TABLE 3.
HRs (95% CIs) for ischemic stroke and hemorrhagic stroke by dietary glycemic index, glycemic load, and intakes of refined and total carbohydrates in the Shanghai Women’s Health Study in 64,328 Chinese women (1996–2011)1
| Percentile of dietary measures |
||||||||
| 10th | 30th | 50th | 70th | 90th | P-linear | P-nonlinear | P-overall | |
| Ischemic stroke | ||||||||
| Glycemic index | 71 | 74 | 76 | 78 | 80 | |||
| Age- and energy-adjusted | 1 (ref) | 1.15 (1.05, 1.25) | 1.23 (1.10, 1.38) | 1.30 (1.16, 1.46) | 1.38 (1.22, 1.55) | <0.0001 | 0.60 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 1.10 (1.00, 1.20) | 1.14 (1.02, 1.28) | 1.17 (1.03, 1.32) | 1.18 (1.03, 1.36) | 0.02 | 0.39 | 0.04 |
| Glycemic load | 174 | 194 | 207 | 220 | 239 | |||
| Age- and energy-adjusted | 1 (ref) | 1.15 (1.07, 1.24) | 1.25 (1.12, 1.38) | 1.32 (1.18, 1.47) | 1.40 (1.25, 1.56) | <0.0001 | 0.16 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 1.11 (1.02, 1.22) | 1.18 (1.03, 1.35) | 1.22 (1.04, 1.43) | 1.25 (1.02, 1.53) | 0.04 | 0.17 | 0.049 |
| Refined carbohydrates, g/d | 189 | 217 | 236 | 254 | 280 | |||
| Age- and energy-adjusted | 1 (ref) | 1.16 (1.08, 1.25) | 1.26 (1.13, 1.40) | 1.32 (1.18, 1.48) | 1.38 (1.23, 1.55) | <0.0001 | 0.07 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 1.11 (1.02, 1.21) | 1.16 (1.03, 1.32) | 1.19 (1.02, 1.37) | 1.18 (0.99, 1.42) | 0.09 | 0.08 | 0.05 |
| Total carbohydrates, g/d | 246 | 266 | 278 | 291 | 308 | |||
| Age- and energy-adjusted | 1 (ref) | 1.11 (1.03, 1.19) | 1.18 (1.07, 1.30) | 1.24 (1.12, 1.37) | 1.33 (1.19, 1.48) | <0.0001 | 0.63 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 1.07 (0.97, 1.19) | 1.12 (0.96, 1.30) | 1.15 (0.95, 1.39) | 1.18 (0.92, 1.51) | 0.21 | 0.50 | 0.36 |
| Hemorrhagic stroke | ||||||||
| Glycemic index | 71 | 74 | 76 | 78 | 80 | |||
| Age- and energy-adjusted | 1 (ref) | 0.87 (0.69, 1.12) | 0.95 (0.70, 1.29) | 1.18 (0.86, 1.62) | 1.69 (1.20, 2.39) | 0.001 | 0.002 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 0.85 (0.66, 1.09) | 0.87 (0.63, 1.21) | 1.01 (0.71, 1.43) | 1.29 (0.85, 1.97) | 0.28 | 0.02 | 0.03 |
| Glycemic load | 174 | 194 | 207 | 220 | 239 | |||
| Age- and energy-adjusted | 1 (ref) | 0.98 (0.78, 1.23) | 1.04 (0.76, 1.43) | 1.22 (0.87, 1.71) | 1.73 (1.22, 2.44) | 0.0003 | 0.04 | 0.0002 |
| Multivariable-adjusted2 | 1 (ref) | 0.98 (0.73, 1.30) | 1.02 (0.66, 1.56) | 1.13 (0.67, 1.92) | 1.43 (0.73, 2.80) | 0.22 | 0.17 | 0.19 |
| Refined carbohydrates, g/d | 189 | 217 | 236 | 254 | 280 | |||
| Age- and energy-adjusted | 1 (ref) | 0.91 (0.73, 1.14) | 0.96 (0.70, 1.30) | 1.14 (0.82, 1.58) | 1.70 (1.21, 2.39) | 0.0001 | 0.006 | <0.0001 |
| Multivariable-adjusted2 | 1 (ref) | 0.90 (0.70, 1.17) | 0.92 (0.62, 1.34) | 1.03 (0.65, 1.63) | 1.36 (0.76, 2.44) | 0.22 | 0.04 | 0.05 |
| Total carbohydrates, g/d | 246 | 266 | 278 | 291 | 308 | |||
| Age- and energy-adjusted | 1 (ref) | 1.05 (0.83, 1.33) | 1.14 (0.83, 1.58) | 1.31 (0.93, 1.84) | 1.70 (1.19, 2.42) | 0.002 | 0.23 | 0.003 |
| Multivariable-adjusted2 | 1 (ref) | 0.95 (0.68, 1.34) | 0.94 (0.56, 1.58) | 0.95 (0.50, 1.81) | 0.99 (0.43, 2.27) | 0.97 | 0.65 | 0.90 |
1
ref, referent.
2
Cox model, with age as the time scale, was stratified by 5-y birth cohort and adjusted for education, cigarette smoking, BMI, family history of stroke, history of hypertension, history of dyslipidemia, total energy intake, saturated fat intake, and a partial diet quality score. Dietary intakes and disease history were modeled as time-varying variables.