TABLE 2.
Macronutrients in relation to risk of systemic lupus erythematosus among 51,934 participants in the Black Women's Health Study, 1995–20151
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | P trend5 | |
|---|---|---|---|---|---|---|
| Macronutrients2 | ||||||
| Carbohydrates | ||||||
| Cases/person years | 15/169,675 | 19/172,869 | 25/172,802 | 25/172,546 | 30/169,790 | |
| Age-adj. HR (95% CI)3 | 1.00 Ref | 1.24 (0.63, 2.45) | 1.64 (0.86, 3.11) | 1.67 (0.88, 3.18) | 2.04 (1.10, 3.79) | __ |
| MVHR (95% CI)4 | 1.00 Ref | 1.23 (0.62, 2.42) | 1.61 (0.84, 3.06) | 1.63 (0.86, 3.11) | 1.96 (1.02, 3.67) | 0.02 |
| Proteins | ||||||
| Cases/person years | 29/170,031 | 26/171,787 | 22/172,856 | 18/172,299 | 19/170,708 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.88 (0.52, 1.50) | 0.75 (0.43, 1.31) | 0.61 (0.34, 1.10) | 0.66 (0.37, 1.18) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.90 (0.53, 1.53) | 0.76 (0.44, 1.33) | 0.61 (0.34, 1.11) | 0.66 (0.37, 1.18) | 0.07 |
| Total fat | ||||||
| Cases/person years | 29/170,219 | 27/172,724 | 27/172,430 | 16/172,587 | 15/169,721 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.91 (0.54, 1.53) | 0.90 (0.53, 1.52) | 0.53 (0.29, 0.98) | 0.52 (0.28, 0.96) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.91 (0.54, 1.53) | 0.92 (0.54, 1.56) | 0.54 (0.30, 1.00) | 0.54 (0.28, 1.01) | 0.02 |
| Types of fat | ||||||
| PUFAs | ||||||
| Cases/person years | 31/169,756 | 19/172,209 | 26/172,312 | 19/171,460 | 19/171,943 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.61 (0.34, 1.08) | 0.84 (0.50, 1.41) | 0.62 (0.35, 1.09) | 0.65 (0.36, 1.15) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.61 (0.34, 1.08) | 0.84 (0.50, 1.42) | 0.63 (0.35, 1.12) | 0.66 (0.37, 1.17) | 0.18 |
| ω-3 fatty acids | ||||||
| Cases/person years | 32/167,779 | 19/168,647 | 15/168,906 | 25/168,961 | 21/168,522 | __ |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.59 (0.34, 1.05) | 0.48 (0.26, 0.88) | 0.80 (0.47, 1.35) | 0.68 (0.39, 1.19) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.59 (0.33, 1.04) | 0.47 (0.26, 0.88) | 0.79 (0.46, 1.34) | 0.66 (0.38, 1.16) | 0.47 |
| ω-6 fatty acids | ||||||
| Cases/person years | 29/169,888 | 21/172,002 | 26/172,305 | 20/171,581 | 18/171,905 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.72 (0.41, 1.26) | 0.90 (0.53, 1.52) | 0.69 (0.39, 1.23) | 0.66 (0.36, 1.19) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.72 (0.41, 1.26) | 0.90 (0.53, 1.53) | 0.71 (0.40, 1.25) | 0.66 (0.37, 1.20) | 0.19 |
| MUFAs | ||||||
| Cases/person years | 32/170,292 | 22/172,515 | 28/172,754 | 15/172,055 | 17/170,064 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.67 (0.39, 1.15) | 0.84 (0.51, 1.40) | 0.45 (0.24, 0.84) | 0.53 (0.29, 0.95) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.67 (0.39, 1.16) | 0.86 (0.51, 1.43) | 0.47 (0.25, 0.87) | 0.55 (0.30, 1.00) | 0.02 |
| Saturated fats | ||||||
| Cases/person years | 29/170,633 | 28/172,915 | 23/172,362 | 17/171,797 | 17/169,974 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 0.93 (0.55, 1.56) | 0.75 (0.43, 1.30) | 0.54 (0.30, 0.99) | 0.55 (0.30, 1.00) | __ |
| MVHR (95% CI) | 1.00 Ref | 0.95 (0.56, 1.60) | 0.77 (0.44, 1.34) | 0.57 (0.31, 1.04) | 0.57 (0.31, 1.06) | 0.02 |
| Trans fatty acids | ||||||
| Cases/person years | 30/169,432 | 31/171,655 | 15/173,349 | 20/171,574 | 18/171,671 | |
| Age-adj. HR (95% CI) | 1.00 Ref | 1.02 (0.61, 1.68) | 0.49 (0.26, 0.90) | 0.66 (0.37, 1.16) | 0.60 (0.34, 1.08) | __ |
| MVHR (95% CI) | 1.00 Ref | 1.03 (0.62, 1.70) | 0.49 (0.26, 0.92) | 0.66 (0.38, 1.17) | 0.61 (0.34, 1.10) | 0.03 |
Analysis was done using Cox proportional regression. MVHR, multivariable HR.
All macronutrients were assessed as g/d and were adjusted for energy using the residual method. Each model includes only the respective energy-adjusted macronutrient. For example, the carbohydrate model is comparing carbohydrate intake compared with all other macronutrients.
Age-adjusted (Age-adj.) HRs were adjusted for age, period, and energy intake (continuous).
MVHRs were adjusted for age, period, energy intake (continuous), alcohol intake status (current, past, never), smoking status (current, past, never), BMI (<20, 20–24.9, 25–29.9, ≥30 kg/m2), quintiles of neighborhood socioeconomic status, years of education (≤ 12, 13–15, 16, ≥ 17), vigorous physical activity (none, <5, ≥5 h/wk).
Tests of linear trend assessed the median of each quintile as scores, adjusted for age, period, energy intake (continuous), alcohol intake status (current, past, never), smoking status (current, past, never), BMI (<20, 20–24.9, 25–29.9, ≥30 kg/m2), quintiles of neighborhood socioeconomic status, years of education (≤ 12, 13–15, 16, ≥ 17), vigorous physical activity (none, <5, ≥5 h/wk).