The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk

A 10-year follow-up of the ATTICA study

Alexandra Foscolou, Ekavi Georgousopoulou, Emmanouella Magriplis, Nenad Naumovski, Loukianos Rallidis, Antonia-Leda Matalas, Christina Chrysohoou, Dimitrios Tousoulis, Christos Pitsavos, Demosthenes Panagiotakos

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Τo evaluate the combined modifying effect of dietary habits and/or features of healthy aging, on the lipoprotein-alpha [Lp(a)] and CVD risk association. Design and Methods: Τhe ATTICA is a prospective, population-based study conducted in the greater metropolitan area of Athens (Attica, Greece). During 2001–2002, 3042 CVD-free adults (men/women: 1514/1528, 18–89 years) agreed to participate. In 2011–2012, the 10-year study follow-up was performed, recording the fatal/non-fatal CVD incidence in 2020 participants (mean follow-up: 8.41 years). Various bio-clinical characteristics [including low-density lipoprotein-cholesterol (LDL-C), Lp(a)] were derived through standard procedures. Dietary habits were assessed through the MedDietScore (an index assessing adherence to the Mediterranean diet with theoretical range 0–55). A validated successful aging index (SAI), ranging from 0 to 10, was used to assess healthy aging. Results: Lp(a) levels were positively associated with 10-year CVD incidence (Hazard Ratio: 1.02, 95%CI 1.01–1.04); when MedDietScore was included in the model the observed association between Lp(a) levels and CVD risk disappeared (1.00, 95%CI 0.98–1.01), and a mediating effect of Mediterranean diet was revealed (Sobel's test p < 0.001). In the model that included both MedDietScore and SAI, the interaction effect of these two features on 10-year CVD risk was highly protective (p < 0.001), whereas the association between Lp(a) levels and CVD risk was further mediated (Sobel's test p < 0.001). Conclusions: Adherence to a healthy dietary pattern, like the Mediterranean diet seems to mediate the association between Lp(a) with CVD risk whereas a successful aging together with a healthy diet seems to further explain the previously mentioned association.

Original languageEnglish
Pages (from-to)33-37
Number of pages5
JournalClinical Biochemistry
Volume60
Early online date25 Jul 2018
DOIs
Publication statusPublished - 1 Sep 2018

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Mediterranean Diet
antineoplaston A10
Nutrition
Lipoproteins
Chemical vapor deposition
Cardiovascular Diseases
Aging of materials
Feeding Behavior
Greece
Incidence
LDL Cholesterol
Hazards
Population

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Foscolou, Alexandra ; Georgousopoulou, Ekavi ; Magriplis, Emmanouella ; Naumovski, Nenad ; Rallidis, Loukianos ; Matalas, Antonia-Leda ; Chrysohoou, Christina ; Tousoulis, Dimitrios ; Pitsavos, Christos ; Panagiotakos, Demosthenes. / The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk : A 10-year follow-up of the ATTICA study. In: Clinical Biochemistry. 2018 ; Vol. 60. pp. 33-37.
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abstract = "Objective: Τo evaluate the combined modifying effect of dietary habits and/or features of healthy aging, on the lipoprotein-alpha [Lp(a)] and CVD risk association. Design and Methods: Τhe ATTICA is a prospective, population-based study conducted in the greater metropolitan area of Athens (Attica, Greece). During 2001–2002, 3042 CVD-free adults (men/women: 1514/1528, 18–89 years) agreed to participate. In 2011–2012, the 10-year study follow-up was performed, recording the fatal/non-fatal CVD incidence in 2020 participants (mean follow-up: 8.41 years). Various bio-clinical characteristics [including low-density lipoprotein-cholesterol (LDL-C), Lp(a)] were derived through standard procedures. Dietary habits were assessed through the MedDietScore (an index assessing adherence to the Mediterranean diet with theoretical range 0–55). A validated successful aging index (SAI), ranging from 0 to 10, was used to assess healthy aging. Results: Lp(a) levels were positively associated with 10-year CVD incidence (Hazard Ratio: 1.02, 95{\%}CI 1.01–1.04); when MedDietScore was included in the model the observed association between Lp(a) levels and CVD risk disappeared (1.00, 95{\%}CI 0.98–1.01), and a mediating effect of Mediterranean diet was revealed (Sobel's test p < 0.001). In the model that included both MedDietScore and SAI, the interaction effect of these two features on 10-year CVD risk was highly protective (p < 0.001), whereas the association between Lp(a) levels and CVD risk was further mediated (Sobel's test p < 0.001). Conclusions: Adherence to a healthy dietary pattern, like the Mediterranean diet seems to mediate the association between Lp(a) with CVD risk whereas a successful aging together with a healthy diet seems to further explain the previously mentioned association.",
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author = "Alexandra Foscolou and Ekavi Georgousopoulou and Emmanouella Magriplis and Nenad Naumovski and Loukianos Rallidis and Antonia-Leda Matalas and Christina Chrysohoou and Dimitrios Tousoulis and Christos Pitsavos and Demosthenes Panagiotakos",
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Foscolou, A, Georgousopoulou, E, Magriplis, E, Naumovski, N, Rallidis, L, Matalas, A-L, Chrysohoou, C, Tousoulis, D, Pitsavos, C & Panagiotakos, D 2018, 'The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk: A 10-year follow-up of the ATTICA study', Clinical Biochemistry, vol. 60, pp. 33-37. https://doi.org/10.1016/j.clinbiochem.2018.07.011

The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk : A 10-year follow-up of the ATTICA study. / Foscolou, Alexandra; Georgousopoulou, Ekavi; Magriplis, Emmanouella; Naumovski, Nenad; Rallidis, Loukianos; Matalas, Antonia-Leda; Chrysohoou, Christina; Tousoulis, Dimitrios; Pitsavos, Christos; Panagiotakos, Demosthenes.

