Table_5_Dietary copper intake and risk of myocardial infarction in US adults: A propensity score-matched analysis.DOC

ObjectivesMost studies have examined the association between serum copper and myocardial infarction, but there is little evidence of the association between dietary copper intake and myocardial infarction.
Materials and methodsThe study included a total of 14,876 participants from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression model was used to analyze the association between dietary copper intake and the risk of myocardial infarction. To reduce selection bias, we use nearest neighbor propensity score matching (PSM) in a 1:2 ratio. Restricted cubic spline (RCS) method is used to study the non-linear relationship. Subgroup stratification was used to further investigate the association between copper intake and myocardial infarction.
ResultsThe median dietary copper intake was 1.0825 mg/day. A myocardial infarction had occurred in approximately 4.4% (655) of the participants. Before and after matching, multivariate logistic regression models revealed a negative correlation between dietary copper intake and the risk of myocardial infarction. The higher quartile of subjects had a noticeably lower risk of myocardial infarction in comparison to those in the first quartile of copper intake. According to RCS findings, dietary copper intake and myocardial infarction have a non-linear and dose-response relationship. According to stratified analysis, the dietary copper intake was a substantial protective element for those who were ≥ 50 years old, female, 25 ≤BMI <30, with history of smoking, hypertension, diabetes and ortholiposis.
ConclusionIncreased dietary copper intake was associated with a lower risk of myocardial infarction. It is especially significant in elderly-aged women, overweight individuals, smokers, hypertension, and diabetic patients.

研究目标：既往多数研究已探讨血清铜与心肌梗死的关联，但关于膳食铜摄入与心肌梗死相关性的证据仍较为匮乏。
材料与方法：本研究纳入2011至2018年美国国家健康与营养调查（National Health and Nutrition Examination Survey, NHANES）的14876名参与者。采用多因素logistic回归模型分析膳食铜摄入与心肌梗死发病风险的关联。为降低选择偏倚，本研究采用1:2配比的近邻倾向得分匹配（propensity score matching, PSM）方法进行校正。采用限制性立方样条（restricted cubic spline, RCS）方法探究二者的非线性关联。通过亚组分层分析进一步明确铜摄入与心肌梗死的关联特征。
研究结果：本研究中参与者的膳食铜摄入中位数为1.0825 mg/天，约4.4%（655名）的参与者曾发生心肌梗死。匹配前后的多因素logistic回归分析均显示，膳食铜摄入与心肌梗死发病风险呈负相关。与铜摄入最低四分位组的参与者相比，铜摄入最高四分位组的心肌梗死发病风险显著降低。限制性立方样条分析结果表明，膳食铜摄入与心肌梗死风险之间存在非线性剂量-反应关系。亚组分析结果显示，膳食铜摄入对年龄≥50岁、女性、BMI介于25至30之间（25≤BMI<30）、有吸烟史、高血压、糖尿病及血脂异常的人群具有显著保护作用。
研究结论：膳食铜摄入水平升高与心肌梗死发病风险降低显著相关，该关联在老年女性、超重人群、吸烟者、高血压患者及糖尿病患者中尤为显著。