Associations between diet quality and NT-proBNP in U.S. adults, NHANES 1999-2004

Ping Yang; Mary R Rooney; Amelia S Wallace; Hyunju Kim; Justin B Echouffo-Tcheugui; John W McEvoy; Chiadi Ndumele; Robert H Christenson; Elizabeth Selvin; Casey M Rebholz

doi:10.1016/j.ajpc.2023.100528

Associations between diet quality and NT-proBNP in U.S. adults, NHANES 1999-2004

Am J Prev Cardiol. 2023 Jul 30:16:100528. doi: 10.1016/j.ajpc.2023.100528. eCollection 2023 Dec.

Authors

Ping Yang^{1

2}, Mary R Rooney^{1

2}, Amelia S Wallace^{1

2}, Hyunju Kim^{1

2}, Justin B Echouffo-Tcheugui³, John W McEvoy⁴, Chiadi Ndumele⁵, Robert H Christenson⁶, Elizabeth Selvin^{1

2}, Casey M Rebholz^{1

2}

Affiliations

¹ Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland.
² Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
³ Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁴ National Institute for Prevention and Cardiovascular Health, School of Medicine, National University of Ireland Galway, Galway, Ireland.
⁵ Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.

Abstract

Objective: N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is a marker of cardiac wall stress and is a predictor of cardiovascular disease. Higher diet quality is associated with lower risk of cardiovascular disease. The association between diet quality and subclinical cardiovascular disease assessed by NT-proBNP is uncharacterized. We investigated the associations between diet quality, using Healthy Eating Index-2015 (HEI-2015), and NT-proBNP from the National Health and Nutrition Examination Survey (NHANES) 1999-2004.

Methods: We included 9,782 adults from NHANES 1999-2004 without self-reported cardiovascular disease. The HEI-2015 ranges from 0 to 100, with higher scores indicating better diet quality. The HEI-2015 was categorized into sex-specific quintiles. Regression models were used to quantify associations between the overall HEI-2015 score and its 13 components with log-transformed NT-proBNP. The beta coefficients were converted to percent differences.

Results: Among 9,782 participants, mean age was 45 years, 48% were men, and 72% were non-Hispanic White adults. After adjusting for sociodemographic characteristics, lifestyle factors, and medical history, those in the highest vs. lowest HEI-2015 quintile had an 8.5% (95% CI: -14.6% to -2.0%) lower NT-proBNP level. There was a dose-response association between HEI-2015 and NT-proBNP (P value for trend = 0.01). Each 1-unit higher in sodium and added sugars score indicating lower intake was associated with lower NT-proBNP by 7.7% (95% CI: -12.8% to -2.2%) and 6.5% (95% CI: -12.0% to -0.7%), respectively.

Conclusion: Higher diet quality, especially lower intakes of sodium and added sugars, was associated with lower serum levels of NT-proBNP.

Keywords: Diet quality; Healthy Eating Index-2015; Heart failure; N-terminal pro B-type natriuretic peptide.

Abstract

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