Association of a Combined Mineral Intake Score with All-Cause, All-Cancer, and All-Cardiovascular Mortality among Postmenopausal Women Restricted; Files Only

Chen, Xinying (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/pk02cb74w?locale=en
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Abstract

Introduction: Although various individual minerals have been associated with mortality, there are few such epidemiologic studies, none of which investigated multiple minerals in aggregate.

Methods: We incorporated 11 mineral intakes, including calcium, magnesium, manganese, zinc, selenium, potassium, iodine, iron, copper, phosphorus, and sodium, into a mineral score and investigate its association with all-cause and cause-specific mortality in the Iowa Women’s Health Study (1986-2012), a prospective cohort study of 55-69 year-old postmenopausal women. In the analytic cohort (n=35,211), 4,665 cancer-specific deaths, 7,064 cardiovascular-specific deaths, and 18,687 all-cause deaths were documented during follow-up. Participants’ mineral intakes were either ranked 1-5 (those hypothesized to decrease risk) or reversely ranked 5-1 (those hypothesized to increase risk). The rankings were summed to create the combined mineral scores for each woman. The mineral-score-mortality associations were analyzed using multivariable Cox proportional hazards regression.

Results: There was borderline decreasing risk for all-cardiovascular, and all-cause mortality with an increasing score (P-trend all-cardiovascular = 0.06; P-trend all-cause = 0.06). The adjusted hazard ratios (HR) and 95% confidence intervals (CI) for all-cardiovascular, and all-cause mortality among participants in the highest relative to the lowest quintile of the combined mineral scores were, respectively, 0.93 (95% CI, 0.85-1.01), 0.96 (95% CI, 0.90-1.01). However, no significant association of combined mineral intakes with all-cancer mortality was observed.

Conclusions: Our findings suggest that high intakes of calcium, magnesium, manganese, zinc, selenium, potassium, and iodine, combined with low intakes of iron, copper, phosphorus, and sodium may be inversely associated with risk of all-cardiovascular and all-cause mortality, however, may have no association with all-cancer mortality.

Table of Contents

ABSTRACT.......................................................................................................................... 1

INTRODUCTION................................................................................................................. 2

METHODS.......................................................................................................................... 3

Study design and study population....................................................................................... 3

Data collection.................................................................................................................... 4

Exposure assessment........................................................................................................... 4

Outcome assessment........................................................................................................... 5

Analytic cohort and all-cancer death, all-cardiovascular death, all-cause death....................... 5

Statistical analysis............................................................................................................... 6

RESULTS............................................................................................................................. 8

DISCUSSION...................................................................................................................... 13

REFERENCE....................................................................................................................... 19

TABLES.............................................................................................................................. 30

Table 1............................................................................................................................... 30

Table 2............................................................................................................................... 32

Table 3............................................................................................................................... 33

APPENDICES...................................................................................................................... 34

Appendix 1......................................................................................................................... 34

Appendix 2......................................................................................................................... 35

Appendix 3......................................................................................................................... 36

Appendix 4......................................................................................................................... 37

Appendix 5......................................................................................................................... 38

Appendix 6......................................................................................................................... 39

Appendix 7......................................................................................................................... 40

Appendix 8......................................................................................................................... 41

Appendix 9......................................................................................................................... 42

Appendix 10....................................................................................................................... 43

Appendix 11....................................................................................................................... 44

Appendix 12....................................................................................................................... 45

Appendix 13....................................................................................................................... 46

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