The Association Between Carbonated Beverages And Carotid Atherosclerosis In Middle-aged And Elderly Population

ObjectiveThe aim of this cross-sectional study was to investigate the association between the frequency of carbonated beverages consumption and carotid atherosclerosis in a middle-aged and elderly population,and to provide evidences for early prevention and nutritional therapy of carotid atherosclerosis.MethodsThe observational data were derived from Tianjin chronic low-grade systemic inflammation and health(TCLSIHealth)Cohort Study.The number of participants who had accepted at least one health examination including carotid ultrasonography during 2013-2016 was 4,742.After all the exclusions,a total of 3,451 participants were involved in the final analysis.All participants participated voluntarily and gave written informed consent before participating.Data on questionnaires,physical exams,and laboratory exams were collected for each participant as data for subsequent statistical analysis.Dietary intakes(including carbonated beverages)were assessed by a valid semi-quantitative food frequency questionnaire,carotid atherosclerosis were assessed using ultrasonography.The frequency of carbonated beverages consumption was divided into three categories: “barely drink”,“<1 cup/w” and “?1 cup/w”.Assessments of carotid atherosclerosis included carotid intima-media thickness(IMT)and carotid plaques.Using analysis of variance and logistic regression to compare the differences of basic characteristics between populations with thickened carotid IMT and nonthickened groups,with or without carotid plaque groups and with different frequency of carbonated beverages consumption.The prevalence of thickened carotid IMT and carotid plaques were used as dependent variables,and the frequency of carbonated beverages consumption were used as independent variables.Multiple logistic regression analysis was used to examine the association between frequency of carbonated beverages consumption and carotid atherosclerosis.Multivariate logistic regression stratified by gender was conducted to investigate the association between the frequency of carbonated beverages consumption and carotid atherosclerosis in men and women respectively.ResultsIn the present study,the prevalence of thickened carotid IMT and carotid plaques in overall participants were 25.7% and 21.3% respectively;in men were 31.1% and 24.2% respectively;in women were 19.0% and 17.5% respectively.The prevalence of thickened carotid IMT and carotid plaques in males were higher than that in women(P for trend <0.0001).In analysis of comparion of basic characteristics,the differences of age,gender,body mass index,waist circumference,blood pressure,biochemical measurement,prevalence of several metabolic disease,smoking and drinking status,dietary intakes,etc.were statistical significant between populations with thickened carotid IMT and non-thickened groups,with or without carotid plaque groups and with different frequency of carbonated beverages consumption(P for trend <0.05).Similar results were observed in subsequent stratification analysis stratified by gender.In multiple logistic regression analysis,after adjustments for all potentially confounding factors,the odds ratios(ORs)(95% confidence interval,CI)of thickened IMT across categories of carbonated beverages consumption were 1.00,0.83(0.60,1.14),0.89(0.63,1.25)(P for trend =0.33)in overall participants;1.00,0.91(0.63,1.30),0.96(0.64,1.42)(P for trend =0.72)in men;and 1.00,0.60(0.26,1.25),0.84(0.41,1.63)(P for trend =0.36)in women.No statistically significant differences were observed in any population.After adjustments for all potentially confounding factors,the OR(95% CI)of carotid plaques by categories of carbonated beverages consumption were 1.00,0.92(0.66,1.26),1.15(0.82,1.60)(P for trend =0.59)in overall participants;1.00,0.83(0.56,1.21),0.83(0.54,1.25)(P for trend =0.28)in men;and 1.00,0.94(0.47,1.76),2.18(1.20,3.88)(P for trend =0.02)in women.No statistically significant differences were observed in overall participants and men.However,compared to women in “barely drink” group,those in “?1 cup/w” group had a 1.18-fold increased risk of developing carotid plaques,with a statistically significant difference(P <0.01).ConclusionsHigher frequency of carbonated beverages consumption(?1 cup/w)was positively associated with carotid plaque in middle-aged and elderly women population,but neither in overall participants nor in men.No statistically significant association between frequency of carbonated beverages consumption and carotid IMT were observed in overall participants and gender stratification analysis.Further cohort studies should be conducted to confirm the causal association between serum ferritin and carotid atherosclerosis.