Association between Low-carbohydrate Diets and 10-year Atherosclerosis Cardiovascular Disease Risk: Data from the National Health and Nutrition Examination Survey

INTRODUCTION: To evaluate the association between low-carbohydrate diet (LCD) score and atherosclerotic cardiovascular disease (ASCVD) among individuals with type 2 diabetes mellitus (T2DM). METHODS: A total of 3685 participants from the National Health and Nutrition Examination Survey database 2007-2020 were included in this cross-sectional study. The primary outcome of this study was the 10-year ASCVD risk. We used the weighted logistic regression models to assess the association between LCD score and 10-year ASCVD risk. Stratified analysis based on age, body mass index (BMI), hypertension, dyslipidemia, and chronic kidney disease (CKD) was conducted. Odds ratio (OR) and 95% confidence interval (CI) were calculated. RESULTS: After adjusting for all confounding factors, when LCD was treated as a continuous variable, the findings revealed an inverse association between LCD and 10-year ASCVD risk among individuals with T2DM (OR=0.97, 95% CI: 0.94-0.99, p=0.045). When LCD was stratified into tertiles, individuals in the highest tertiles of LCD exhibited a negative association with 10-year ASCVD risk compared to those in the first tertile (OR=0.66, 95% CI: 0.46-0.95, p=0.025). Subgroup analysis indicated an negative association between high tertiles of LCD and 10-years ASCVD risk in individuals with T2DM who had a BMI≥25kg/m2 (OR=0.66, 95% CI: 0.45-0.97, p