Índice inflamatório da dieta e os fatores associados em indivíduos com insuficiência cardíaca

Abstract

The dietary inflammatory index (DII) and its associations with cardiovascular disease (CVD) have been extensively investigated. Nevertheless, there remain unresolved questions regarding the influence of IID on clinical factors and adverse outcomes in individuals with heart failure (HF). The objective of this study was to identify IID and associated factors in individuals with HF who were being treated on an outpatient basis. A total of 124 individuals diagnosed with heart failure were included in the study. The participants were adults and elderly individuals of both sexes, treated at the Interprofessional Heart Failure Outpatient Clinic of the Onofre Lopes University Hospital. The data collected included sociodemographic, anthropometric, clinical, biochemical parameters, and clinical results (hospitalization and mortality), occurring over a period of up to 36 months. The 24-hour dietary recall (R24h) was employed to assess food and dietary intake, and dietary parameters were identified for the calculation of IID. The variables were confirmed according to the IID tertiles (T1: -3.427 to -1.1866; T2: -1.1865 to -0.15643; T3: -0.15642 to 2.872). To facilitate comparison between groups, the Kruskal-Wallis test was employed, with the Dunn post-test subsequently applied. The comparison of qualitative variables was conducted using the Chi-Square (χ²) or Fisher's Exact test. Binomial logistic regression models were employed to examine the relationships between IID tertiles and the aforementioned study variables. Associations between IID and clinical outcomes (hospitalization and mortality) were observed using Cox regression. Individuals with HF were predominantly male (66.1%), overweight (60.0%), and had HF with reduced (HFrEF) or intermediate (iHFrEF) ejection fraction (79.8%). It was observed that 13.7% of the scientific population had terminal disease and 32.3% had been hospitalized. It was found that 74.2% of individuals with HF were on an anti-inflammatory diet. Participants in T3 of total IID had lower concentrations of hemoglobin (p=0.020) and hs-CRP (p=0.008) and higher levels of non-HDL cholesterol (p=0.049) compared to T1. Consumption of total dietary fiber, beta-carotene, vitamin A, vitamin B6, vitamin C, magnesium, potassium, garlic and onion was lower in T3 IBD subjects compared to T1 and T2 (all p<0.05). Consumption of protein, vitamin B3 and phosphorus was higher in IBD participants in T3 compared to T2 (all p<0.05) and consumption of saturated fat was higher in T3 compared to T1 (p=0.012). We identified differences in hemoglobin, hematocrit, non-HDL cholesterol and hs-CRP levels between IID tertiles (all p<0.05). However, regression models showed a significant association only between IID and hematocrit (p=0.036). No associations were observed between IID categorized into tertiles and mortality and hospitalization outcomes (all p>0.05). In conclusion, higher consumption of a diet with anti-inflammatory potential was associated with a significant frequency of hospitalization and mortality, without association with IID.