a Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang , Beijing , China.
b Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS) , West Beichen Road , Chaoyang , China.
J Am Coll Nutr. 2019 Aug;38(6):552-563. doi: 10.1080/07315724.2018.1534620. Epub 2019 Jun 7.
The associations of egg consumption with total, coronary heart disease (CHD), and stroke mortality are poorly understood. We prospectively evaluated the link between total, CHD, and stroke mortality with egg consumption using a randomly selected sample of U.S. adults. Next we validated these results within a meta-analysis and systematic review of all available prospective results. We assessed the mean of cardiometabolic risk factors across the intake of eggs. We made the analysis based on data from the National Health and Nutrition Examination Surveys (NHANES; 1999-2010). In NHANES, vital status through December 31, 2011, was ascertained. Cox proportional hazard regression models were used to relate baseline egg consumption with all-cause and cause-specific mortality. PubMed, Scopus, Web of Science, and Google Scholar databases were also searched (up to December 2017). The DerSimonian-Laird method and generic inverse variance methods were used for quantitative data synthesis. Overall, 23,524 participants from NHANES were included (mean age of 47.7 years; 48.7% were men). Across increasing the intake of eggs, adjusted mean levels of cardiometabolic risk factors worsened. Adjusted logistic regression showed that participants in the highest category of egg intake had a greater risk of diabetes (T2DM; 30%) and hypertension (HTN; 48%). With regard to total and CHD mortality, multivariable Cox regression in a fully adjusted model showed no link in males and females. In males, egg intake had a reverse (66%) association with stroke mortality, while this link was not significant among females. The results of pooling data from published prospective studies also showed no link between CHD and total mortality with egg consumption, whereas we observed a reverse (28%) association between egg intake and stroke mortality. These findings were robust after sensitivity analysis. According to our findings, egg intake had no association with CHD and total mortality, whereas was associated with lower risk of mortality from stroke. Egg consumption was associated with T2DM, HTN, C-reactive protein, and markers of glucose/insulin homeostasis. If confirmed in clinical trials (causation), this information may have applications for population-wide health measures. Key teaching points No link between total and CHD mortality with eggs intake in males and females. In males, egg intake had a reverse association with stroke mortality, while this link was not significant among females. The results of pooling data from published prospective studies also showed no link between CHD and total mortality with egg consumption, whereas we observed a reverse association between egg intake and stroke mortality.
目前，人们对鸡蛋摄入量与总死亡率、冠心病死亡率和中风死亡率之间的关系知之甚少。我们前瞻性地评估了美国成年人中鸡蛋摄入量与总死亡率、冠心病死亡率和中风死亡率之间的联系。接下来，我们在荟萃分析和系统评价中对这些结果进行了验证，该分析评估了所有可用前瞻性结果。我们评估了不同鸡蛋摄入量下的心血管代谢风险因素平均值。我们基于美国国家健康与营养调查（NHANES；1999-2010 年）的数据进行了分析。在 NHANES 中，通过 2011 年 12 月 31 日的生存状态来确定。使用 Cox 比例风险回归模型来比较基线鸡蛋摄入量与全因死亡率和死因特异性死亡率。我们还检索了 PubMed、Scopus、Web of Science 和 Google Scholar 数据库（截至 2017 年 12 月）。使用 DerSimonian-Laird 方法和通用逆方差方法进行定量数据合成。共有来自 NHANES 的 23524 名参与者（平均年龄为 47.7 岁，48.7%为男性）。随着鸡蛋摄入量的增加，心血管代谢风险因素的调整后平均水平恶化。调整后的逻辑回归显示，摄入鸡蛋最多的一组参与者患糖尿病（T2DM；30%）和高血压（HTN；48%）的风险更高。关于总死亡率和冠心病死亡率，多变量 Cox 回归在完全调整模型中显示男性和女性之间没有联系。在男性中，鸡蛋摄入量与中风死亡率呈反向（66%）关联，而女性中这种关联不显著。从已发表的前瞻性研究中汇总数据的结果也表明，鸡蛋摄入与冠心病和总死亡率之间没有关联，而我们观察到鸡蛋摄入与中风死亡率呈反向（28%）关联。这些发现经过敏感性分析后仍然可靠。根据我们的研究结果，鸡蛋摄入与冠心病和总死亡率没有关联，而与中风死亡率的降低有关。鸡蛋摄入与 T2DM、HTN、C 反应蛋白和葡萄糖/胰岛素稳态标志物有关。如果在临床试验中得到证实（因果关系），这些信息可能会应用于人群健康措施。主要教学要点 男性和女性中，鸡蛋摄入量与总死亡率和冠心病死亡率之间没有关联。在男性中，鸡蛋摄入量与中风死亡率呈反向（66%）关联，而女性中这种关联不显著。从已发表的前瞻性研究中汇总数据的结果也表明，鸡蛋摄入与冠心病和总死亡率之间没有关联，而我们观察到鸡蛋摄入与中风死亡率呈反向（28%）关联。
