遗传风险与坚持饮食方法停止高血压饮食与发展静脉血栓栓塞之间的关系

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis Pub Date : 2025-02-01 DOI:10.1016/j.rpth.2025.102731

Si Li , Minghui Jiang , Yunlong Guan , Xi Cao , Zhonghe Shao , Jun Deng , Xingjie Hao

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引用次数: 0

摘要

饮食与静脉血栓栓塞（VTE）之间的关系尚不清楚，饮食模式和遗传易感性对VTE风险的共同影响尚不清楚。目的探讨DASH （Dietary Approaches to Stop Hypertension）饮食依从性和多基因风险评分（polygenic risk score， PRS）对静脉血栓栓塞（VTE）风险的独立和联合影响。方法共纳入411,539名英国生物银行参与者。DASH评分采用食物频率问卷计算，PRS量化遗传风险。Cox比例风险模型估计VTE的风险比（hr），评估DASH饮食与遗传易感性之间的相互作用。结果在中位13.4年的随访期间，10,543名参与者被诊断为静脉血栓栓塞。DASH评分越高，静脉血栓栓塞风险越低(HR, 0.87；95% ci, 0.82-0.92)。低依从性DASH饮食合并高遗传风险的VTE风险最高(HR, 2.78；95% ci, 2.47-3.14)。高DASH评分降低了高遗传风险个体的静脉血栓栓塞风险(HR, 0.84；95% ci, 0.76-0.92)。在DASH分数和PRS的联合效应和相互作用中发现了性别特异性关联。值得注意的是，高DASH分数可以抵消男性的中等遗传风险(HR, 0.79；95% ci, 0.67-0.94)。在所有受试者和男性中，DASH评分与高遗传风险之间存在加性相互作用，而在女性中没有观察到。结论DASH饮食可降低静脉血栓栓塞风险，并可部分抵消遗传易感性。低依从DASH饮食会增加静脉血栓栓塞的风险，特别是在高遗传风险个体中。高DASH分数对静脉血栓栓塞遗传风险的保护作用在男性中更为明显。精准医学应该同时考虑饮食和基因预防静脉血栓栓塞。

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Association between genetic risk and adherence to the Dietary Approaches to Stop Hypertension diet for developing venous thromboembolism

Background

The relationship between diet and venous thromboembolism (VTE) remains unclear, and the joint effects of diet patterns and genetic susceptibility on VTE risk are unknown.

Objectives

Investigate the independent and joint effects of Dietary Approaches to Stop Hypertension (DASH) diet adherence and polygenic risk scores (PRS) on VTE risk.

Methods

A total of 411,539 UK Biobank participants were included. DASH scores were calculated using Food Frequency Questionnaires, and PRS quantified genetic risk. Cox proportional hazard models estimated hazard ratios (HRs) for VTE, assessing interactions between the DASH diet and genetic susceptibility.

Results

During a median follow-up of 13.4 years, 10,543 participants were diagnosed with VTE. Higher DASH scores were associated with a lower VTE risk (HR, 0.87; 95% CI, 0.82-0.92). A low-adherent DASH diet combined with high-genetic risk had the highest VTE risk (HR, 2.78; 95% CI, 2.47-3.14). High DASH scores reduced VTE risk in high-genetic-risk individuals (HR, 0.84; 95% CI, 0.76-0.92). Sex-specific associations were detected in the joint effect and interaction of DASH scores and PRS. Notably, high DASH scores can offset moderate genetic risk among men (HR, 0.79; 95% CI, 0.67-0.94). There were additive interactions between DASH scores and high genetic risk in total subjects and men, while not observed in women.

Conclusion

The DASH diet is associated with reduced VTE risk and can partially offset genetic predisposition. Low adherence to the DASH diet increases VTE risk, particularly in high-genetic-risk individuals. The protective effect of high DASH scores against genetic risks for VTE is more pronounced in males. Precision medicine should consider both diet and genetics for VTE prevention.

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