男性载脂蛋白 E 表型与颈动脉内膜中层厚度及冠心病发病风险的关联：来自于芬兰库奥皮奥缺血性心脏病风险因素研究的证据。鸡蛋和胆固醇摄入量与载脂蛋白 E 表型在男性中的关联：库奥皮奥缺血性心脏病风险因素研究。
Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study.
机构信息
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
出版信息
Am J Clin Nutr. 2016 Mar;103(3):895-901. doi: 10.3945/ajcn.115.122317. Epub 2016 Feb 10.
BACKGROUND
In general populations, the effects of dietary cholesterol on blood cholesterol concentrations are modest. However, the relation is stronger in those with an ɛ4 allele in the apolipoprotein E gene (APOE). There is little information on the association between cholesterol intake and the risk of coronary artery disease (CAD) among those with the ApoE4 phenotype.
OBJECTIVE
We investigated the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with carotid intima-media thickness and the risk of incident CAD in middle-aged and older men from eastern Finland.
DESIGN
The study included 1032 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on common carotid artery intima-media thickness (CCA-IMT) were available for 846 men. Dietary intakes were assessed with 4-d food records. Associations with incident CAD and baseline CCA-IMT were analyzed by using Cox regression and ANCOVA, respectively.
RESULTS
The ApoE4 phenotype was found in 32.5% of the men. During the average follow-up of 20.8 y, 230 CAD events occurred. Egg or cholesterol intakes were not associated with the risk of CAD. Each 1 additional egg (55 g)/d was associated with a multivariable-adjusted HR of 1.17 (95% CI: 0.85, 1.61) in the ApoE4 noncarriers and an HR of 0.93 (95% CI: 0.50, 1.72) in the ApoE4 carriers (P-interaction = 0.34). Each 100-mg/d higher cholesterol intake was associated with an HR of 1.04 (95% CI: 0.89, 1.22) in the ApoE4 noncarriers and an HR of 0.95 (95% CI: 0.73, 1.25) in the ApoE4 carriers (P-interaction = 0.81). Egg or cholesterol intakes were also not associated with increased CCA-IMT.
CONCLUSION
Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals).
背景
在一般人群中，饮食胆固醇对血液胆固醇浓度的影响是适度的。然而，在载脂蛋白 E 基因（APOE）中存在ɛ4 等位基因的人群中，这种关系更强。关于胆固醇摄入量与载脂蛋白 E4 表型人群中冠心病（CAD）风险之间的关系，信息很少。
目的
我们调查了在芬兰东部中年和老年男性中，胆固醇和鸡蛋（胆固醇的主要膳食来源）摄入量与颈动脉内膜中层厚度（CCA-IMT）和 CAD 事件风险之间的关系。
设计
这项研究包括 1984-1989 年前瞻性、基于人群的库奥皮奥缺血性心脏病危险因素研究中基线检查时的 1032 名年龄在 42-60 岁的男性。846 名男性有颈总动脉内膜中层厚度（CCA-IMT）的数据。通过 4 天的食物记录评估饮食摄入量。采用 Cox 回归和协方差分析分别分析与 CAD 事件和基线 CCA-IMT 的相关性。
结果
研究人群中发现 32.5%的男性存在 ApoE4 表型。在平均 20.8 年的随访期间，发生了 230 例 CAD 事件。鸡蛋或胆固醇的摄入量与 CAD 风险无关。在 ApoE4 非携带者中，每多吃一个鸡蛋（55 克/天），校正多变量后的 HR 为 1.17（95%CI：0.85，1.61），在 ApoE4 携带者中 HR 为 0.93（95%CI：0.50，1.72）（P 交互=0.34）。胆固醇摄入量每增加 100mg/d，在 ApoE4 非携带者中的 HR 为 1.04（95%CI：0.89，1.22），在 ApoE4 携带者中的 HR 为 0.95（95%CI：0.73，1.25）（P 交互=0.81）。鸡蛋或胆固醇的摄入量也与 CCA-IMT 的增加无关。
结论
即使在 ApoE4 携带者（即高度易感人群）中，鸡蛋或胆固醇的摄入量也与 CAD 风险的增加无关。
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