title: Genetic susceptibility to dyslipidemia and incidence of cardiovascular disease depending on a diet quality index in the Malmö Diet and Cancer cohort.
abstract: BACKGROUND
  By taking diet quality into account, we may clarify the relationship between genetically elevated triglycerides (TG) and low-density lipoprotein-cholesterol (LDL-C), and better understand the inconsistent results regarding genetically elevated high-density lipoprotein-cholesterol (HDL-C), and cardiovascular disease (CVD) risk.
  
  
  METHODS
  We included 24,799 participants (62 % women, age 44-74 years) from the Malmö Diet and Cancer cohort. During a mean follow-up time of 15 years, 3068 incident CVD cases (1814 coronary and 1254 ischemic stroke) were identified. Genetic risk scores (GRSs) were constructed by combining 80 validated genetic variants associated with higher TG and LDL-C or lower HDL-C. The participants' dietary intake, assessed by a modified diet history method, was ranked according to a diet quality index that included six dietary components: saturated fat, polyunsaturated fat, fish, fiber, fruit and vegetables, and sucrose.
  
  
  RESULTS
  The GRSLDL-C (P = 5 × 10(-6)) and GRSHDL-C (P = 0.02) but not GRSTG (P = 0.08) were significantly associated with CVD risk. No significant interaction between the GRSs and diet quality was observed on CVD risk (P > 0.39). A high compared to a low diet quality attenuated the association between GRSLDL-C and the risk of incident ischemic stroke (P interaction = 0.01).
  
  
  CONCLUSIONS
  We found some evidence of an interaction between diet quality and GRSLDL-C on ischemic stroke.
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Sophie
authors.identifier: 0000-0003-2225-5621
authors.initials: S
authors.lastname: Hellstrand
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Ericson
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Christina-Alexandra
authors.initials: CA
authors.lastname: Schulz
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Isabel
authors.initials: I
authors.lastname: Drake
authors.affiliation: Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Gullberg
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Hedblad
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Engström
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Marju
authors.initials: M
authors.lastname: Orho-Melander
authors.affiliation: Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-20502 Malmö, Sweden.
authors.forename: Emily
authors.initials: E
authors.lastname: Sonestedt
keywords: Cholesterol; Epidemiology; Lipoproteins; Nutrition; Triglycerides