Abstract 3223: Dietary Pattern, Metabolic Syndrome and Left Ventricular Systolic Dysfunction - The Multi-Ethnic Study of Atherosclerosis
Little is known about the association between dietary patterns and left ventricular (LV) function. We assessed the hypothesis that dietary patterns may influence LV function via pathways related to metabolic dysfunction. With a cross-sectional study design, using reduced rank regression (RRR), dietary patterns that maximally explained variation in metabolic syndrome (MetSyn) components (waist circumference, serum triglycerides, fasting glucose, HDL cholesterol, SBP, and DBP) were identified. We used magnetic resonance imaging to assess LV ejection fraction (LVEF), LV mass, and stroke volume. LV mass and stroke volume were adjusted for body surface area (m2). Insulin resistance (IR) was estimated using HOMA-IR method. A total of 4574 (M: 2173, F: 2401) White, African American, Hispanic and Chinese adults aged 45– 84 and free of clinical cardiovascular disease were included in these analyses. After adjusting for age, sex, and race/ethnicity, scores on the primary dietary pattern (RRR1) were positively correlated with intake of added fats, processed meats, and cheeses, and negatively correlated with vegetable, soy, wine, green/black tea, and fish intake. With adjustment for demographics, lifestyle factors, and anti-hypertensive drug use, means for LV mass increased across quintiles of RRR1 scores, and means for LVEF and stroke volume decreased across quintiles of RRR1 scores. Multiple linear regression analyses indicated that each one unit increase in RRR1 score (i.e. toward high-fat food intake) was associated with 0.32 g/m2 (95%CI: 0.05–0.69 g/m2) increase in LV mass, and with 0.26 % (−0.44 ~ − 0.08 %) and 0.28 ml/m2 (−0.52~ −0.05, ml/m2) decreases in LVEF and stroke volume, respectively. The associations remained significant after adjustment for IR alone, but were not significant after adjustment for all MetSyn components. A dietary pattern characterized by high intakes of added fats, meats, and cheese and low intakes of vegetables, soy and fish, as indicative of variation in MetSyn components, was significantly associated with unfavorable LV function. The result supports the hypothesis that the influence of dietary pattern on LV function may be through a pathway related to metabolic dysfunction.