Association between composite dietary antioxidant index and stroke among individuals with diabetes

Hong-Qiang Zhang; Jie Shi; Tong Yue; Jia-Hao Weng; Xu-Lin Wang; Hao Wang; Xiao-Yu Su; Xue-Ying Zheng; Si-Hui Luo; Yu Ding; Chao-Fan Wang

doi:10.4239/wjd.v15.i8.1742

Association between composite dietary antioxidant index and stroke among individuals with diabetes

World J Diabetes. 2024 Aug 15;15(8):1742-1752. doi: 10.4239/wjd.v15.i8.1742.

Authors

Hong-Qiang Zhang¹, Jie Shi², Tong Yue², Jia-Hao Weng², Xu-Lin Wang², Hao Wang³, Xiao-Yu Su³, Xue-Ying Zheng², Si-Hui Luo², Yu Ding², Chao-Fan Wang⁴

Affiliations

¹ Department of Cardiology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China.
² Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China.
³ Graduate School, Bengbu Medical College, Bengbu 233030, Anhui Province, China.
⁴ Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, Guangdong Province, China. wangchf25@mail.sysu.edu.cn.

Abstract

Background: Recent research has underscored the potentially protective role of dietary antioxidants against chronic conditions, such as cardiovascular diseases and stroke. The composite dietary antioxidant index (CDAI), which reflects the overall intake of key dietary antioxidants, has been identified as a crucial metric for exploring this relationship. Although previous research has shown a negative correlation between CDAI levels and stroke risk in prediabetic individuals, there remains a substantial gap in understanding this association among individuals with dia-betes, who are at an inherently greater risk for cerebrovascular events.

Aim: To investigate the association between CDAI and stroke risk in individuals with diabetes.

Methods: Using a cross-sectional study design, this investigation analyzed data from the National Health and Nutrition Examination Survey spanning from 2003 to 2018 that included 6735 participants aged over 20 years with diabetes. The CDAI was calculated from 24-h dietary recalls to assess intake of key antioxidants: Vitamins A, C, and E; carotenoids; selenium; and zinc. Multivariate logistic regression and restricted cubic spline analysis were used to rigorously examine the relationship between CDAI and stroke risk.

Results: The participant cohort, with an average age of 59.5 years and a slight male majority, reflected the broader demographic characteristics of individuals with diabetes. The analysis revealed a strong inverse relationship between CDAI levels and stroke risk. Remarkably, those in the highest quintile of CDAI demonstrated a 43% lower prevalence of stroke compared to those in the lowest quintile, even after adjustments for various confounders. This finding not only highlights the negative association between CDAI and stroke risk but also underscores the significant potential of antioxidant-rich diets in reducing stroke prevalence among patients with diabetes.

Conclusion: Our findings suggested that CDAI was inversely associated with stroke prevalence among patients with diabetes. These results suggest incorporating antioxidant-rich foods into dietary regimens as a potential strategy for stroke prevention.

Keywords: Composite dietary antioxidant index; Cross-sectional study; Diabetes; National Health and Nutrition Examination Survey; Stroke.