Higher composite dietary antioxidant index (CDAI) was associated with a 7% reduced odds of AA/AD incidence (OR 0.93) and a 17% reduction in mortality risk (HR 0.83) compared to lowest CDAI quartile in UK adults aged 37–73.
Cohort (n=172,450)
Yes
Does a higher composite dietary antioxidant index (CDAI) reduce the incidence and mortality of aortic aneurysm and dissection in adults?
A higher composite dietary antioxidant index is associated with a reduced risk of incidence and mortality from aortic aneurysm and dissection, suggesting a potential protective role of dietary antioxidants.
Effect estimate: Incidence OR 0.93 (95% CI 0.88–0.99), p=0.024; Mortality HR 0.83 (95% CI 0.71–0.96), p=0.018 comparing highest (Q4) vs lowest CDAI quartile (95% CI Incidence 0.88–0.99; Mortality 0.71–0.96)
p-value: p=Incidence 0.024; Mortality 0.018
Background The composite dietary antioxidant index (CDAI) is a scoring system designed to assess overall dietary antioxidant capacity and has been associated with a reduced risk of cardiovascular diseases. However, its specific impact on aortic aneurysm and dissection (AA/AD) remains unclear. This study aimed to investigate the associations of CDAI with both the incidence and mortality of AA/AD. Methods In this UK Biobank-based study, univariate and multivariate logistic regression models were used to assess the association between CDAI and the incidence of AA/AD, the association of CDAI with mortality was evaluated using Cox proportional hazards models. We employed restricted cubic spline (RCS) analyses to examine potential linear or non-linear relationships between the key nutrient components of the CDAI and the outcomes. Furthermore, mediation analysis was performed to assess the potential mediating effects of selected metabolic indicators. Results A total of 172,450 participants were included in this study, of whom 1,486 developed AA/AD. Univariate logistic regression analysis revealed a significant inverse association between CDAI and the incidence of AA/AD (OR = 0.93, 95% CI: 0.88–0.99, p = 0.024). A significantly lower risk of AA/AD mortality was observed in participants within the highest quartile of CDAI compared to those in the lowest quartile (HR = 0.83, 95% CI: 0.71–0.96, p = 0.018), based on the Cox regression analysis. RCS analysis indicated a linear relationship between CDAI and the mortality of AA/AD (P for overall 0.001; P for nonlinear 0.05). Furthermore, mediation analysis suggested that uric acid, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and high-density lipoprotein cholesterol (HDL-C) mediated the association between CDAI and AA/AD incidence. Conclusion This study supports the pathogenic role of oxidative stress and inflammation in AA/AD, demonstrating that a higher CDAI is associated with lower incidence and mortality of AA/AD in a UK-based adult population. These findings provide new insights, suggesting that dietary antioxidant intervention could serve as a potential preventive strategy against these conditions.
Lai et al. (Fri,) conducted a cohort in Adults aged 37-73 in the United Kingdom without prior aortic aneurysm or dissection, severe liver disease, or malignancy, assessed for incidence and mortality of aortic aneurysm and dissection (AA/AD) (n=172,450). Composite dietary antioxidant index (CDAI) vs. Lowest quartile (Q1) CDAI score was evaluated on Incidence and mortality of aortic aneurysm and dissection (AA/AD) (Incidence OR 0.93 (95% CI 0.88–0.99), p=0.024; Mortality HR 0.83 (95% CI 0.71–0.96), p=0.018 comparing highest (Q4) vs lowest CDAI quartile, 95% CI Incidence 0.88–0.99; Mortality 0.71–0.96, p=Incidence 0.024; Mortality 0.018). Higher composite dietary antioxidant index (CDAI) was associated with a 7% reduced odds of AA/AD incidence (OR 0.93) and a 17% reduction in mortality risk (HR 0.83) compared to lowest CDAI quartile in UK adults aged 37–73.