Abstract
To explore the direct and indirect associations of dietary patterns with hypertension using structural equation modelling (SEM). Factor analysis with varimax rotation was used to classify different dietary patterns and SEM was employed to investigate the associations of dietary patterns with hypertension. Total cholesterol to HDL-cholesterol (TC:HDL-C) ratio and LDL-cholesterol to HDL-cholesterol (LDL-C:HDL-C) ratio were used as observed indicator variables of the lipid latent variable. Waist circumference, body fat percentage and BMI, which were associated with hypertension, were used as observed indicator variables of the obesity latent variable. International Chronic Disease Cohort (ICDC) that began in 2005 with the purpose of describing the frequency and determinants of chronic diseases in Jilin Province, China. A total of 1492 adults (40-79 years) were enrolled in the baseline study from August 2010 to August 2011. Hypertension prevalence in our study population was 34·9 %. It was found that the wine pattern, condiment pattern, obesity latent variable, lipid latent variable, glucose, age and family history of hypertension were factors that had an association with hypertension via SEM, and the corresponding coefficients were 0·056, 0·011, 0·230, 0·281, 0·098, 0·232 and 0·116, respectively. The wine pattern and lipid latent variable had positive direct associations with hypertension. The condiment pattern had a positive indirect association with hypertension via the obesity latent variable. The vegetables pattern, modern pattern and snack pattern were not associated with hypertension.
Highlights
We evaluated the model fit using the normed χ2 statistic (χ2/df), the goodness-of-fit index (GFI), the adjusted goodness-of-fit fit index (AGFI), the normed fit index (NFI), the root-mean-square error of approximation (RMSEA), the comparative fit index (CFI), the Tucker–Lewis index (TLI) and the standardized rootmean-square residual (SRMR)
Acceptable model fit was defined according to the following criteria: χ2/df < 3, GFI > 0·90, AGFI > 0·90, NFI > 0·90, TLI > 0·90, CFI > 0·90, SRMR < 0·08, RMSEA ≤ 0·05 and 90 % CI < 0·08(14,15)
There were significant differences between hypertensive and non-hypertensive participants by age, BMI, Waist circumference (WC), fat percentage (FAT), GLU, to HDL-cholesterol (TC):HDL-C, LDL-C:HDL-C and family history of hypertension, whereas there were no significant differences by gender, educational level, occupation and smoking status
Summary
Study population Data were obtained from the International Chronic Disease Cohort (ICDC) that began in 2005 with the purpose of describing the frequency and determinants of chronic diseases in Jilin Province, China. All procedures in the study involving human subjects were approved by the Research Ethics Committees at the School of Public Health, University of Jilin All participants provided their written informed consent before data collection in each stage of the study. Dietary data collection Trained investigators from Jilin University visited participants in their homes to collect dietary information using a validated FFQ over the past year. This FFQ was based on the FFQ used in the 2002 China National Nutrition and Health Survey. Identification of dietary patterns First, the Kaiser–Meyer–Olkin measure of sample adequacy and the Bartlett test of sphericity were used to assess data adequacy for factor analysis. Acceptable model fit was defined according to the following criteria: χ2/df < 3, GFI > 0·90, AGFI > 0·90, NFI > 0·90, TLI > 0·90, CFI > 0·90, SRMR < 0·08, RMSEA ≤ 0·05 and 90 % CI < 0·08(14,15)
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