The link between dietary nutrients intake and cardiovascular diseases in cold regions

Rennan Feng; Qianqi Hong; Jingjing Cao; Jian Li; Lanxin Deng; Jing Wang; Yang Zhao; Cheng Wang

doi:10.2478/fzm-2024-0001

The link between dietary nutrients intake and cardiovascular diseases in cold regions

doi: 10.2478/fzm-2024-0001

Rennan Feng^{1, #},
Qianqi Hong^{2, 3, #},
Jingjing Cao^{2, #},
Jian Li²,
Lanxin Deng²,
Jing Wang²,
Yang Zhao²,
Cheng Wang^{2
, ,}

1.
Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
2.
Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin 150081, China
3.
Harbin Center for Disease Control and Prevention, Harbin 150056, China

Funds:

the National Natural Science Foundation of China 82273613

Heilongjiang Provincial Natural Science Foundation of China LC2016032

More Information

Corresponding author: Cheng Wang, E-mail: wangchenghlj@163.com

摘要

Abstract: Background The cold winter weather in northern China influences the dietary habits of its residents, contributing to a heightened risk of cardiovascular disorders, such as hypertension and coronary heart disease. Key factors include low vegetable consumption and high salt and fat intakes. This study aims to investigate the relationships between northern dietary nutrient intake in northern China and cardiovascular disorders during the winter season. Methods A food frequency questionnaire tailored to the actual eating habits in northern China was designed. Retrospective data from 955 Chinese adults were collected from November to March between 2014 to 2023. Logistic regression was employed to analyze the relationship between dietary nutrients and cardiovascular diseases, with model performance assessed using receiver operating characteristic (ROC) curves. Results Adjusted for gender, age, and body mass index (BMI), an inverse association was observed between vitamin A (OR = 0.706, 95% CI: 0.550, 0.907), nicotinic acid (OR = 0.584, 95% CI: 0.447, 0.762), phosphorus (OR = 0.777, 95% CI: 0.608, 0.994), selenium (OR = 0.719, 95% CI: 0.560, 0.923), zinc (OR = 0.683, 95% CI: 0.531, 0.880), methionine (OR = 0.730, 95% CI: 0.569, 0.936), arginine (OR = 0.753, 95% CI: 0.588, 0.964), lysine (OR = 0.706, 95% CI: 0.550, 0.907), aspartic acid (OR = 0.730, 95% CI: 0.569, 0.936) and hypertension. Additionally, a negative association was found between niacin (OR = 0.752, 95% CI: 0.597, 0.946) and coronary heart disease. Conversely, a positive association was identified between iodine and hypertension (OR = 1.305, 95% CI: 1.020, 1.669) and coronary heart disease (OR = 1.301, 95% CI: 1.037, 1.634). Conclusion Our study suggests that maintaining a balanced dietary intake of vitamin A, niacin, phosphorus, selenium, zinc, methionine, arginine, lysine, and aspartic acid can be beneficial in preventing hypertension. Adequate niacin intake is associated with a lower risk of coronary heart disease. However, excessive iodine intake may contribute to hypertension and coronary heart disease.
- nutrients /
- northern /
- hypertension /
- coronary heart disease /
- cold

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Figure 1. Areas under receiver operating characteristic curves of hypertension. A, protein; B, Vitamins; C, Minerals; D, Amino acids (Adjusted estimation: adjusted for gender, age, and BMI).

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Figure 2. Areas under receiver operating characteristic curves of coronary heart disease. A, Nicotinic acid; B, Iodine (Adjusted estimation: adjusted for gender, age, and BMI).

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Table 1. Characteristics of variables in cardiovascular disease patients and controls

Group	Age group	Body Mass Index	Male, N (%)	Protein (g)		Fat (g)	Carbohydrate (g)
Hypertension
No (N = 898)	28.00(26.00, 33.00)	20.79 (19.22, 23.33)	333.00 (94.07%)	90.51 (60.45, 122.12)		72.22 (45.87, 106.79)	387.04 (272.79, 509.90)
Yes (N = 57)	28.00 (26.00, 37.50)	21.26 (19.6, 24.42)	21.00 (5.93%)	80.08 (56.27, 122.17)		64.27 (46.28, 88.20)	372.50 (285.82, 615.75)
P-value	0.555	0.125	< 0.001	0.388		0.197	0.419
Coronary Heart Disease
No (N = 885)	28.00 (26.00, 33.00)	20.82 (19.23, 23.39)	333.00 (94.07%)	90.42 (60.58, 122.17)		71.79 (45.66, 106.79)	388.28 (274.42, 511.81)
Yes (N = 70)	28.00 (27.00, 40.25)	21.11 (19.31, 23.09)	21.00 (5.93%)	80.80 (53.28, 122.71)		69.33 (48.50, 87.80)	365.41 (224.89, 531.62)
P-value	0.023	0.858	< 0.001	0.185		0.694	0.474

