(P13-008-24) Longitudinal Associations of Healthy Dietary Patterns With Biomarkers of Inflammation and Atherosclerosis in Adults With and Without Type 1 Diabetes

Objectives: People with type 1 diabetes (T1D) have a greater risk of developing cardiovascular diseases than people without diabetes. Inflammation plays a key role in atherosclerosis and diet has been known to modify inflammation. However, little is known about this association in T1D.

Methods: We conducted a six-year longitudinal analysis of data from Coronary Artery Calcification in Type 1 Diabetes study [n=1255; T1D: n=563; non-DM: n=692] collected at baseline, year 3 and year 6. Participants completed a validated food frequency questionnaire, a physical examination, and fasting (12h overnight fast) biochemical analyses. Biomarkers of inflammation and atherosclerosis [C-reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and homocysteine (Hcy)] were determined in serum samples at three time points. Dietary scores were calculated using three healthy dietary patterns, the alternative healthy eating index (AHEI), dietary approaches to stop hypertension (DASH) diet and the Mediterranean diet. Mixed effect models were used to examine associations of dietary scores with inflammation in models adjusted for traditional cardiovascular risks.

Results: In the multivariate model adjusted for age, sex, calories, BMI, follow-up time, blood pressure, LDL- and HDL-cholesterol, smoking status and physical activity, DASH dietary scores were inversely associated with Hcy in adults with and without T1D [% change (95% CI): non-DM: -0.53 (-0.82, -0.23) p=0.0005; T1D: -0.57 (-1.01, -0.12) p=0.014]. DASH scores also revealed inverse association with PAI-1 only in the non-DM group [-0.99 (-1.83, -0.14) p=0.0226]. The Mediterranean diet scores were inversely associated with Hcy in the T1D group [-0.25 (-0.50, -0.00) p=0.0476]. No associations were noted between AHEI scores and any biomarker in the adjusted models.

Conclusions: Increasing adherence to DASH and Mediterranean dietary scores revealed protective associations against increasing Hcy and PAI-I in adults with and without T1D. These findings support the role of these dietary patterns in reducing risk of atherosclerosis especially in the T1D population.

Funding Sources: American Diabetes Association, NHLBI