Godos Justyna, Micek Agnieszka, Brzostek Tomasz, Toledo Estefania, Iacoviello Licia, Astrup Arne, Franco Oscar H, Galvano Fabio, Martinez-Gonzalez Miguel A, Grosso Giuseppe
Oasi Research Institute, IRCCS, Troina, Italy.
Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Eur J Nutr. 2021 Jun;60(4):1833-1862. doi: 10.1007/s00394-020-02345-7. Epub 2020 Aug 31.
Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure.
MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose-response fashion through random-effects meta-analyses.
Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk).
There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption.
心血管疾病（CVD）是全球主要的死亡原因，受饮食风险因素的影响很大。本研究旨在评估鸡蛋摄入量与CVD风险/死亡率之间的关联，包括冠心病（CHD）、中风和心力衰竭。
检索MEDLINE、Embase和Web of Science数据库至2020年4月的前瞻性研究。两名独立的评审员通过标准化方法筛选和提取数据。通过随机效应荟萃分析，以剂量反应方式将效应量计算为汇总相对风险（SRR）。
纳入了39项研究，涉及近200万人，包括85053例冠心病、25103例中风、7536例心力衰竭和147124例CVD病例。对来自14项关于CVD（发病率和/或死亡率）研究的17个数据集的汇总分析表明，与不食用鸡蛋相比，每周摄入多达6个鸡蛋与CVD事件呈负相关[每周摄入4个鸡蛋时，SRR = 0.95（95%CI：0.90；1.00）]；每天摄入多达1个鸡蛋时，观察到CVD发病率风险降低[SRR = 0.94（95%CI：0.89；0.99）]。对冠心病发病率/死亡率的汇总分析包括来自16项研究的24个数据集，结果表明每周摄入多达2个鸡蛋时风险降低[（SRR = 0.96（95%CI：0.91；1.00）]。未发现与中风风险有关联。对心力衰竭风险的汇总分析包括来自4项研究的6个数据集，结果表明与不食用鸡蛋相比，每天摄入1个鸡蛋与更高摄入量时风险增加有关[每天摄入1个鸡蛋时，SRR = 1.15（95%CI：1.02；1.30）]。在考虑证据强度的GRADE标准后，除中风外所有结局的证据强度均被评为低，中风的证据强度为中等（但无风险）。
关于鸡蛋在CVD风险中的作用尚无确凿证据，尽管需要更高质量的研究来获得更强的证据，以证明与不摄入鸡蛋相比，适度每周食用鸡蛋可能对CVD有保护作用；同样，未来的研究可能会加强关于经常大量食用鸡蛋会增加心力衰竭风险的证据。