Group	Riboflavin (mg)	Thiamine (mg)	Vitamin A (μg)	Vitamin B6 (mg)		Vitamin C (mg)	Vitamin E (mg)
Hypertension
No (N = 898)	1.41 (0.92, 2.05)	1.20 (0.82, 1.63)	925.54 (517.59, 1, 710.44)	0.24 (0.14, 0.44)		120.08 (58.28, 209.39)	40.14 (24.87, 60.68)
Yes (N = 57)	1.32 (0.82, 2.03)	1.16 (0.80, 1.89)	801.00 (284.87, 1, 343.33)	0.24 (0.10, 0.53)		106.95 (61.73, 202.70)	38.23 (20.55, 64.54)
P-value	0.613	0.904	0.029	0.673		0.625	0.733
Coronary Heart Disease
No (N = 885)	1.41 (0.93, 2.06)	1.20 (0.82, 1.64)	943.71 (519.69, 1705.79)	0.25 (0.13, 0.44)		121.98 (59.64, 213.96)	40.41 (24.92, 61.45)
Yes (N = 70)	1.22 (0.76, 1.93)	1.06 (0.74, 1.59)	735.89 (296.19, 1354.86)	0.21 (0.11, 0.46)		98.92 (48.79, 155.37)	34.64 (22.31, 56.64)
P-value	0.193	0.305	0.025	0.555		0.046	0.249

Group	Niacin (mg)	Folic acid (μg)	Iodine (μg)	Calcium (mg)		Potassium (mg)	Phosphorus (mg)
Hypertension
No (N = 898)	20.38 (13.83, 28.73)	73.84 (41.44, 128.70)	81.86 (42.70, 125.39)	615.41 (375.11, 934.22)		2, 542.93 (1, 615.01, 3, 642.86)	1, 362.93 (919.71, 1, 860.15)
Yes (N = 57)	18.00 (11.22, 29.79)	62.65 (25.54, 122.97)	104.42 (68.04, 153.63)	597.23 (340.93, 997.81)		2, 482.19 (1, 470.94, 4, 019.28)	1, 277.14 (832.72, 1, 899.95)
P-value	0.225	0.238	0.013	0.862		0.788	0.524
Coronary Heart Disease
No (N = 885)	20.48 (13.76, 29.03)	73.97 (41.39, 127.68)	81.89 (42.21, 124.60)	618.73 (380.44, 935.29)		2,560.09 (1,637.66, 3,668.76)	1,362.79 (918.85, 1,878.76)
Yes (N = 70)	18.04 (10.95, 26.21)	59.07 (27.64, 146.35)	101.22 (68.07, 171.15)	543.73 (343.58, 939.36)		2,322.45 (1,449.14, 3,353.92)	1,183.31 (782.70, 1,812.27)
P-value	0.119	0.292	0.002	0.247		0.181	0.221

Group	Magnesium (mg)	Manganese (mg)	Sodium (mg)	Iron (mg)		Copper (mg)	Selenium (μg)
Hypertension
No (N = 898)	440.03 (298.73, 645.32)	7.53 (5.34, 10.47)	2,568.41 (1,704.26, 3,732.52)	25.70 (17.67, 36.19)		3.40 (2.33, 4.94)	63.46 (39.46, 94.65)
Yes (N = 57)	433.98 (260.22, 675.52)	7.22 (4.78, 11.47)	3,026.25 (2,014.28, 4,098.46)	25.03 (16.99, 41.12)		3.28 (2.29, 5.05)	56.61 (37.66, 95.31)
P-value	0.806	0.790	0.111	0.887		0.741	0.387
Coronary Heart Disease
No (N = 885)	442.46 (298.1, 647.99)	7.57 (5.33, 10.46)	2,562.77 (1,700.28, 3,728.87)	25.67 (17.67, 36.73)		3.41 (2.35, 4.92)	63.46 (39.40, 95.16)
Yes (N = 70)	412.58 (271.69, 595.50)	6.61 (5.13, 10.96)	2,983.25 (1,941.12, 4,107.40)	23.94 (17.17, 36.85)		3.23 (2.21, 5.03)	55.46 (34.62, 85.42)
P-value	0.342	0.347	0.041	0.740		0.247	0.175

