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Original Article

Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women

Fatemeh Gholami1orcid, Mahsa Samadi1orcid, Niloufar Rasaei1orcid, Mir Saeid Yekaninejad2orcid, Seyed Ali Keshavarz3orcid, Gholamali Javdan4orcid, Farideh Shiraseb1orcid, Niki Bahrampour5orcid, Khadijeh Mirzaei1orcid
Clinical Nutrition Research 2023;12(3):199-217.
Published online: August 8, 2023

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Correspondence to Khadijeh Mirzaei. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran 14155-6117, Iran. mirzaei_kh@tums.ac.ir
• Received: May 9, 2023   • Revised: July 30, 2023   • Accepted: July 31, 2023

Copyright © 2023. The Korean Society of Clinical Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women
Clin Nutr Res. 2023;12(3):199-217.   Published online August 8, 2023
DOI: https://doi.org/10.7762/cnr.2023.12.3.199
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Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women
Clin Nutr Res. 2023;12(3):199-217.   Published online August 8, 2023
DOI: https://doi.org/10.7762/cnr.2023.12.3.199
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Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women
Image Image
Figure 1 The interaction between tertiles of h-PDI and GRS. (A) BMI, (B) BFM, and (C) WC. Data shown are mean ± standard error of the mean, T1 (< 51): n = 139, T2 (51–57): n = 97, and T3 (> 57): n = 141.h-PDI, healthy plant-based diet index; GRS, genetic risk score; BMI, body mass index; BFM, body fat mass; WC, waist circumference.
Figure 2 The interaction between tertiles of h-PDI and GRS. (A) hs-CRP, (B) ALT, (C) AST, (D) insulin, (E) PAI-1. Data shown are mean ± standard error of the mean.h-PDI, healthy plant-based diet index; GRS, genetic risk score; hs-CRP, high-sensitivity C-reactive protein; ALT, alanine transaminase; AST, aspartate aminotransferase; PAI-1, plasminogen activator inhibitor 1.

