膳食和生活方式氧化平衡评分与血浆致动脉粥样硬化指数的关联

Association between dietary and lifestyle oxidative balance score and atherogenic index of plasma

摘要

目的 探讨氧化平衡评分（OBS）与血浆致动脉粥样硬化指数（AIP）的关联，为动脉粥样硬化（AS）的早期识别和预防提供科学依据。方法 基于2020年8月至2021年4月福建省心血管病及其危险因素监测数据，纳入8 851名合格研究对象。通过4种膳食营养素和6种生活方式因素计算OBS，根据AIP评估AS风险，将研究对象分为低AIP组（AIP＜0.24）和高AIP组（AIP ≥ 0.24）。采用非条件logistic回归分析OBS与AIP的关联，运用限制性立方样条（RCS）曲线分析剂量-反应关系，通过亚组分析及相乘交互作用检验探究在不同人群中OBS与AIP的关联，并通过中介效应分析评估尿酸、白细胞和中性粒细胞（NE）潜在的中介作用。结果 多因素logistic回归结果显示，OBS与高AIP水平呈负相关（OR = 0.89，95%CI：0.87～0.91，P＜0.001）。与OBS最低四分位数（Q1）相比，最高四分位数（Q4）人群高AIP的风险降低40%（OR = 0.60，95%CI：0.49～0.72，P＜0.001）。亚组分析显示，OBS与年龄（P_交互 = 0.012）和血脂异常（P_交互 = 0.010）存在相乘交互作用。此外，OBS与AIP之间存在非线性剂量反应关系（P_非线性＜0.001）。中介效应结果显示，尿酸、白细胞及NE在OBS与AIP的关联中发挥部分中介作用。结论 OBS与AIP呈负相关，且年龄和血脂异常与OBS存在相乘交互作用。

Abstract

Objective To investigate the association between the oxidative balance score (OBS) and atherogenic index of plasma (AIP), providing scientific evidence for the early identification and prevention of atherosclerosis (AS). Methods A total of 8 851 eligible participants from the surveillance data of cardiovascular diseases and related risk factors in Fujian Province from August 2020 to April 2021 were included. The OBS was calculated using four dietary nutrient factors and six lifestyle-related factors. AIP was used as a surrogate marker of AS risk, and participants were categorized into a low-AIP group (AIP ＜ 0.24) and a high-AIP group (AIP ≥ 0.24). Unconditional logistic regression was used to examine the association between OBS and AIP. Restricted cubic spline (RCS) analysis was conducted to evaluate the dose–response relationship. Subgroup analyses and multiplicative interaction tests were performed to explore the associations in different populations. Mediation analysis was used to assess the potential mediating effects of uric acid (UA), white blood cells (WBC), and neutrophil (NE). Results Multivariable logistic regression analysis showed a negative association between OBS and high AIP levels (OR = 0.89, 95%CI: 0.87–0.91, P < 0.001). Compared with the lowest quartile (Q1) of OBS, the risk of high AIP in the highest quartile (Q4) was reduced by 40% (OR = 0.60, 95%CI: 0.49–0.72, P < 0.001). Subgroup analyses showed multiplicative interactions between OBS and age (P_interaction = 0.012) and dyslipidemia (P_interaction = 0.010). In addition, there was a nonlinear dose-response relationship between OBS and AIP (P_nonlinearity < 0.001). Mediation analysis results indicated that UA, WBC, and NE played partial mediating roles in the association between OBS and AIP. Conclusions OBS is negatively associated with AIP, and there are multiplicative interactions between age and dyslipidemia with OBS.

关键词

氧化平衡评分 / 氧化应激 / 血浆致动脉粥样硬化指数 / 动脉粥样硬化 / 食物 / 生活方式

Key words

oxidative balance score / oxidative stress / atherogenic index of plasma / atherosclerosis / diet / lifestyle

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基金资助

国家卫生健康委员会项目(NHC2020-609)

福建省财政补助卫生专项(BPB-2025HY)

福建省卫健委青年科研课题(2023QNA025)