Group	Zinc (mg)	Phenylalanine (mg)	Alanine (mg)	Methionine (mg)		Glycine (mg)	Glutamic (mg)
Hypertension
No (N = 898)	14.37 (10.29, 20.04)	2, 452.74 (1, 429.96, 3, 503.79)	2, 704.55 (1, 582.74, 4, 057.18)	804.74 (471.40, 1, 215.04)		2,491.57 (1,430.86, 3,693.00)	10,006.82 (6,099.84, 14,887.29)
Yes (N = 57)	13.36 (8.73, 19.64)	2, 102.83 (1, 499.31, 3, 688.03)	2, 171.41 (1, 622.00, 4, 272.82)	645.85 (465.14, 1, 219.02)		2,094.41 (1,495.31, 3,764.14)	9,515.27 (6,221.20, 15,955.90)
P-value	0.355	0.557	0.357	0.17		0.404	0.913
Coronary Heart Disease
No (N = 885)	14.39 (10.30, 20.05)	2, 450.90 (1, 445.22, 3, 531.06)	2, 709.43 (1, 601.39, 4, 072.64)	806.53 (478.10, 1, 227.53)		2,491.04 (1,447.51, 3,729.27)	10,167.11 (6,133.60, 14,999.23)
Yes (N = 70)	12.71 (8.58, 19.92)	1, 964.76 (1, 330.83, 3, 073.76)	2, 274.25 (1, 465.48, 3, 518.46)	650.94 (411.30, 1, 103.53)		2,073.89 (1,408.37, 3,299.27)	8,312.50 (5,751.56, 13,982.29)
P-value	0.249	0.147	0.115	0.053		0.172	0.216

Group	Cystine (mg)	Arginine (mg)	Lysine (mg)	Tyrosine (mg)		Leucine (mg)	Proline (mg)
Hypertension
No (N = 898)	844.43 (494.29, 1, 259.87)	3, 335.42 (1, 923.87, 4, 976.38)	3, 206.37 (1, 909.13, 4, 869.15)	1, 819.72 (1, 077.51, 2, 674.60)		4,175.34 (2,465.20, 6,157.57)	3,051.24 (1,844.42, 4,506.25)
Yes (N = 57)	838.53 (484.25, 1, 484.28)	2, 523.52 (1, 886.05, 5, 025.71)	2, 604.95 (1, 729.35, 4, 460.87)	1, 501.33 (1, 126.23, 2, 802.08)		3,535.24 (2,626.79, 6,196.59)	3,271.71 (1,821.18, 5,588.25)
P-value	0.629	0.237	0.130	0.443		0.474	0.467
Coronary Heart Disease
No (N = 885)	854.68 (497.82, 1, 290.68)	3, 337.59 (1, 922.76, 5, 003.71)	3, 208.75 (1, 916.36, 4, 930.73)	1, 819.53 (1, 086.62, 2, 684.79)		4,178.11 (2,487.75, 6,200.85)	3,117.56 (1,847.31, 4,557.99)
Yes (N = 70)	710.08 (463.58, 1, 202.81)	2, 815.21 (1, 882.05, 4, 812.81)	2, 597.67 (1, 734.08, 4, 404.98)	1, 477.30 (976.56, 2, 359.55)		3,432.64 (2,230.87, 5,298.00)	2,633.85 (1,762.23, 4,403.17)
P-value	0.223	0.198	0.090	0.118		0.119	0.226

