Fresh vegetable and fruit consumption and carotid atherosclerosis in high-cardiovascular-risk population: a cross-sectional study in Jiangsu, China

This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.本研究旨在探讨中国江苏省城乡心血管疾病（CVD, cardiovascular diseases）高风险成人群体中，蔬菜水果摄入与颈动脉粥样硬化两项预测指标——颈动脉斑块（CP, carotid plaque）及颈动脉内膜中层厚度（CIMT, carotid intima-media thickness）之间的关联。本项横断面研究于2015年11月至2016年5月在江苏省开展，从71511名普通人群中筛选出11392名CVD高风险成人。在这11392名高风险参与者中，颈动脉斑块的患病率为36.7%。本研究通过食物频率问卷评估自变量——蔬菜水果摄入频率，通过超声检查测定结局指标——颈动脉内膜中层厚度与颈动脉斑块。协方差分析（ANCOVA, analysis of covariance）结果显示，颈动脉内膜中层厚度值与蔬菜水果摄入频率无显著关联。研究采用多因素logistic回归模型，探究蔬菜水果摄入与颈动脉斑块的关联。在校正潜在混杂因素后，与极少摄入蔬菜的参与者相比，偶尔摄入及每日摄入蔬菜的参与者发生任意类型颈动脉斑块的比值比（OR, odds ratios）分别为0.67（95%CI: 0.58-0.78）与0.70（95%CI: 0.62-0.79）；而相较于极少摄入蔬菜的参与者，偶尔摄入及每日摄入蔬菜的参与者发生单发颈动脉斑块的校正后比值比分别为0.77（95%CI: 0.64-0.92）与0.80（95%CI: 0.68-0.94）。不过，未观察到水果摄入与颈动脉斑块存在显著关联。综上，在CVD高风险中国人群中，新鲜蔬菜摄入与颈动脉斑块发病风险呈负相关。