{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:24:21Z","timestamp":1787163861032,"version":"build-2736575974"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Endothelial Activation and Stress Index (EASIX) has been proposed as a marker of endothelial stress and may be associated with atherosclerotic cardiovascular disease (ASCVD) risk. Whether urinary genistein modifies this association remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multivariable logistic regression examined the association between EASIX and estimated 10-year ASCVD risk classification. Effect modification by urinary genistein (&lt;54.105 vs.\u2009\u2265\u200954.105 \u03bcg\/g) was assessed using interaction terms and stratified analyses. Restricted cubic splines (RCS) evaluated dose\u2013response relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the fully adjusted model, higher EASIX was independently associated with increased ASCVD risk (OR per unit increase\u2009=\u20091.407; 95% CI: 1.208\u20131.640;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). A significant multiplicative interaction between EASIX and genistein was observed (OR = 1.66; 95% CI: 1.17\u20132.35;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005). Stratified analysis showed that this adverse association was slightly attenuated in the higher genistein group (OR = 1.360; 95% CI: 1.066\u20131.736;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015) compared to the lower group (OR = 1.397; 95% CI: 1.202\u20131.624;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). RCS analyses showed a non-linear S-shaped association in the lower-genistein group (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>nonlinear<\/jats:sub>\n                      \u2009=\u20090.020), whereas a predominantly linear relationship was observed in the higher-genistein group (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>nonlinear<\/jats:sub>\n                      \u2009=\u20090.108).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher EASIX was associated with elevated estimated 10-year ASCVD risk classification, and this association differed across urinary genistein strata. These findings should be interpreted as hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0356477","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:27:42Z","timestamp":1787160462000},"page":"e0356477","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interaction between genistein and the endothelial activation and stress index in relation to estimated 10-year atherosclerotic cardiovascular disease risk 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