Group	Tryptophan (mg)	Serine (mg)	Threonine (mg)	Aspartic (mg)	Valine (mg)	Isoleucine (mg)	Histidine (mg)
Hypertension
No (N = 898)	682.79 (410.16, 998.28)	2,443.07 (1,444.74,	2,174.30 (1,283.10,	4,910.27 (2,923.00,	2,634.84 (1,583.07,	2,361.87 (1,420.43,	1,367.87 (812.18,
		3,512.75)	3,169.26)	7,249.60)	3,837.36)	3,490.25)	2,034.38)
Yes (N = 57)	584.06 (445.65, 1006.89)	2,133.17 (1,504.37,	1,809.59 (1,357.18,	3,784.74 (2,772.53,	2,303.76 (1,681.28,	1,932.22 (1,511.23,	1,128.85 (852.37,
		3,817.04)	3,271.83)	7,818.86)	4,042.45)	3,764.42)	2,121.03)
P-value	0.630	0.688	0.443	0.258	0.497	0.349	0.429
Coronary Heart Disease
No (N = 885)	683.64 (417.80, 1009.06)	2,443.68 (1,463.02,	2,181.23 (1,303.60,	4,919.08 (2,956.43,	2,635.44 (1,601.45,	2,362.93 (1,438.17,	1,367.91 (825.89,
		3,538.73)	3,180.69)	7,277.07)	3,873.66)	3,524.50)	2,039.53)
Yes (N = 70)	555.24 (373.39, 925.48)	1,950.61 (1,306.93,	1,794.58 (1,200.29,	4,018.36 (2,743.24,	2,165.47 (1,460.66,	1,932.71 (1,321.35,	1,140.37 (730.45,
		3,361.83)	2,818.03)	6,782.53)	3,302.72)	3,220.44)	1,812.08)
P-value	0.182	0.147	0.125	0.119	0.136	0.130	0.136
Data are presented as numbers (percentage) for categorical variables or 50th (25th, 75th) for continuous variables.

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Table 2. ORs and 95% CIs for hypertension and coronary heart disease according to the quartiles of nutrient density.

Nutrient density	Crude			Model 1
	OR	95% CI	P-value	OR	95% CI	P-value
Hypertension
Protein	0.661^**	0.512–0.853	0.001	0.658^**	0.506–0.856	0.002
Fat	0.949	0.747–0.206	0.669	0.962	0.756–0.224	0.755
Carbohydrate	1.263	0.989–0.613	0.061	1.248	0.972–0.603	0.083
Coronary heart disease
Protein	0.829	0.664–0.033	0.095	0.837	0.667–0.050	0.124
Fat	1.236	0.991–0.543	0.060	1.231	0.985–0.537	0.067
Carbohydrate	0.986	0.793–0.226	0.902	0.975	0.779–0.219	0.822
CI, confidence interval; OR, odds ratio; Crude has not been adjusted by any potential factors; Model 1 has been adjusted by age, gender and body mass index; ^P < 0.05 or ^*P < 0.01.

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Table 3. Associations between the quartiles of nutrient density and hypertension

Nutrient density	Crude			Model 1
	OR	95% CI	P-value	OR	95% CI	P-value
Vitamins
Riboflavin	0.827	0.649–0.055	0.126	0.823	0.644–0.052	0.120
Thiamine	0.948	0.746–0.205	0.661	0.922	0.721–0.178	0.516
Vitamin A	0.706^**	0.550–0.907	0.007	0.678^**	0.525–0.875	0.003
Vitamin B6	0.879	0.691–0.119	0.295	0.863	0.676–0.102	0.238
Vitamin C	0.906	0.712–0.152	0.421	0.900	0.698–0.160	0.415
Vitamin E	0.948	0.746–0.205	0.661	0.970	0.760–0.238	0.806
Niacin	0.584^**	0.447–0.762	< 0.001	0.588^**	0.449–0.771	< 0.001
Folic acid	0.816	0.640–0.041	0.101	0.805	0.630–0.028	0.083
Minerals
Lodine	1.305^*	1.020–0.669	0.034	1.316^*	1.026–0.688	0.031
Calcium	0.920	0.723–0.169	0.495	0.920	0.716–0.182	0.514
Potassium	0.866	0.680–0.102	0.242	0.857	0.665–0.104	0.232
Phosphorus	0.777^*	0.608–0.994	0.044	0.778^*	0.606–0.999	0.049
Magnesium	0.892	0.702–0.135	0.354	0.868	0.673–0.119	0.273
Manganese	0.866	0.680–0.102	0.242	0.815	0.635–0.046	0.108
Sodium	1.187	0.932–0.513	0.165	1.220	0.953–0.562	0.114
Iron	0.892	0.702–0.135	0.354	0.877	0.686–0.120	0.293
Copper	1.037	0.816–0.317	0.768	1.018	0.798–0.298	0.885
Selenium	0.719^*	0.560–0.923	0.010	0.718^*	0.558–0.924	0.010
Zinc	0.683^**	0.531–0.880	0.003	0.672^**	0.520–0.868	0.002
Amino acids
Phenylalanine	0.934	0.734–0.187	0.575	0.949	0.739–0.220	0.685
Alanine	0.840	0.659–0.070	0.158	0.852	0.661–0.097	0.214
Methionine	0.730^*	0.569–0.936	0.013	0.740^*	0.572–0.958	0.022
Glycine	0.892	0.702–0.135	0.354	0.907	0.706–0.166	0.447
Glutamic	1.052	0.828–0.337	0.677	1.074	0.838–0.377	0.572
Cystine	1.117	0.878–0.422	0.366	1.129	0.884–0.442	0.331
Arginine	0.753^*	0.588–0.964	0.025	0.757^*	0.586–0.978	0.033
Lysine	0.706^**	0.550–0.907	0.007	0.715^*	0.550–0.929	0.012
Tyrosine	0.840	0.659–0.070	0.158	0.848	0.658–0.093	0.202
Leucine	0.920	0.723–0.169	0.495	0.937	0.730–0.203	0.611
Proline	1.117	0.878–0.422	0.366	1.141	0.890–0.463	0.297
Tryptophan	0.920	0.723–0.169	0.495	0.940	0.732–0.206	0.625
Serine	0.948	0.746–0.205	0.661	0.961	0.749–0.233	0.756
Threonine	0.866	0.680–0.102	0.242	0.880	0.684–0.132	0.321
Aspartic	0.730^*	0.569–0.936	0.013	0.731^*	0.563–0.948	0.018
Valine	0.920	0.723–0.169	0.495	0.936	0.730–0.202	0.606
Lsoleucine	0.853	0.670–0.086	0.197	0.859	0.668–0.104	0.235
Histidine	0.879	0.691–0.119	0.295	0.898	0.698–0.154	0.400
Notes: CI, confidence interval; OR, odds ratio; Crude has not been adjusted by any potential factors; Model 1 has been adjusted by age, gender and Body Mass Index; ^P < 0.05 or ^*P < 0.01.

