Table 4.
Adjusted* relative concentrations† of biomarkers in quintiles of insulinemic dietary and lifestyle patterns in the three cohorts
| Quintile 1 (reference) |
Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | P-trend‡ | |
|---|---|---|---|---|---|---|
| Empirical dietary index for hyperinsulinemia (EDIH) | ||||||
| C-peptide (NHS, n=5,812) | ||||||
| Age-adjusted | 1 | 1.09 (1.04, 1.15) | 1.20 (1.14, 1.25) | 1.28 (1.23, 1.35) | 1.44 (1.38, 1.51) | <0.0001 |
| Multivariable-adjusted | 1 | 1.09 (1.04, 1.14) | 1.18 (1.13, 1.24) | 1.27 (1.21, 1.32) | 1.40 (1.34, 1.46) | <0.0001 |
| C-peptide (HPFS, n=4,002) | ||||||
| Age-adjusted | 1 | 1.13 (1.07, 1.20) | 1.16 (1.09, 1.23) | 1.21 (1.14, 1.29) | 1.29 (1.22 1.37) | <0.0001 |
| Multivariable-adjusted | 1 | 1.12 (1.06, 1.19) | 1.16 (1.09, 1.23) | 1.22 (1.15, 1.29) | 1.29 (1.22 1.37) | <0.0001 |
| C-peptide (NHS-II, n=1,717) | ||||||
| Age-adjusted | 1 | 1.05 (0.96, 1.15) | 1.15 (1.05, 1.26) | 1.19 (1.09, 1.30) | 1.37 (1.25, 1.50) | <0.0001 |
| Multivariable-adjusted | 1 | 1.05 (0.96, 1.15) | 1.13 (1.04, 1.24) | 1.16 (1.06, 1.27) | 1.32 (1.21, 1.45) | <0.0001 |
| Empirical lifestyle index for hyperinsulinemia (ELIH) | ||||||
| C-peptide (NHS, n=5,812) | ||||||
| Age-adjusted | 1 | 1.10 (1.06, 1.15) | 1.26 (1.21, 1.32) | 1.54 (1.48, 1.60) | 2.04 (1.96, 2.13) | <0.0001 |
| Multivariable-adjusted | 1 | 1.10 (1.05, 1.14) | 1.25 (1.19, 1.30) | 1.51 (1.44, 1.57) | 1.97 (1.89, 2.06) | <0.0001 |
| C-peptide (HPFS, n=4,002) | ||||||
| Age-adjusted | 1 | 1.20 (1.13, 1.27) | 1.31 (1.24 1.38) | 1.46 (1.38, 1.54) | 1.83 (1.73, 1.94) | <0.0001 |
| Multivariable-adjusted | 1 | 1.19 (1.12, 1.25) | 1.29 (1.22, 1.36) | 1.43 (1.35, 1.51) | 1.78 (1.68, 1.88) | <0.0001 |
| C-peptide (NHS-II, n=1,717) | ||||||
| Age-adjusted | 1 | 1.16 (1.06, 1.26) | 1.31 (1.21, 1.43) | 1.41 (1.29, 1.54) | 1.96 (1.80, 2.14) | <0.0001 |
| Multivariable-adjusted | 1 | 1.16 (1.06, 1.26) | 1.31 (1.21, 1.43) | 1.41 (1.29, 1.54) | 1.90 (1.74, 2.08) | <0.0001 |
| Empirical dietary index for insulin resistance (EDIR) | ||||||
| TG/HDL (NHS, n=3,929) | ||||||
| Age-adjusted | 1 | 1.19 (1.11, 1.28) | 1.41 (1.32, 1.52) | 1.56 (1.45, 1.67) | 1.98 (1.84, 2.12) | <0.0001 |
| Multivariable-adjusted | 1 | 1.18 (1.10, 1.26) | 1.34 (1.25, 1.44) | 1.43 (1.33, 1.54) | 1.67 (1.55, 1.80) | <0.0001 |
| TG/HDL (HPFS, n=3,559) | ||||||
| Age-adjusted | 1 | 1.09 (1.01, 1.18) | 1.24 (1.15, 1.34) | 1.35 (1.25, 1.45) | 1.59 (1.48, 1.72) | <0.0001 |
| Multivariable-adjusted | 1 | 1.11 (1.03, 1.19) | 1.21 (1.13, 1.30) | 1.29 (1.20, 1.39) | 1.44 (1.34, 1.55) | <0.0001 |
| TG/HDL (NHS-II, n=1,008) | ||||||
| Age-adjusted | 1 | 1.02 (0.90, 1.14) | 1.12 (0.99, 1.26) | 1.32 (1.17, 1.49) | 1.32 (1.17, 1.49) | <0.0001 |
| Multivariable-adjusted | 1 | 0.98 (0.87, 1.10) | 1.08 (0.96, 1.22) | 1.23 (1.09, 1.38) | 1.19 (1.05, 1.34) | 0.001 |
| Empirical lifestyle index for insulin resistance (ELIR) | ||||||
| TG/HDL (NHS, n=3,929) | ||||||
| Age-adjusted | 1 | 1.24 (1.15, 1.32) | 1.57 (1.46, 1.68) | 1.98 (1.85, 2.12) | 2.60 (2.43, 2.78) | <0.0001 |
| Multivariable-adjusted | 1 | 1.24 (1.16, 1.33) | 1.54 (1.44, 1.65) | 1.84 (1.72, 1.98) | 2.27 (2.11, 2.45) | <0.0001 |
| TG/HDL (HPFS, n=3,559) | ||||||
| Age-adjusted | 1 | 1.28 (1.19, 1.37) | 1.58 (1.47, 1.70) | 1.92 (1.79, 2.06) | 2.34 (2.18, 2.52) | <0.0001 |
| Multivariable-adjusted | 1 | 1.23 (1.15, 1.32) | 1.49 (1.39, 1.60) | 1.76 (1.64, 1.89) | 2.03 (1.89, 2.19) | <0.0001 |
| TG/HDL (NHS-II, n=1,008) | ||||||
| Age-adjusted | 1 | 1.12 (1.00, 1.26) | 1.29 (1.15, 1.44) | 1.64 (1.46, 1.83) | 1.90 (1.69, 2.13) | <0.0001 |
| Multivariable-adjusted | 1 | 1.06 (0.95, 1.19) | 1.21 (1.08, 1.36) | 1.49 (1.32, 1.68) | 1.67 (1.48, 1.89) | <0.0001 |
NHS, Nurses' Health Study, 1990; NHS-II, Nurses' Health Study-II, 1999; HPFS, Health Professional Follow-up Study, 1994;
Multivariable-adjusted models were adjusted for regular aspirin/NSAIDs use, age, physical activity, smoking status, diabetes, other chronic diseases/conditions, case-control status; NHS-II models were additionally adjusted for menopausal status and postmenopausal hormone use;
Values are relative concentrations of fasting plasma biomarkers (i.e., ratio of concentration in higher index quintiles to concentration in lowest quintile 1 as reference). All values were back transformed (ex where x is the transformed biomarker value) since all biomarkers were transformed using natural log prior to analyses;
The P-value for trend was the P-value of the index as a continuous variable, adjusted for all covariates listed in footnote *;