Background: Abdominal aortic aneurysm (AAA) is a progressive vascular disease with high mortality after rupture. Although genetic susceptibility is a major determinant of AAA risk, the role of dietary quality in its development remains unclear. We therefore investigated the association between adherence to the Alternative Healthy Eating Index-2010 (AHEI-2010) and incident AAA, and examined whether this association was modified by genetic susceptibility, as measured by a polygenic risk score (PRS) Methods: We analyzed 176,397 UK Biobank participants who completed at least one web-based 24-h dietary recall. Dietary quality was assessed using the AHEI-2010, and a PRS for AAA was derived using the polygenic risk score–continuous shrinkage (PRS-CS) method. Incident AAA cases were ascertained through hospital inpatient and death registry records, and Cox proportional hazards models estimated hazard ratios (HRs) with multivariable adjustment. Interactions and joint effects of AHEI-2010 and PRS were further examined. Results: Over a mean follow-up of 13.3 years, 619 AAA cases occurred. Higher AHEI-2010 scores were associated with a lower risk of AAA (HR for highest vs. lowest tertile = 0.73; 95% confidence interval CI: 0.59–0.89; HR per 1-standard deviation SD increase = 0.88; 95% CI: 0.81–0.96), with a linear dose–response relationship. Fruit and whole grain intake were independently protective. Participants in the highest PRS quintile had a more than twofold increased risk of AAA (HR = 2.36; 95% CI: 2.10–3.36). No significant multiplicative or additive interactions were detected between diet and genetics; however, joint analyses showed that individuals with low PRS and high AHEI-2010 scores had nearly 90% lower risk of AAA compared with those with high PRS and low AHEI-2010 scores (HR = 0.11; 95% CI: 0.05–0.21). Conclusion: This study demonstrates that higher AHEI-2010 scores and lower genetic susceptibility are both strongly associated with reduced risk of AAA. These findings suggest that integrating dietary strategies and genetic screening into targeted AAA prevention programs may have substantial utility.
Liu et al. (Wed,) studied this question.