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Table 4. Associations between the quartiles of nutrient density and coronary heart disease

Nutrient density	Crude			Model 1
	OR	95% CI	P-value	OR	95% CI	P-value
Vitamins
Riboflavin	0.882	0.709–0.098	0.262	0.856	0.685–0.070	0.172
Thiamine	0.927	0.745–0.153	0.498	0.885	0.706–0.108	0.285
Vitamin A	0.829	0.664–0.033	0.095	0.808	0.644–0.015	0.066
Vitamin B6	0.951	0.764–0.182	0.648	0.929	0.745–0.158	0.510
Vitamin C	0.871	0.700–0.085	0.218	0.813	0.644–0.026	0.081
Vitamin E	0.905	0.727–0.125	0.368	0.906	0.726–0.131	0.383
Niacin	0.728^**	0.581–0.912	0.006	0.752^*	0.597–0.946	0.015
Folic acid	0.964	0.775–0.199	0.742	0.939	0.754–0.169	0.572
Minerals
Lodine	1.336^*	1.068–0.672	0.011	1.301^*	1.037–0.634	0.023
Calcium	0.974	0.784–0.211	0.815	0.927	0.737–0.165	0.515
Potassium	0.893	0.718–0.112	0.312	0.841	0.668–0.059	0.141
Phosphorus	0.882	0.709–0.098	0.262	0.877	0.700–0.098	0.253
Magnesium	0.905	0.727–0.125	0.368	0.846	0.672–0.067	0.157
Manganese	0.893	0.718–0.112	0.312	0.846	0.675–0.060	0.145
Sodium	1.267^*	1.014–0.582	0.037	1.253	0.997–0.576	0.053
Iron	0.999	0.803–0.242	0.990	0.964	0.772–0.205	0.748
Copper	0.916	0.736–0.139	0.430	0.878	0.704–0.095	0.248
Selenium	0.851	0.683–0.060	0.149	0.839	0.672–0.049	0.124
Zinc	0.850	0.682–0.059	0.147	0.831	0.665–0.039	0.104
Amino acids
Phenylalanine	0.916	0.736–0.139	0.430	0.934	0.743–0.173	0.555
Alanine	0.850	0.682–0.059	0.147	0.864	0.686–0.088	0.213
Methionine	0.797^*	0.639–0.996	0.046	0.811	0.643–0.023	0.077
Glycine	0.871	0.700–0.085	0.218	0.891	0.708–0.121	0.324
Glutamic	0.939	0.755–0.168	0.570	0.953	0.759–0.195	0.675
Cystine	0.986	0.793–0.226	0.902	0.995	0.797–0.243	0.965
Arginine	0.882	0.709–0.098	0.262	0.893	0.711–0.121	0.327
Lysine	0.818	0.656–0.020	0.075	0.834	0.661–0.053	0.127
Tyrosine	0.860	0.691–0.072	0.180	0.873	0.693–0.100	0.249
Leucine	0.939	0.755–0.168	0.570	0.967	0.770–0.215	0.775
Proline	0.974	0.784–0.211	0.815	0.990	0.790–0.240	0.929
Tryptophan	0.939	0.755–0.168	0.570	0.960	0.765–0.206	0.728
Serine	0.871	0.700–0.085	0.218	0.883	0.702–0.110	0.286
Threonine	0.905	0.727–0.125	0.368	0.924	0.735–0.162	0.501
Aspartic	0.85	0.682–0.059	0.147	0.858	0.681–0.082	0.195
Valine	0.916	0.736–0.139	0.430	0.937	0.746–0.177	0.574
Lsoleucine	0.905	0.727–0.125	0.368	0.918	0.732–0.153	0.462
Histidine	0.882	0.709–0.098	0.262	0.903	0.718–0.137	0.386
CI, confidence interval; OR, odds ratio; Crude has not been adjusted by any potential factors; Model 1 has been adjusted by age, gender and body mass index; ^P < 0.05 or ^*P < 0.01.