Figure 1

Figure 2

Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women
< 0.001 0.002 Body weight (kg)82.06 ± 11.5479.70 ± 11.1980.10 ± 11.210.200.23BMI (kg/m2)31.22 ± 4.1330.90 ± 3.8230.93 ± 3.590.760.46‡Body compositionWC (cm)100.34 ± 9.9098.94 ± 9.5098.22 ± 9.300.200.24‡WHR (ratio)0.94 ± 0.050.93 ± 0.050.92 ± 0.050.11 0.07 BFM (kg)35.37 ± 8.5033.83 ± 7.8733.59 ± 7.570.160.17BF (%)42.59 ± 5.7341.86 ± 5.2141.68 ± 5.090.360.20BMC (g)2.66 ± 0.322.63 ± 0.342.65 ± 0.370.730.39VFA (cm2)169.94 ± 40.10164.58 ± 36.19162.27 ± 36.280.250.22Blood pressureSBP (mmHg)110.83 ± 12.86110.07 ± 12.99112.96 ± 14.690.320.43DBP (mmHg)77.27 ± 9.1877.47 ± 9.7077.86 ± 9.910.910.62Blood sampleFBS (mg/dL)88.09 ± 7.9486.73 ± 9.9887.18 ± 10.570.690.71Total cholesterol (g/dL)188.44 ± 35.70178.95 ± 35.80184.35 ± 35.440.260.19TG (mg/dL)121.47 ± 65.82113.27 ± 57.18127.89 ± 83.060.390.53HDL (mg/dL)46.68 ± 9.5846.44 ± 9.5446.84 ± 12.350.960.97LDL (mg/dL)94.93 ± 25.1091.12 ± 23.1196.47 ± 23.350.320.59hs-CRP (mg/L)5.80 ± 4.715.32 ± 4.673.96 ± 4.10 0.005 0.03 HOMA index3.60 ± 1.243.34 ± 1.173.11 ± 1.36 0.06 0.13Insulin (mIU/mL)1.24 ± 0.251.18 ± 0.201.21 ± 0.220.290.74AST (IU/L)19.09 ± 9.0717.04 ± 5.1617.61 ± 7.800.230.65ALT (IU/L)21.41 ± 15.4017.43 ± 9.5319.01 ± 14.010.180.55MCP-1 (ng/mL)45.97 ± 62.3359.22 ± 103.6649.47 ± 103.990.680.18Galectin 3 (ng/mL)6.87 ± 9.503.28 ± 5.853.65 ± 7.600.240.51PAI-1 (ng/mL)16.41 ± 24.1017.73 ± 28.6314.62 ± 34.720.840.66 0.01 0.01‡ Body compositionWC (cm)98.02 ± 9.0099.46 ± 9.61100.15 ± 10.080.170.16WHR (ratio)0.93 ± 0.050.93 ± 0.040.93 ± 0.050.590.41BFM (kg)32.92 ± 7.2134.85 ± 8.0835.21 ± 8.58 0.04 0.03 BF (%)41.14 ± 5.1042.68 ± 5.0342.51 ± 5.72 0.04 0.02 BMC (g)2.68 ± 0.332.63 ± 0.362.62 ± 0.330.260.20VFA (cm2)160.25 ± 36.11167.07 ± 38.74170.06 ± 37.90 0.08 0.05 Blood pressureSBP (mmHg)110.76 ± 11.95111.12 ± 15.20112.02 ± 14.310.800.82DBP (mmHg)77.38 ± 9.6677.64 ± 10.0977.68 ± 9.240.970.70Blood sampleFBS (mg/dL)87.05 ± 9.0486.03 ± 7.4488.38 ± 11.600.360.69Total cholesterol (g/dL)187.07 ± 34.38184.49 ± 39.12178.48 ± 34.550.270.17TG (mg/dL)122.10 ± 67.92109.47 ± 51.66127.20 ± 81.900.330.34HDL (mg/dL)47.04 ± 9.8548.43 ± 12.4144.93 ± 9.980.140.22LDL (mg/dL)95.93 ± 22.2096.98 ± 25.4089.87 ± 24.080.130.09hs-CRP (mg/L)4.59 ± 3.974.62 ± 4.145.81 ± 5.28 0.04 0.07 HOMA index3.36 ± 1.163.11 ± 1.143.44 ± 1.480.320.43AST (IU/L)17.63 ± 6.5018.19 ± 9.3117.72 ± 6.850.890.80ALT (IU/L)18.56 ± 13.3619.59 ± 14.8819.32 ± 11.230.870.75Insulin (mIU/mL)1.19 ± 0.221.22 ± 0.221.22 ± 0.230.700.55MCP-1 (ng/mL)48.38 ± 90.6550.73 ± 86.8558.19 ± 104.530.790.70Galectin 3 (ng/mL)3.44 ± 6.915.53 ± 7.904.12 ± 7.610.640.61PAI-1 (ng/mL)17.10 ± 35.9911.55 ± 18.0818.71 ± 29.690.470.43 0.02 −2.41−4.76 to −0.05 0.04 −2.29−4.72 to 0.12 0.06 −1.94−4.44 to 0.550.12T3−1.99−4.12 to 0.14 0.06 −2.15−4.36 to 0.04 0.054 −2.93−5.10 to −0.76 0.008 −2.51−4.76 to −0.27 0.02 Body compositionWC (cm)T1ReferenceT2−6.70−12.52 to −0.89 0.02 −5.09−11.07 to 0.870.09†−6.96−13.00 to −0.93 0.02 −4.33−10.66 to 2.000.18†T3−6.53−11.86 to −1.19 0.01 −5.70−11.29 to −0.12 0.04† −7.86−13.27 to −2.45 0.004 −5.54−11.23 to 0.14 0.056† WHR (ratio)T1ReferenceT2−0.02−0.05 to 0.0080.14−0.01−0.04 to 0.010.40−0.02−0.05 to 0.010.16−0.006−0.04 to 0.020.74T3−0.03−0.06 to −0.003 0.03 −0.02−0.05 to 0.0080.14−0.03−0.06 to −0.002 0.03 −0.01−0.04 to 0.010.26BFM (kg)T1ReferenceT2−5.35−10.20 to −0.51 0.03 −4.02−8.96 to 0.910.11−6.19−11.22 to −1.16 0.01 −5.09−10.33 to 0.14 0.05 T3−4.22−8.66 to 0.22 0.06 −3.71−8.33 to 0.900.11−6.27−10.78 to −1.76 0.006 −4.88−9.59 to −0.17 0.04 BF (%)T1ReferenceT2−1.97−5.25 to 1.290.23−1.02−4.40 to 2.360.55−2.31−5.72 to 1.080.18−2.10−5.69 to 1.490.25T3−0.50−3.51 to 2.500.740.22−2.94 to 3.390.89−1.96−5.01 to 1.080.20−1.15−4.37 to 2.070.48BMC (g)T1ReferenceT2−0.09−0.30 to 0.110.38−0.07−0.29 to 0.140.51−0.18−0.40 to 0.030.10−0.08−0.32 to 0.140.47T3−0.14−0.33 to 0.050.15−0.13−0.34 to 0.070.19−0.12−0.32 to 0.070.20−0.05−0.26 to 0.150.59VFA (cm2)T1ReferenceT2−13.18−36.11 to 9.740.26−5.51−28.94 to 17.910.64−16.05−39.86 to 7.750.18−9.54−34.39 to 15.300.45T3−17.06−38.10 to 3.980.11−11.86−33.79 to 10.050.28−25.40−46.74 to −4.05 0.02 −17.09−39.42 to 5.230.13Blood pressureSBP (mmHg)T1ReferenceT22.56−7.46 to 12.590.613.03−7.09 to 13.160.559.02−1.19 to 19.240.089.44−1.22 to 20.110.08T3−2.70−11.92 to 6.510.56−3.03−12.52 to 6.450.530.77−8.62 to 10.160.872.58−7.10 to 12.260.60DBP (mmHg)T1ReferenceT2−4.28−11.35 to 2.770.23−3.82−10.86 to 3.210.284.98−2.21 to 12.180.176.10−1.31 to 13.510.10T3−5.28−11.77 to 1.210.11−3.03−9.63 to 3.560.361.29−5.32 to 7.910.702.21−4.51 to 8.940.52Blood sampleFBS (mg/dL)T1ReferenceT2−1.24−9.14 to 6.660.75−1.04−8.77 to 6.680.79−4.24−12.17 to 3.680.29−4.49−12.42 to 3.430.26T32.29−4.93 to 9.520.530.85−6.26 to 7.960.81−1.65−8.89 to 5.590.65−1.93−9.14 to 5.270.60Total cholesterol (g/dL)T1ReferenceT2−16.99−45.84 to 11.850.24−16.31−45.19 to 12.570.260.81−28.11 to 29.730.95−1.51−31.13 to 28.100.92T39.62−16.73 to 35.990.4713.48−13.09 to 40.060.3220.67−5.77 to 47.110.1220.83−6.10 to 47.760.13TG (mg/dL)T1ReferenceT2−1.64−58.66 to 55.360.952.65−57.01 to 62.310.93−7.89−65.05 to 49.250.78−9.14−70.32 to 52.030.77T3−2.90−55.00 to 49.190.918.96−45.93 to 63.860.7412.88−39.37 to 65.130.6210.75−44.88 to 66.390.70HDL (mg/dL)T1ReferenceT21.02−7.59 to 9.630.811.83−7.00 to 10.670.686.77−1.86 to 15.410.126.60−2.45 to 15.670.15T3−0.51−8.39 to 7.350.89−0.93−9.06 to 7.190.82−1.21−9.11 to 6.670.760.14−8.09 to 8.390.97LDL (mg/dL)T1ReferenceT26.20−13.06 to 25.480.526.23−13.08 to 25.550.526.59−12.73 to 25.910.504.93−14.87 to 24.740.62T311.39−6.22 to 29.000.2011.53−6.23 to 29.310.2011.04−6.62 to 28.710.2211.86−6.15 to 29.870.19hs-CRP (mg/L)T1ReferenceT2−3.08−5.83 to −0.34 0.02 −3.49−6.41 to −0.57 0.01 −2.89−5.74 to −0.04 0.04 −3.42−6.52 to −0.33 0.03 T3−1.98−4.49 to 0.530.12−2.16−4.89 to 0.550.11−0.90−3.45 to 1.650.49−0.34−3.12 to 2.430.80HOMA indexT1ReferenceT2−0.72−1.75 to 0.300.17−0.64−1.72 to 0.440.250.10−0.93 to 1.130.840.50−0.61 to 1.620.37T3−0.37−1.31 to 0.570.44−0.36−1.37 to 0.650.480.12−0.82 to 1.060.790.23−0.77 to 1.250.64AST (IU/L)T1ReferenceT2−2.89−8.88 to 3.080.34−3.80−9.94 to 2.340.220.71−5.28 to 6.700.81−1.11−7.41 to 5.190.73T3−4.96−10.42 to 0.50 0.07 −5.89−11.54 to −0.23 0.04 −3.49−8.98 to 1.980.21−4.95−10.68 to 0.780.09ALT (IU/L)T1ReferenceT2−4.73−15.31 to 5.840.38−5.94−16.91 to 5.020.28−0.79−11.40 to 9.810.88−2.83−14.08 to 8.410.62T3−7.18−16.85 to 2.480.14−9.64−19.74 to 0.44 0.06 −7.75−17.44 to 1.940.11−10.14−20.37 to 0.08 0.05 Insulin (mIU/mL)T1ReferenceT2−0.07−0.26 to 0.100.40−0.08−0.27 to 0.100.37−0.02−0.21 to 0.150.76−0.06−0.26 to 0.130.51T3−0.15−0.32 to 0.01 0.07 −0.19−0.37 to −0.02 0.02 −0.15−0.32 to 0.010.08−0.18−0.36 to −0.009 0.04 MCP-1 (ng/mL)T1ReferenceT26.81−75.26 to 88.880.87−2.48−80.36 to 75.380.95−44.58−128.06 to 38.880.29−44.57−125.25 to 36.090.27T3−31.52−104.54 to 41.490.39−33.74−104.13 to 36.640.34−24.23−98.52 to 50.060.52−27.96−98.95 to 43.020.44Galectin 3 (ng/mL)T1ReferenceT2−5.15−15.51 to 5.200.32−7.64−18.69 to 3.390.17−7.42−19.00 to 4.160.20−9.16−21.22 to 2.900.13T3−6.11−15.63 to 3.410.20−8.36−18.78 to 2.050.11−1.10−11.06 to 8.850.82−2.72−13.21 to 7.760.61PAI-1 (ng/mL)T1ReferenceT2−2.07−30.13 to 25.990.88−9.88−37.08 to 17.310.47−21.42−49.43 to 6.580.13−28.27−55.25 to −1.30 0.04 T3−13.49−40.73 to 13.730.33−14.58−41.05 to 11.880.28−32.78−59.58 to −5.980.01−41.73−67.75 to −15.72 0.002
Table 1 Anthropometric body composition, blood parameters and blood pressure according to tertile categories of h-PDI

