鸡蛋及膳食胆固醇摄入量与全因、心血管疾病和癌症死亡率风险：前瞻性队列研究的系统评价与剂量反应荟萃分析
Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.
作者信息
Darooghegi Mofrad Manije, Naghshi Sina, Lotfi Keyhan, Beyene Joseph, Hypponen Elina, Pirouzi Aliyar, Sadeghi Omid
机构信息
Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Front Nutr. 2022 May 27;9:878979. doi: 10.3389/fnut.2022.878979. eCollection 2022.
OBJECTIVE
This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer.
METHODS
We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose-response analyses were conducted to examine the dose-response relationships.
RESULTS
We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02-1.12, I = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06-1.20, I = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92-1.09, I = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03-1.08, I = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05-1.07, I = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99-1.10, I = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively.
CONCLUSIONS AND RELEVANCE
High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564, PROSPERO, identifier: CRD42021252564.
目的
本项对前瞻性队列研究的系统评价和荟萃分析，探讨了鸡蛋及膳食胆固醇摄入量与全因死亡率（包括心血管疾病（CVD）和癌症死亡率）之间的关联。
方法
我们检索了截至2021年4月的PubMed、Scopus、ISI Web of Knowledge和谷歌学术，以及所检索到的相关文章的参考文献。采用随机效应模型计算鸡蛋和膳食胆固醇摄入量最高组与最低组相比的汇总相对风险（RR）和95%置信区间（CI）。此外，还进行了线性和非线性剂量反应分析，以检验剂量反应关系。
结果
我们纳入了55项研究，包括来自2,772,486人的数据，分别有228,425例、71,745例和67,211例全因、CVD和癌症死亡病例。每天多摄入一个鸡蛋与全因死亡风险增加7%（1.07，95%CI：1.02-1.12，I²=84.8%）和癌症死亡风险增加13%（1.13，95%CI：1.06-1.20，I²=54.2%）相关，但与CVD死亡率无关（1.00，95%CI：0.92-1.09，I²=81.5%）。非线性分析显示，每天食用超过1.5个和0.5个鸡蛋的风险分别增加。膳食胆固醇摄入量每增加100mg/天，全因死亡风险增加6%（1.06，95%CI：1.03-1.08，I²=34.5%）和癌症死亡风险增加6%（1.06，95%CI：1.05-1.07，I²=0%），但与CVD死亡率无关（1.04，95%CI：0.99-1.10，I²=85.9%）。非线性分析表明，摄入量分别超过450mg/天和250mg/天会增加CVD和癌症死亡风险。
结论及意义
高膳食鸡蛋和胆固醇摄入量与全因和癌症死亡率相关。每天食用鸡蛋少于0.5个或膳食胆固醇摄入量低于250mg/天，几乎没有证据表明风险会升高。由于风险估计值较小且研究间异质性中等，我们的研究结果应谨慎看待。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564，PROSPERO，标识符：CRD42021252564 。
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