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Table 5. Receiver operator characteristic analysis between nutrient density and hypertension

	AUC (95% CI)	Best cutoff	Sensitivity (%)	Specificity (%)	Maximum of Youden index^*
Protein
Protein	0.549 (0.471–0.628)	0.059	63.20	50.90	0.14
Model of Protein^#	0.600 (0.521–0.679)	0.075	40.40	81.10	0.22
Vitamins
vitamin A	0.605 (0.526–0.685)	0.079	42.10	76.20	0.18
Model of vitamin A^#	0.643 (0.559–0.727)	0.062	66.70	62.10	0.29
Nicotinic acid	0.657 (0.583–0.730)	0.088	49.10	76.60	0.26
Model of Nicotinic acid^#	0.684 (0.612–0.756)	0.067	68.40	66.40	0.35
Minerals
Lodine	0.582 (0.507–0.657)	0.058	61.40	50.80	0.12
Model of Iodine^#	0.628 (0.552–0.704)	0.060	61.40	59.20	0.21
Phosphorus	0.577 (0.501–0.654)	0.074	36.80	75.80	0.13
Model of Phosphorus^#	0.619 (0.544–0.694)	0.044	89.50	30.70	0.20
Selenium	0.600 (0.528–0.673)	0.057	70.20	51.30	0.22
Model of Selenium^#	0.636 (0.563–0.709)	0.054	77.20	51.00	0.28
Zinc	0.615 (0.537–0.692)	0.080	43.90	76.30	0.20
Model of Zinc^#	0.657 (0.584–0.729)	0.062	64.90	61.40	0.26
Amino acids
Methionine	0.596 (0.523–0.669)	0.057	64.90	51.00	0.16
Model of Methionine^#	0.632 (0.560–0.705)	0.051	75.40	46.80	0.22
Arginine	0.587 (0.519–0.654)	0.058	64.90	51.00	0.16
Model of Arginine^#	0.625 (0.552–0.699)	0.051	75.40	46.50	0.22
Lysine	0.605 (0.535–0.676)	0.057	68.40	51.20	0.20
Model of Lysine^#	0.636 (0.562–0.709)	0.051	75.40	48.00	0.23
Aspartic acid	0.596 (0.527–0.665)	0.057	68.40	51.20	0.20
Model of Aspartic acid^#	0.632 (0.560–0.705)	0.051	73.70	47.30	0.21
AUC, area under the curve; CI, confidence interval; ^* Sensitivity + specificity?1; ^# Model has been adjusted by age, gender and body mass index.

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Table 6. Receiver operator characteristic analysis between nutrient density and coronary heart disease

	AUC (95% CI)	Best cutoff	Sensitivity (%)	Specificity (%)	Maximum of Youden index^*
Vitamins
Nicotinic acid	0.597 (0.527?.667)	0.090	40.00	76.30	0.16
Model of Nicotinic acid^#	0.623 (0.553?.693)	0.067	68.60	53.70	0.22
Minerals
Lodine	0.589 (0.519?.658)	0.090	38.60	76.00	0.15
Model 1 of Iodine^#	0.609 (0.540?.678)	0.060	72.90	45.60	0.19
AUC, area under the curve; CI, confidence interval; ^* Sensitivity + specificity?1; ^# Model has been adjusted by age, gender and body mass index.

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