Dietary Amino Acids and Risk of Stroke Subtypes: Results from 3 Large Prospective Cohort Studies

IF 3.7 3区医学 Q2 NUTRITION & DIETETICS

Journal of Nutrition Pub Date : 2025-05-01 DOI:10.1016/j.tjnut.2025.03.026

Tammy YN Tong , Yanping Li , Kathryn M Rexrode , Walter C Willett , Qi Sun , JoAnn E Manson , Valter D Longo , Timothy J Key , Frank B Hu

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引用次数: 0

Abstract

Background

Differences in dietary protein have been associated with stroke risk, with possible heterogeneity in associations by stroke type or food sources of protein.

Objectives

We examined the associations of individual dietary amino acids, as the constituents of dietary protein, with risks of ischemic, hemorrhagic, and total stroke.

Methods

We analyzed data from 73,830 females in the Nurses’ Health Study (1984–2012), 92,333 females in the Nurses’ Health Study II (1991–2013), and 43,268 males in the Health Professionals Follow-Up Study (1986–2016). Dietary intakes of 22 (20 standard and 2 nonstandard) amino acids were assessed using validated food frequency questionnaires, administered typically every 4 y. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischemic, hemorrhagic, and total stroke in relation to the energy-adjusted intakes of individual amino acids.

Results

During a mean follow-up of 23.7 y, 3058 ischemic, 872 hemorrhagic, and 5997 total stroke cases were documented. After correction for multiple testing, lower risks of ischemic stroke were observed with higher intakes of glutamine (HR per 1 standard deviation higher: 0.94, 95% CI: 0.90, 0.98, P = 0.004) and proline (0.94, 0.90, 0.98, P = 0.005). The associations remained directionally consistent across sensitivity analyses but attenuated upon mutual adjustment. All other amino acids, including branched-chain amino acids, were not significantly associated with ischemic stroke. For hemorrhagic stroke, no significant associations were observed for any of the amino acids. For total stroke, inverse associations were also observed for both glutamine (0.94, 0.91–0.97, P < 0.001) and proline (0.96, 0.93–0.99, P = 0.004). In terms of dietary sources, glutamine was most strongly correlated with plant protein and whole grains, whereas proline was most strongly correlated with dairy protein and dairy products.

Conclusions

Higher intakes of glutamine and proline were associated with lower risks of ischemic and total stroke.

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膳食氨基酸与卒中亚型风险：来自三个大型前瞻性队列研究的结果。

背景：饮食蛋白质的差异与卒中风险相关，可能存在卒中类型或蛋白质食物来源相关性的异质性。目的：我们研究了作为膳食蛋白质成分的单个膳食氨基酸与缺血性、出血性和全脑卒中风险的关系。方法：我们分析了护士健康研究（1984-2012）中的73830名女性、护士健康研究II（1991-2013）中的92333名女性和卫生专业人员随访研究（1986-2016）中的43268名男性的数据。通过有效的食物频率问卷评估22种（20种标准和2种非标准）氨基酸的膳食摄入量，通常每四年进行一次。采用多变量校正Cox回归模型估计缺血性、出血性和总卒中的风险比（hr）和95%置信区间（CIs）与能量调整后的单个氨基酸摄入量之间的关系。结果：在23.7年的平均随访中，记录了3058例缺血性卒中，872例出血性卒中和5997例卒中。经多重检验校正后，谷氨酰胺（HR / 1 SD高0.94,95% CI: 0.90-0.98， p值=0.004）和脯氨酸（0.94,0.90-0.98，p值=0.005）的摄入量较高，缺血性卒中风险较低。这些关联在敏感性分析中保持方向一致，但在相互调整后减弱。所有其他氨基酸，包括支链氨基酸，与缺血性脑卒中无显著相关性。对于出血性中风，没有观察到任何氨基酸的显著关联。对于总卒中，谷氨酰胺和脯氨酸也呈负相关（0.94,0.91-0.97，p值）。结论：谷氨酰胺和脯氨酸的高摄入量与缺血性卒中和总卒中的风险降低相关。

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来源期刊

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.