鸡蛋摄入量与 2 型糖尿病风险：来自 3 项大型美国男女队列研究的结果以及对前瞻性队列研究的系统评价和荟萃分析。
Egg consumption and risk of type 2 diabetes: findings from 3 large US cohort studies of men and women and a systematic review and meta-analysis of prospective cohort studies.
机构信息
Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Centre for Nutrition, Health and Society (NUTRISS), Laval University, Québec, Quebec, Canada.
出版信息
Am J Clin Nutr. 2020 Sep 1;112(3):619-630. doi: 10.1093/ajcn/nqaa115.
BACKGROUND
Whether egg consumption is associated with the risk of type 2 diabetes (T2D) remains unsettled.
OBJECTIVES
We evaluated the association between egg consumption and T2D risk in 3 large US prospective cohorts, and performed a systematic review and meta-analysis of prospective cohort studies.
METHODS
We followed 82,750 women from the Nurses' Health Study (NHS; 1980-2012), 89,636 women from the NHS II (1991-2017), and 41,412 men from the Health Professionals Follow-up Study (HPFS; 1986-2016) who were free of T2D, cardiovascular disease, and cancer at baseline. Egg consumption was assessed every 2-4 y using a validated FFQ. We used Cox proportional hazard models to estimate HRs and 95% CIs.
RESULTS
During a total of 5,529,959 person-years of follow-up, we documented 20,514 incident cases of T2D in the NHS, NHS II, and HPFS. In the pooled multivariable model adjusted for updated BMI, lifestyle, and dietary confounders, a 1-egg/d increase was associated with a 14% (95% CI: 7%, 20%) higher T2D risk. In random-effects meta-analysis of 16 prospective cohort studies (589,559 participants; 41,248 incident T2D cases), for each 1 egg/d, the pooled RR of T2D was 1.07 (95% CI: 0.99, 1.15; I2 = 69.8%). There were, however, significant differences by geographic region (P for interaction = 0.01). Each 1 egg/d was associated with higher T2D risk among US studies (RR: 1.18; 95% CI: 1.10, 1.27; I2 = 51.3%), but not among European (RR: 0.99; 95% CI: 0.85, 1.15; I2 = 73.5%) or Asian (RR: 0.82; 95% CI: 0.62, 1.09; I2 = 59.1%) studies.
CONCLUSIONS
Results from the updated meta-analysis show no overall association between moderate egg consumption and risk of T2D. Whether the heterogeneity of the associations among US, European, and Asian cohorts reflects differences in egg consumption habits warrants further investigation.This systematic review was registered at www.crd.york.ac.uk/prospero as CRD42019127860.
背景
鸡蛋摄入量与 2 型糖尿病（T2D）风险之间的关系仍未确定。
目的
我们评估了 3 项大型美国前瞻性队列研究中鸡蛋摄入量与 T2D 风险之间的关联，并对前瞻性队列研究进行了系统评价和荟萃分析。
方法
我们随访了 82750 名来自护士健康研究（NHS；1980-2012 年）的女性、89636 名来自 NHS II（1991-2017 年）的女性和 41412 名来自健康专业人员随访研究（HPFS；1986-2016 年）的男性，这些人在基线时均无 T2D、心血管疾病和癌症。鸡蛋摄入量每 2-4 年使用经过验证的 FFQ 进行评估。我们使用 Cox 比例风险模型估计 HR 和 95%CI。
结果
在总共 5529959 人年的随访中，我们在 NHS、NHS II 和 HPFS 中记录了 20514 例 T2D 新发病例。在调整了最新 BMI、生活方式和饮食混杂因素的多变量模型中，每天增加 1 个鸡蛋与 T2D 风险增加 14%（95%CI：7%，20%）相关。对 16 项前瞻性队列研究（589559 名参与者；41248 例 T2D 新发病例）进行随机效应荟萃分析，对于每天 1 个鸡蛋，T2D 的汇总 RR 为 1.07（95%CI：0.99，1.15；I2=69.8%）。然而，按地理区域存在显著差异（P 交互=0.01）。在美国的研究中，每天 1 个鸡蛋与更高的 T2D 风险相关（RR：1.18；95%CI：1.10，1.27；I2=51.3%），但在欧洲（RR：0.99；95%CI：0.85，1.15；I2=73.5%）或亚洲（RR：0.82；95%CI：0.62，1.09；I2=59.1%）的研究中并非如此。
结论
更新荟萃分析的结果表明，中等鸡蛋摄入量与 T2D 风险之间没有总体关联。美国、欧洲和亚洲队列之间关联的异质性是否反映了鸡蛋摄入量习惯的差异，值得进一步研究。本系统评价已在 www.crd.york.ac.uk/prospero 上注册为 CRD42019127860。
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