Abstract P194: Fruit and Vegetable Slows Subclinical Atherosclerosis in Chinese Women

Abstract

Objectives: This study aimed to investigate lifestyle factors, particularly fruit and vegetable intake in the protection against the progression of SA in early postmenopausal Chinese women. Methods: This is a community-based 5-year followup study on a cohort of 518 women recruited through random telephone dialing. All were aged 50-64y and within 10 years menopause. Lifestyle and dietary variables based on validated and structured questionnaires, clinical assessments and fasting blood samples were obtained at baseline (T 1 ) and 5-year followup (T 2 ). A 12.5-MHz linear probe of the HDI 5000 ultrasound scanner was used for measuring intima-media thickness (IMT) at the near and far walls of three 10-mm segments: distal common carotid, bifurcation, proximal internal carotid of both the left and right carotid arteries. The final IMT was the averages of maximum IMT free of atherosclerotic plaques measured at each of the 12 segments. Atherosclerotic plaques defined as a focal wall thickening of at least 1.5mm were also identified along the defined segments. Plaque was graded as: grade 0, no observable plaque; 1, one small plaque <30% of vessel diameter; 2, one medium plaque between 30-50% of vessel diameter or multiple small plaques; 3, one large plaque >50% vessel diameter or multiple plaques with at least one medium plaque. Repeated measurements of IMT and plaque were also obtained at T 2 . Plaque progression was computed by subtracting the plaque index at T 1 from the plaque index at T 2 . The within-sonographer intraclass correlations were 0.83-0.88 for IMT and 0.99 for plaque index, and between sonographer correlations were 0.81-0.88 for IMT, and 0.88- 0.99 for plaque index. Results: The five-year followup study of asymptomatic Chinese early postmenopausal women (mean age 61.5 years at T 2 ) has revealed a progression of IMT of 2.1 % (standard deviation =1.7) or a progression rate of 0.015 mm/year (standard deviation = 0.013). 25 % were found to have plaque progression (change of plaque index score of ≧1). Besides the traditional CVD risk factors (age, higher values of total cholesterol, systolic and diastolic blood pressure, LDL-cholesterol and triglyceride), multiple regression analysis showed that higher fruit and vegetable intake was a significant (p=0.001) and independent predictor of lower IMT at T 2 . Analysis of the followup data showed that maintenance of high intake of fruit and vegetable (>median) at both T 1 and T 2 was associated with lower IMT at T 2 , even adjusted for the other significant predictors. Similar relationship with plaque progression was also observed. Conclusion: This population-based cohort study of Chinese asymptomatic midlife women has identified maintenance of high fruit and vegetable intake tended to reduce the risk of SA.