Values are presented as mean ± standard deviation. Bold-style p values indicate statistical significance.

h-PDI, healthful plant-based diet index; BMI, body mass index; WC, waist circumference; WHR, waist height ratio; BFM, body fat mass; BF, body fat; BMC, bone mineral content; VAF, visceral fat area; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar; TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein; hs-CRP, high-sensitivity C-reactive protein; HOMA, Homeostasis Model Assessment; AST, aspartate aminotransferase; ALT, alanine aminotransferase; MCP-1, monocyte chemoattractant protein-1; PAI-1, plasminogen activator inhibitor 1.

*Calculated by analysis of variance. †Adjusted for age, BMI, physical activity, and total energy intake. ‡BMI considered as collinear and this variable adjusted for age, physical activity, and total energy intake.

Table 2 Anthropometric body composition, blood parameters and blood pressure according to tertile categories of GRS

Values are presented as mean ± standard deviation. Bold-style p values indicate statistical significance.

GRS, genetic risk score; BMI, body mass index; WC, waist circumference; WHR, waist height ratio; BFM, body fat mass; BF, body fat; BMC, bone mineral content; VFA, visceral fat area; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar; TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein; hs-CRP, high-sensitivity C-reactive protein; HOMA, Homeostasis Model Assessment; AST, aspartate aminotransferase; ALT, alanine aminotransferase; MCP-1, monocyte chemoattractant protein-1; PAI-1, plasminogen activator inhibitor 1.

*Calculated by analysis of variance. †Adjusted for age, BMI, physical activity, and total energy intake. ‡BMI considered as collinear and this variable adjusted for age, physical activity, and total energy intake.

Table 3 Nutrient intake according to tertile categories of h-PDI

Values are presented as mean ± standard deviation.

h-PDI, healthy plant-based diet index; PUFA, polyunsaturated fatty acid; SFA, saturated fatty acid.

*Calculated by analysis of variance.

Table 4 The interaction between GRS and h-PDI on anthropometric body composition, blood parameters, and blood pressure

Bold-style p values indicate statistical significance. p < 0.05 was considered significant.

GRS, genetic risk score; h-PDI, healthy plant-based diet index; T; tertile; CI, confidence interval; BMI, body mass index; WC, waist circumference; WHR, waist height ratio; BFM, body fat mass; BF, body fat; BMC, bone mineral content; VFA, visceral fat area; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar; TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein; hs-CRP, high-sensitivity C-reactive protein; HOMA, Homeostasis Model Assessment; AST, aspartate aminotransferase; ALT, alanine aminotransferase; MCP-1, monocyte chemoattractant protein-1; PAI-1, plasminogen activator inhibitor 1.

*GLM was performed to identify the interaction between GRS and h-PDI on cardiometabolic risk factors: Model 1= Adjusted for potential confounding factors including (age, energy intake, physical activity, BMI). †BMI considered as collinear and this variable adjusted for age, physical activity, and total energy intake.

Table 1

Table 2

Table 3

Table 4

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