A nutrient-wide association study on blood pressure.
A nutrient-wide association study on blood pressure.
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DOI：
10.1161/circulationaha.112.114058
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发表时间：
2012-11-20
期刊：
影响因子：
37.8
通讯作者：
Elliott P
中科院分区：
文献类型：
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作者：
Tzoulaki I;Patel CJ;Okamura T;Chan Q;Brown IJ;Miura K;Ueshima H;Zhao L;Van Horn L;Daviglus ML;Stamler J;Butte AJ;Ioannidis JP;Elliott P
全营养素方法可能有助于全面测试和验证营养素（来自食物和补充剂）与血压（BP）之间的关联。来自4，680名年龄在40-59岁之间的参与者的数据在宏观/微观营养素和血压的横断面国际研究（INTERMAP）中随机分层为训练集和测试集。1999-2000年至2005-2006年的NHANES横截面队列用于外部验证。我们进行了多元线性回归分析，将82种营养素和3种尿电解质与INTERMAP训练集中的收缩压和舒张压相关联。在INTERMAP测试集中以及在NHANES群组中进一步验证了显著的发现（训练中的错误发现率<5%，内部和外部验证的p<0.05）。在验证的营养素中，酒精和尿钠钾比与收缩压直接相关，饮食中的磷、镁、铁、硫胺素、叶酸和核黄素与收缩压呈负相关。此外，膳食叶酸和核黄素与舒张压呈负相关。验证数据（NHANES）中的绝对效应量范围为收缩压（磷）降低0.97 mmHg至收缩压（硫胺素）降低0.39 mmHg/1 SD营养变量差异。除了食物外，补充剂中的营养摄入量对某些营养素也产生了类似的结果，尽管它削弱了叶酸、硫胺素和核黄素摄入量与血压的相关性。我们发现B族维生素和血压之间存在显著的负相关关系，这种关系迄今为止研究得很少。我们的分析代表了一个系统的无偏的方法来评估和验证营养素BP协会。
A nutrient-wide approach may be useful comprehensively to test and validate associations between nutrients (derived from foods and supplements) and blood pressure (BP) in an unbiased manner. Data from 4,680 participants ages 40–59 in the cross-sectional International Study of Macro/Micro-nutrients and Blood Pressure (INTERMAP) were stratified randomly into training and testing sets. NHANES cross-sectional cohorts of 1999–2000 to 2005–2006 were used for external validation. We performed multiple linear regression analyses associating each of 82 nutrients and 3 urine electrolytes with systolic and diastolic BP in the INTERMAP training set. Significant findings were validated in the INTERMAP testing set and further in the NHANES cohorts (False Discovery Rate <5% in training, p<0.05 for internal and external validation). Among the validated nutrients, alcohol and urinary sodium-to-potassium ratio were directly associated with systolic BP, and dietary phosphorus, magnesium, iron, thiamin, folacin, and riboflavin were inversely associated with systolic BP. In addition, dietary folacin, and riboflavin were inversely associated with diastolic BP. The absolute effect sizes in the validation data (NHANES) ranged from 0.97 mmHg lower systolic BP (phosphorus) to 0.39 mmHg lower systolic BP (thiamin) per 1SD difference in nutrient variable. Inclusion of nutrient intake from supplements in addition to foods gave similar results for some nutrients, though it attenuated the associations of folacin, thiamin and riboflavin intake with BP. We identified significant inverse associations between B vitamins and BP, relationships hitherto poorly investigated. Our analyses represent a systematic unbiased approach to the evaluation and validation of nutrient-BP associations.