与生物标志物校准的蛋白质摄入相关的心力衰竭风险和亚型：妇女健康倡议队列研究

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-07-10 DOI:10.1016/j.ajpc.2025.101051

Muhammad Baig , Ali A Khan , Miremad Moafi-Madani , Mary B. Roberts , Matthew Allison , Karen C. Johnson , Michael J. LaMonte , Aabiha Kermani , Yasaa Mohammad , Charles B. Eaton

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引用次数: 0

摘要

心力衰竭（HF）是一种日益流行的疾病，与男性相比，绝经后女性发生具有保留射血分数（HFpEF）的心力衰竭的风险明显更高。关于其与膳食蛋白质摄入量之间关系的数据有限。方法为了研究饮食蛋白质摄入与绝经后妇女HF及其亚型风险的关系，我们纳入了妇女健康倡议（WHI） HF队列的绝经后妇女。通过WHI营养生物标志物研究（WHI- nbs）中的生物标志物测量来评估蛋白质摄入量，并根据基于食物频率问卷（FFQ）的蛋白质摄入量进行校准。采用cox -比例风险回归分析研究相关性。结果共纳入14789例女性，平均年龄62(7)岁，随访14(8)年。参与者主要是非裔美国人（48.5%）。校正了年龄、教育程度、收入、种族/民族、体力活动、吸烟、饮酒、冠心病流行和发病率、高血压、高脂血症和房颤的多变量cox -比例风险回归模型显示，在所有五分位数（Q2-Q5）中，与第一分位数相比，摄入较高的膳食蛋白质会增加住院HF和HFpEF的总发生率(HF的HR， Q5与第一分位数相比：2.26,95% CI: 1.66, 3.09, P<；HFpEF的HR， Q5与Q1相比：2.50,95% CI 1.62, 3.84, P< 0.0001)。当按BMI分层时，HF和HFpEF的风险在BMI的五分位数中均升高；30，表明BMI可能是一种效果调节剂。总之，较高的蛋白质摄入与HF和HFpEF的风险增加有关，特别是在肥胖参与者中。

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Risk of heart failure and subtypes with biomarker-calibrated protein intake: Women’s health initiative cohort study

Introduction

Heart failure (HF) is a growing epidemic, with risk of HF with preserved ejection fraction (HFpEF) significantly higher in post-menopausal women compared to men. Data on its association with dietary protein intake is limited.

Methods

To study the association of dietary protein intake with risk of HF and its subtypes in post-menopausal women, we included post-menopausal women from Women’s Health Initiative’s (WHI) HF cohort. Protein intake was assessed from the biomarker measurements in the WHI Nutrient Biomarker Study (WHI-NBS), and its calibration on Food-Frequency-Questionnaire (FFQ) based protein intake. Cox-proportional hazards regression analysis was used to study associations.

Results

Total of 14,789 women were included with a mean age (SD) of 62 (7) years and follow-up of 14 (8) years. Participants were predominantly African American (48.5 %). Multivariable Cox-proportional hazards regression model adjusted for age, education, income, race/ethnicity, physical activity, smoking, alcohol, prevalent and incident CHD, hypertension, hyperlipidemia, and atrial fibrillation showed elevated risk of total incident hospitalized HF and HFpEF with higher intake of dietary protein across all quintiles (Q2-Q5) compared to Q1 in a dose-response relationship (HR of HF, Q5 compared to Q1: 2.26, 95 % CI: 1.66, 3.09, P<.0001; HR of HFpEF, Q5 compared to Q1: 2.50, 95 % CI 1.62, 3.84, P<.0001). When stratified by BMI, HF and HFpEF risk was elevated across quintiles of BMI > 30, indicating BMI may be an effect modifier.