Correlation Study Of Diet And Lifestyle With Carotid Artery Plaque Formation In Health People In Shenzhen

Objective:This study explored the correlation between carotid plaque formation and different diet and lifestyle in the physical examination group without cardiovascular disease in Shenzhen.The purpose of the current investigation was to further analyze the association of self-reported diet and lifestyle with subclinical atherosclerosis in economically developed areas.Early identification of carotid plaque formation related lifestyle factors can help to support effective primary prevention strategies.Methods:This was a single center,cross-sectional survey in south China.From January 1,2019 to June 30,2019,2338 patients were examined by carotid artery ultrasonography and completed lifestyle questionnaire in Shenzhen People hospital.Those with any prior history of cardiovascular disease,stroke or dyslipidemia,Lack of biochemical indicators,the questionnaire completion rate is below 90%(blank items>3 items)were excluded.This study retrospectively analyzed the medical examination data of 1861 people among health checkup examinees.Details of demographics(age,sex,height,weight,history of accompanying diseases,family history of cardiovascular disease),self-reported diet and lifestyle data(including smoking,drinking,eating habits,exercise and sleeping)and classical risk factors(including blood pressure,fasting glucose,blood lipid level,glycated hemoglobin(HbA1c),serum uric acid and homocysteine)were collected for all the participants.To assess the relationship between multiple traditional risk factors and lifestyle choices associated with cardiovascular disease and the incidence of carotid atherosclerotic plaque through the cross-sectional analysis of the health examination population in Shenzhen.Subjects were categorized as“carotid plaque"group(n=429)or“non-carotid plaque"group(n=1812)according to their carotid artery ultrasonography.Multivariate logistic regression models were used in the analysis.Correlation analysis were performed to assess the independent risk of all the factors and their inter-variable association.Results:1.Baseline DataThere were 1312(70.5%)males and 549(29.5%)females in 1861 health checkups aged from 25 to 85 years.The mean age was 48.9±10.1 years.There were 427(22.89%)cases with carotid plaque,105(5.64%)patients with carotid artery intima-media thickness,1329(71.47%)patients in normal group.The plaque detection rate in 45-54 years old group was 19.91%.Of the 1861 cases,There were 427 carotid plaques,42.9%were bilateral plaques,30.2%left plaque,26.9%right plaque.Of these,54.1%had one plaque,17.1%more than 3 plaques.Most(99.3%)without stenosis,only 0.2%had mild stenosis and 0.5%had moderate stenosis.However,73.1%are vulnerable plaques with hypoechoic or uneven echo on ultrasound.2.Comparison between plaque group and non-plaque group2.1 General characteristics comparisonCompared with the non-plaque group,the plaque group was older,male proportion was higher,and the patients with hypertension and diabetes history were more.With age,the detection rate of carotid plaque increased significantly.Among subjects under 45,the incidence of carotid plaque was only 7.3%(52/713),while the incidence of plaque in patients over 75 years old was as high as 76.9%.Carotid plaque prevalence increased with age,the difference was statistically significant(P<0.05).Compared with women,the detection rate of carotid plaque in men was higher,P<0.05.The detection rate of carotid plaque in postmenopausal women was significantly higher,but still lower than that in men of the same age.2.2 Comparison of laboratory testsCompared with the non-plaque group,the plaque group had higher systolic blood pressure,diastolic blood pressure,fasting blood glucose and glycated hemoglobin,higher TC and UA,lower HDL-C,and higher proportion of fatty liver.The differences between the two groups were significant,P<0.05.2.3 Comparison of diet and lifestyleIn terms of diet,the general intake of beans is insufficient,with 61.8%consuming less than 25-50g per day recommended by dietary guidelines.The intake of other nutrient,eggs,grains,fish,fruits and vegetables accounted for 40.7-62.8%of the population.Most people were relatively healthy,84.7%of them insist on breakfast daily,Only 6%had breakfast less than 3 times a week;81.9%did not overeat,72.1%had more than six glasses of water daily.Most of the subjects in the study had healthier lifestyles,which may be related to their conscious lifestyle improvement as a result of the cross-sectional survey.Tobacco and alcohol are still risk factors related to the development of atherosclerosis.Compared with the non-plaque group,the daily intake of eggs,grains,beans,fish,fruits,vegetables and water in the plaque group were not significantly different,as well as in the frequency of breakfast,meal on time,overeating and weekly exercise.The plaque detection rate of people those daily fruit intake more than 500 g,drinking 300-600ml,daily met intake less than 75g was lower.Spicy preference was associated with a lower risk of carotid plaque.The proportion of those who exercise more than 5 times per week was higher,and the proportion of those who exercise less than 1 time per week is lower in the plaque group.No correlation was found between the duration of exercise and moderate intensity exercise and carotid plaque.Irregular sleep habits were also different,regular irregular sleep was more prone to plaque,P=0.002.While there was no significant difference in sleep duration.The plaque group had more smokers,P<0.01,reported smoking or previous smoking,And a higher number of cigarettes,(5-10 cigarettes,11-15 cigarettes,16-20 cigarettes and≥20 cigarettes per day)more than the non-plaque group.There were also differences in alcohol consumption between the two groups,P=0.002,In the plaque group,more people drank more than 600ml/d,and those who drank 300-600ml were less likely to have plaque(17.7%),while those who drank more than 600ml were 29.7%.3.Logistics regression analysisThere are 18 indicators such as age,gender,history of hypertension,diabetes,glycated hemoglobin,blood pressure,BMI,serum UA,LDL,TG,HDL,fatty liver,smoking,drinking,daily intake of fruit,spicy food preference,sleep regularity and daily intake of meat used as independent variables,Carotid artery plaque is a binary dependent variable for Logistic regression analysis.Choose the Forward LR method,the obtained logistics model was statistically significant,(x2=397.693,P<0.05).This model can correctly classify 80.1%of the research objects.Taking the prediction probability 0.5 as the discriminant cut-off point,The sensitivity of carotid plaque was 36.6%,The specificity was 93.4%,The total judgment rate is 80.1%.Regression analysis showed that subclinical atherosclerosis was influenced significantly by age,gender(male),history of hypertension,fatty liver,glycated hemoglobin increased and smoking.(P<0.05).Moderate alcohol intake(300-600ml per day)also caused a noteworthy decrease in carotid artery plaque compared with heavy drinking(more than 600ml/day).From the age of 35,The plaque detection rate increased by 11.3%per year.Men risk was 1.942 times that of women.The incidence of carotid plaques in smoking was 1.562 times higher than that in nonsmokers(OR=1.562,95%CI:1.176-2.073,P=0.002).However,alcohol consumption decreased the incidence of plaque(OR=0.753,95%CI:0.571--0.993,P=0.044).Conclusion:1.The results of diet and lifestyle survey of the physical examination people in Shenzhen indicated that fruit intake greater than 100g per day and spicy diet may reduce the risk of carotid plaque,while meat intake was not an independent risk factor.There is no significant correlation between the frequency of breakfast,regular meals,binge eating and the incidence of carotid plaque.2.The results of the exercise and sleep habits survey of the physical examination people in Shenzhen indicated that the incidence of carotid artery plaque is higher in the people with irregular sleep.Insufficient exercise times per week was not an independent risk factor for the incidence of carotid plaque.There was no correlation between the duration of exercise and moderate intensity exercise and the carotid plaque.3.The results of the traditional risk factors survey of the physical examination people in Shenzhen indicated that there were still some independent risk factors for the incidence of carotid plaque,such as age,gender,history of hypertension,high glycated hemoglobin,fatty liver and smoking.While moderate alcohol consumption may contribute to prevent carotid plaque.