± 1.0 | 118.3 ± 0.9 | 117.3 ± 1.1 | 0.51 |
| Triglycerides (mg/dL) | ||||||
| Model 14 | 116.2 (112.6, 119.8) | 111.6 (108.2, 115.1) | 111.2 (107.7, 114.7) | 108.1 (105.1, 111.3) | 102.6 (99.3, 106.0) | <0.001 |
| Model 25 | 113.5 (110.0, 117.1) | 111.2 (107.8, 114.7) | 111.3 (107.8, 114.9) | 108.9 (105.8, 112.0) | 104.5 (101.1, 108.0) | 0.01 |
| Model 36 | 112.0 (108.6, 115.4) | 110.0 (106.8, 113.4) | 111.0 (107.6, 114.5) | 109.7 (106.7, 112.8) | 106.6 (103.2, 110.0) | 0.33 |
| Other CVD risk factors9 | ||||||
| Systolic blood pressure (mmHg) | ||||||
| Model 14 | 125.0 ± 0.6 | 124.6 ± 0.6 | 125.9 ± 0.6 | 125.1 ± 0.6 | 124.3 ± 0.6 | 0.49 |
| Model 25 | 124.5 ± 0.6 | 124.5 ± 0.6 | 125.9 ± 0.6 | 125.3 ± 0.6 | 124.8 ± 0.7 | 0.61 |
| Model 36 | 124.2 ± 0.6 | 124.3 ± 0.6 | 125.8 ± 0.6 | 125.5 ± 0.6 | 125.3 ± 0.7 | 0.15 |
| Diastolic blood pressure (mmHg) | ||||||
| Model 14 | 71.9 ± 0.3 | 71.8 ± 0.3 | 72.0 ± 0.3 | 71.8 ± 0.3 | 71.3 ± 0.3 | 0.57 |
| Model 25 | 71.7 ± 0.3 | 72.0 ± 0.3 | 72.1 ± 0.3 | 71.8 ± 0.3 | 71.4 ± 0.3 | 0.44 |
| Model 36 | 71.6 ± 0.3 | 71.7 ± 0.3 | 72.0 ± 0.3 | 71.9 ± 0.3 | 71.5 ± 0.3 | 0.99 |
| Fasting glucose (mg/dL) | ||||||
| Model 14 | 96.5 ± 0.3 | 96.1 ± 0.3 | 95.3 ± 0.3 | 95.3 ± 0.3 | 95.0 ± 0.3 | <0.001 |
| Model 25 | 96.1 ± 0.3 | 96.1 ± 0.3 | 95.2 ± 0.3 | 95.5 ± 0.3 | 95.3 ± 0.3 | 0.11 |
| Model 36 | 95.8 ± 0.3 | 95.8 ± 0.3 | 95.2 ± 0.3 | 95.7 ± 0.3 | 95.7 ± 0.3 | 0.91 |
| Fasting insulin (pmol/L) | ||||||
| Model 14 | 49.0 ± 0.9 | 45.9 ± 0.9 | 43.8 ± 0.9 | 41.3 ± 0.8 | 36.6 ± 1.0 | <0.001 |
| Model 25 | 48.0 ± 0.9 | 45.7 ± 0.9 | 43.7 ± 0.9 | 41.6 ± 0.8 | 37.9 ± 1.0 | <0.001 |
| Model 36 | 46.6 ± 0.8 | 44.7 ± 0.8 | 43.4 ± 0.8 | 42.3 ± 0.8 | 39.9 ± 0.9 | <0.001 |
| Waist circumference (cm) | ||||||
| Model 14 | 98.5 ± 0.4 | 98.0 ± 0.4 | 97.0 ± 0.4 | 95.7 ± 0.4 | 93.9 ± 0.4 | <0.001 |
| Model 25 | 98.0 ± 0.4 | 97.7 ± 0.4 | 96.9 ± 0.4 | 95.9 ± 0.4 | 94.5 ± 0.4 | <0.001 |
| BMI (kg/m2) | ||||||
| Model 14 | 28.3 ± 0.2 | 28.2 ± 0.2 | 27.9 ± 0.2 | 27.6 ± 0.1 | 27.0 ± 0.2 | <0.001 |
| Model 25 | 28.2 ± 0.2 | 28.1 ± 0.2 | 27.9 ± 0.2 | 27.6 ± 0.1 | 27.2 ± 0.2 | <0.001 |
1
CRP, C-reactive protein; IL-6, interleukin-6; CAC, coronary artery calcification; ABI, ankle brachial index; LAE, large artery elasticity; SAE, small artery elasticity; ACR, albumin to creatinine ratio; IMT, intima-media thickness; CC, common carotid artery; IC, internal carotid artery.
2
P for trend across quintiles calculated with the Healthy Dietary Pattern modeled continuously (score).
3
All values are geometric x̄; 95% CI in parentheses.
4
Adjusted for energy intake (kcal/d), age (y), race-ethnicity (white, black, Hispanic, Chinese), and study center.
5
Adjusted as for model 1 plus education (<high school, high school, >high school), physical activity (active and inactive leisure in metabolic equivalents per min/wk), smoking (current or not current and pack-years), and supplement use (≥ weekly). Data for LAE and SAE also adjusted for height, weight, systolic blood pressure, and pulse rate.
6
Adjusted as for model 2 plus waist circumference (cm).
7
All values are odds ratios; 95% CI in parentheses.
8
Values calculated in 2380 participants with an Agatston score > 0.
9
All values are x̄ ± SD.