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Mediating effect of cumulative lipid profile burden on the effect of diet and obesity on hypertension incidence: a cohort study of people aged 35-65 in rural China

European Journal of Clinical Nutrition volume 78, pages 54–63 (2024)Cite this article

Subjects

Abstract

Background and objectives

Cumulative lipid profile burden is designed to dynamically measure lipid accumulation, and its effect on hypertension has been poorly studied. Our main purpose was to investigate the effect of cumulative lipid profile burden on the incidence of essential hypertension (EH) and to investigate whether cumulative lipid burden mediates the pathogenesis of the effects of diet and obesity on EH.

Subjects and methods

A total of 1295 participants were included in the study, which started in 2017. The average follow-up time was 2.98 years. A total of 240 EH patients occurred during the follow-up period.

Results

The HR (95% CI) of the highest quartile in cumulative Total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL) burden were 1.747 (1.145 - 2.664), 1.502 (1.038 - 2.173), 0.615 (0.413 - 0.917) for incidence of EH respectively, compared to the respective reference groups. Participants with EH consumed more red meat and refined grains, and red meat was positively associated with cumulative TC burden. BMI and Waist-To-Height Ratio (WHtR) increased the incidence of EH, and obesity was positively correlated with cumulative TG burden. Mediating analysis showed that cumulative TG had a partial mediating effect in the causal relationship between obesity and EH, and Mendelian randomization (MR) also proved this result. Diet was not found to influence EHn through cumulative lipid profile burden.

Conclusions

The cumulative TG burden partially mediates the effect of obesity on EH.

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Fig. 1: The flow chart shows the follow-up process from 2017 to 2020, with a total of 4869 participants included in the baseline population.
Fig. 2: Z score radar plot of daily food intake between new-onset EH patients and participants without EH.
Fig. 3: HR (95% CI) and P value for EH and ascending quartiles of cumulative lipid profile burden.
Fig. 4: HR (95%CI) and P values of EH of obesity index.

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Data availability

Original data may be reasonably requested from corresponding authors.

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Acknowledgements

Thanks to the lab teachers and students for their efforts in the cohort follow-up process, and thanks to the participants in the cohort study for participating in this study.

Funding

This work was supported by the National Natural Science Foundation of China (NO.81660566), the Open Project Fund of the Key Laboratory of Cardiovascular and Cerebrovascular Diseases of the Ministry of Education (XN201907).

Author information

Authors and Affiliations

  1. Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China

    Ting Zhang & Xiao-Ting Luo

  2. School of Public Health and Health Management, Gannan Medical University, Ganzhou, China

    Ting Zhang, Qi Wang, Xiao-mei Cui, Yu-Ying Zhang, Fang-xi Guo, Qing-feng Wu & Ming-Hua Dong

  3. College of General Medicine, Gannan Medical University, Ganzhou, China

    Xiao-Ting Luo

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Contributions

TZ is responsible for collecting data, analyzing data and assisting in paper writing; QW, XC, YZ, TX, YD and FG are responsible for collecting, sorting out and analyzing data; QW and MD are responsible for assisting in paper writing; XL is responsible for research design and paper writing.

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Correspondence to Xiao-Ting Luo.

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The authors declare no competing interests.

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The research proposal was approved by the Ethics Committee of Gannan medical university.

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Supplementary information

Supplementary figure 1 Box chart of dietary intake of total participants.

Supplementary figure 2 Box chart of dietary intake of non-EH participants.

Supplementary figure 3 Box chart of dietary intake of new-onset EH patient.

Supplementary table1 Association between diet and hypertension.

Supplementary table 2 Mediating analysis of red meat, cumulative TC profiles burden and EH.

Supplementary table 3 UVMR estimates for the causal associations of obesity with hypertension.

Supplementary table 4 MR heterogeneity test of the associations of obesity with hypertension.

41430_2023_1348_MOESM8_ESM.docx

Supplementary table 5 MR directional pleiotropy test (MR Egger) of the associations of education, intelligence, or cognition with hypertension and blood pressure.

Supplementary table 6 Causal effects of obesity on triglyceride.

Supplementary table 7 Causal effects of triglyceride on obesity.

Supplementary table 8 MR heterogeneity test of the associations of obesity with triglyceride.

Supplementary table 9 MR directional pleiotropy test (MR Egger) of the associations of obesity with triglyceride.

Supplementary table 10 MVMR estimates for the causal associations of triglyceride with hypertension.

Supplementary table 11 MR heterogeneity test of the associations of triglyceride with hypertension.

Supplementary table 12 MR directional pleiotropy test (MR Egger) of the associations of triglyceride with hypertension.

41430_2023_1348_MOESM16_ESM.docx

Supplementary table 13 Mendelian randomization (MR) estimates of proportions mediated by triglyceride in the causal association between obesity and hypertension.

Supplementary table 14 Information of GWAS datasets used in the MR study.

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Zhang, T., Wang, Q., Cui, Xm. et al. Mediating effect of cumulative lipid profile burden on the effect of diet and obesity on hypertension incidence: a cohort study of people aged 35-65 in rural China. Eur J Clin Nutr 78, 54–63 (2024). https://doi.org/10.1038/s41430-023-01348-x

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