Polygenic risk score, dietary inflammatory potential, and incident coronary heart disease

Aims Dietary inflammatory potential and genetic factors are reported as being linked to coronary heart disease (CHD). We aimed to investigate their joint association with CHD incidence.Methods and results We included 51 889 British participants from the UK Biobank who completed the 24-h dietary assessment at baseline. We used reduced rank regression and stepwise linear regression analyses to generate an empirical dietary inflammatory pattern (EDIP) score to assess dietary inflammatory potential. A polygenic risk score (PRS) for CHD was constructed based on 1.7 million genetic variants. During a median follow-up of 11 years, 1346 incident cases of CHD were observed. High EDIP scores significantly increased the risk of CHD with the hazard ratio (HR) [95% confidence interval (CI)] of 1.26 (1.10-1.45) for high EDIP scores (T3) compared with low EDIP scores (T1). Interestingly, we observed a gradient in the risk of CHD across PRS categories, with the HRs of 1.12 (95% CI: 0.73-1.71), 1.20 (95% CI: 1.01-1.43), and 1.42 (95% CI: 1.10-1.83) in low (Q1), intermediate (Q2-4), and high (Q5) PRS categories, respectively. When the joint effect was examined, individuals with high PRS (Q5) and high EDIP scores (T3) would have the highest risk of CHD with a HR of 3.87 (95% CI: 2.74-5.46) compared with individuals with both low PRS (Q1) and low EDIP scores.Conclusion High dietary inflammatory potential was associated with a higher CHD risk, especially in those with high PRS, suggesting that a comprehensive assessment of inflammatory diet and genetic factors may be beneficial in the prevention of CHD. This study explored the combined impact of dietary inflammatory potential and genetic factors on the risk of coronary heart disease (CHD) in the UK Biobank. Reduced rank regression and stepwise linear regression analyses were used to generate an empirical dietary inflammatory pattern (EDIP) score to assess dietary inflammatory potential. A polygenic risk score (PRS) for CHD was constructed using 1.7 million genetic variants to assess participants' genetic risk. High EDIP scores were significantly associated with increased CHD risk, and this association showed a potential upward gradient across low, intermediate, and high PRS categories.Individuals with both high EDIP scores and high PRS had the highest risk of CHD.