In: Clinical Biochemistry, Vol. 60, 01.09.2018, p. 33-37.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk

T2 - A 10-year follow-up of the ATTICA study

AU - Foscolou, Alexandra

AU - Georgousopoulou, Ekavi

AU - Magriplis, Emmanouella

AU - Naumovski, Nenad

AU - Rallidis, Loukianos

AU - Matalas, Antonia-Leda

AU - Chrysohoou, Christina

AU - Tousoulis, Dimitrios

AU - Pitsavos, Christos

AU - Panagiotakos, Demosthenes

N1 - Copyright © 2018. Published by Elsevier Inc.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objective: Τo evaluate the combined modifying effect of dietary habits and/or features of healthy aging, on the lipoprotein-alpha [Lp(a)] and CVD risk association. Design and Methods: Τhe ATTICA is a prospective, population-based study conducted in the greater metropolitan area of Athens (Attica, Greece). During 2001–2002, 3042 CVD-free adults (men/women: 1514/1528, 18–89 years) agreed to participate. In 2011–2012, the 10-year study follow-up was performed, recording the fatal/non-fatal CVD incidence in 2020 participants (mean follow-up: 8.41 years). Various bio-clinical characteristics [including low-density lipoprotein-cholesterol (LDL-C), Lp(a)] were derived through standard procedures. Dietary habits were assessed through the MedDietScore (an index assessing adherence to the Mediterranean diet with theoretical range 0–55). A validated successful aging index (SAI), ranging from 0 to 10, was used to assess healthy aging. Results: Lp(a) levels were positively associated with 10-year CVD incidence (Hazard Ratio: 1.02, 95%CI 1.01–1.04); when MedDietScore was included in the model the observed association between Lp(a) levels and CVD risk disappeared (1.00, 95%CI 0.98–1.01), and a mediating effect of Mediterranean diet was revealed (Sobel's test p < 0.001). In the model that included both MedDietScore and SAI, the interaction effect of these two features on 10-year CVD risk was highly protective (p < 0.001), whereas the association between Lp(a) levels and CVD risk was further mediated (Sobel's test p < 0.001). Conclusions: Adherence to a healthy dietary pattern, like the Mediterranean diet seems to mediate the association between Lp(a) with CVD risk whereas a successful aging together with a healthy diet seems to further explain the previously mentioned association.

AB - Objective: Τo evaluate the combined modifying effect of dietary habits and/or features of healthy aging, on the lipoprotein-alpha [Lp(a)] and CVD risk association. Design and Methods: Τhe ATTICA is a prospective, population-based study conducted in the greater metropolitan area of Athens (Attica, Greece). During 2001–2002, 3042 CVD-free adults (men/women: 1514/1528, 18–89 years) agreed to participate. In 2011–2012, the 10-year study follow-up was performed, recording the fatal/non-fatal CVD incidence in 2020 participants (mean follow-up: 8.41 years). Various bio-clinical characteristics [including low-density lipoprotein-cholesterol (LDL-C), Lp(a)] were derived through standard procedures. Dietary habits were assessed through the MedDietScore (an index assessing adherence to the Mediterranean diet with theoretical range 0–55). A validated successful aging index (SAI), ranging from 0 to 10, was used to assess healthy aging. Results: Lp(a) levels were positively associated with 10-year CVD incidence (Hazard Ratio: 1.02, 95%CI 1.01–1.04); when MedDietScore was included in the model the observed association between Lp(a) levels and CVD risk disappeared (1.00, 95%CI 0.98–1.01), and a mediating effect of Mediterranean diet was revealed (Sobel's test p < 0.001). In the model that included both MedDietScore and SAI, the interaction effect of these two features on 10-year CVD risk was highly protective (p < 0.001), whereas the association between Lp(a) levels and CVD risk was further mediated (Sobel's test p < 0.001). Conclusions: Adherence to a healthy dietary pattern, like the Mediterranean diet seems to mediate the association between Lp(a) with CVD risk whereas a successful aging together with a healthy diet seems to further explain the previously mentioned association.

KW - CVD risk

KW - Mediterranean diet

KW - lipoprotein(a)

KW - successful aging

KW - Greece/epidemiology

KW - Life Style

KW - Diet, Mediterranean

KW - Follow-Up Studies

KW - Cardiovascular Diseases/epidemiology

KW - Humans

KW - Middle Aged

KW - Risk Factors

KW - Male

KW - Lipoprotein(a)/blood

KW - Incidence

KW - Young Adult

KW - Aged, 80 and over

KW - Adult

KW - Aging/blood

KW - Female

KW - Aged

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