鸡蛋消费与冠状动脉疾病风险，高遗传易感性的潜在放大作用：一项前瞻性队列研究。
Egg consumption and risk of coronary artery disease, potential amplification by high genetic susceptibility: a prospective cohort study.
作者信息
Xia Xue, Liu Fangchao, Huang Keyong, Chen Shufeng, Li Jianxin, Cao Jie, Yang Xueli, Liu Xiaoqing, Shen Chong, Yu Ling, Zhao Yingxin, Zhao Liancheng, Li Ying, Hu Dongsheng, Huang Jiangfeng, Lu Xiangfeng, Gu Dongfeng
机构信息
Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Am J Clin Nutr. 2023 Oct;118(4):773-781. doi: 10.1016/j.ajcnut.2023.06.009. Epub 2023 Aug 21.
BACKGROUND
Remarkable heterogeneity has been observed among population-based studies on egg consumption and risk of coronary artery disease (CAD). Whether genetic susceptibility serves as a potential explanation for this inconsistency remains unknown.
OBJECTIVES
We performed a prospective cohort study to investigate the association of egg consumption with incident CAD at different genetic susceptibilities.
METHODS
We included 34,111 participants without CAD at baseline from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Egg consumption was assessed with food frequency questionnaires. Genetic susceptibility was quantified by a predefined polygenic risk score (PRS) with 540 genetic variants. The hazard ratio (HR) and 95% confidence interval (95% CI) of incident CAD associated with egg consumption and PRS were estimated using the Cox proportional hazards models.
RESULTS
Over a median 11.7 y of follow-up, 1,128 incident cases of CAD were recorded. Both higher egg consumption and increased PRS were related to higher risk of CAD. When stratified by genetic risk, each increment of 3 eggs/wk was associated with a 5% higher risk of CAD for participants at low to intermediate genetic risk (HR: 1.05; 95% CI: 1.01, 1.09), whereas risk increased to HR 1.10 (95% CI: 1.05, 1.16) for those at high genetic risk; a significant synergistic interaction was also indicated at both multiplicative (P = 0.007) and additive (relative excess risk: 0.73; 95% CI: 0.24, 1.22) scales. When the joint effect was examined, in comparison with those at low to intermediate genetic risk and consuming <1 egg/wk, the HR (95% CI) was 2.95 (2.41, 3.62) for participants with high genetic risk and consumption of ≥10 eggs/wk, and the corresponding standardized 10-y CAD rates increased from 1.37% to 4.24%.
CONCLUSIONS
Genetic predisposition may synergistically interact with egg consumption in relation to increased CAD risk. PRS-stratified recommendations on egg consumption may help formulate personalized nutrition policies.
背景
在基于人群的鸡蛋消费与冠状动脉疾病（CAD）风险的研究中观察到了显著的异质性。基因易感性是否是这种不一致性的潜在解释尚不清楚。
目的
我们进行了一项前瞻性队列研究，以调查在不同基因易感性下鸡蛋消费与CAD发病之间的关联。
方法
我们纳入了来自中国动脉粥样硬化性心血管疾病风险预测项目的34111名基线时无CAD的参与者。通过食物频率问卷评估鸡蛋消费情况。通过具有540个基因变异的预定义多基因风险评分（PRS）对基因易感性进行量化。使用Cox比例风险模型估计与鸡蛋消费和PRS相关的CAD发病的风险比（HR）和95%置信区间（95%CI）。
结果
在中位11.7年的随访期间，记录了1128例CAD发病病例。较高的鸡蛋消费量和增加的PRS均与较高的CAD风险相关。按遗传风险分层时，对于低至中度遗传风险的参与者，每周多吃3个鸡蛋与CAD风险增加5%相关（HR：1.05；95%CI：1.01，1.09），而对于高遗传风险的参与者，风险增加至HR 1.10（95%CI：1.05，1.16）；在乘法（P = 0.007）和加法（相对超额风险：0.73；95%CI：0.24，1.22）尺度上也显示出显著的协同相互作用。在检查联合效应时，与低至中度遗传风险且每周食用<1个鸡蛋的参与者相比，高遗传风险且每周食用≥10个鸡蛋的参与者的HR（95%CI）为2.95（2.41，3.62），相应的标准化10年CAD发病率从1.37%增加到4.24%。
结论
在CAD风险增加方面，遗传易感性可能与鸡蛋消费产生协同相互作用。基于PRS分层的鸡蛋消费建议可能有助于制定个性化的营养政策。
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