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Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study.
Am J Clin Nutr. 2016 Mar; 103(3):895-901.AJ

Abstract

BACKGROUND

In general populations, the effects of dietary cholesterol on blood cholesterol concentrations are modest. However, the relation is stronger in those with an ɛ4 allele in the apolipoprotein E gene (APOE). There is little information on the association between cholesterol intake and the risk of coronary artery disease (CAD) among those with the ApoE4 phenotype.

OBJECTIVE

We investigated the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with carotid intima-media thickness and the risk of incident CAD in middle-aged and older men from eastern Finland.

DESIGN

The study included 1032 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on common carotid artery intima-media thickness (CCA-IMT) were available for 846 men. Dietary intakes were assessed with 4-d food records. Associations with incident CAD and baseline CCA-IMT were analyzed by using Cox regression and ANCOVA, respectively.

RESULTS

The ApoE4 phenotype was found in 32.5% of the men. During the average follow-up of 20.8 y, 230 CAD events occurred. Egg or cholesterol intakes were not associated with the risk of CAD. Each 1 additional egg (55 g)/d was associated with a multivariable-adjusted HR of 1.17 (95% CI: 0.85, 1.61) in the ApoE4 noncarriers and an HR of 0.93 (95% CI: 0.50, 1.72) in the ApoE4 carriers (P-interaction = 0.34). Each 100-mg/d higher cholesterol intake was associated with an HR of 1.04 (95% CI: 0.89, 1.22) in the ApoE4 noncarriers and an HR of 0.95 (95% CI: 0.73, 1.25) in the ApoE4 carriers (P-interaction = 0.81). Egg or cholesterol intakes were also not associated with increased CCA-IMT.

CONCLUSION

Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals).

Authors+Show Affiliations

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and jyrki.virtanen@uef.fi.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.Faculty of Agriculture and Forestry, Department of Food and Environmental Sciences, and.Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26864369

Citation

Virtanen, Jyrki K., et al. "Associations of Egg and Cholesterol Intakes With Carotid Intima-media Thickness and Risk of Incident Coronary Artery Disease According to Apolipoprotein E Phenotype in Men: the Kuopio Ischaemic Heart Disease Risk Factor Study." The American Journal of Clinical Nutrition, vol. 103, no. 3, 2016, pp. 895-901.
Virtanen JK, Mursu J, Virtanen HE, et al. Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2016;103(3):895-901.
Virtanen, J. K., Mursu, J., Virtanen, H. E., Fogelholm, M., Salonen, J. T., Koskinen, T. T., Voutilainen, S., & Tuomainen, T. P. (2016). Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, 103(3), 895-901. https://doi.org/10.3945/ajcn.115.122317
Virtanen JK, et al. Associations of Egg and Cholesterol Intakes With Carotid Intima-media Thickness and Risk of Incident Coronary Artery Disease According to Apolipoprotein E Phenotype in Men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2016;103(3):895-901. PubMed PMID: 26864369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. AU - Virtanen,Jyrki K, AU - Mursu,Jaakko, AU - Virtanen,Heli Ek, AU - Fogelholm,Mikael, AU - Salonen,Jukka T, AU - Koskinen,Timo T, AU - Voutilainen,Sari, AU - Tuomainen,Tomi-Pekka, Y1 - 2016/02/10/ PY - 2015/09/15/received PY - 2015/12/31/accepted PY - 2016/2/12/entrez PY - 2016/2/13/pubmed PY - 2016/7/9/medline KW - apolipoproteins KW - atherosclerosis KW - cholesterol KW - coronary heart disease KW - diet SP - 895 EP - 901 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 3 N2 - BACKGROUND: In general populations, the effects of dietary cholesterol on blood cholesterol concentrations are modest. However, the relation is stronger in those with an ɛ4 allele in the apolipoprotein E gene (APOE). There is little information on the association between cholesterol intake and the risk of coronary artery disease (CAD) among those with the ApoE4 phenotype. OBJECTIVE: We investigated the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with carotid intima-media thickness and the risk of incident CAD in middle-aged and older men from eastern Finland. DESIGN: The study included 1032 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on common carotid artery intima-media thickness (CCA-IMT) were available for 846 men. Dietary intakes were assessed with 4-d food records. Associations with incident CAD and baseline CCA-IMT were analyzed by using Cox regression and ANCOVA, respectively. RESULTS: The ApoE4 phenotype was found in 32.5% of the men. During the average follow-up of 20.8 y, 230 CAD events occurred. Egg or cholesterol intakes were not associated with the risk of CAD. Each 1 additional egg (55 g)/d was associated with a multivariable-adjusted HR of 1.17 (95% CI: 0.85, 1.61) in the ApoE4 noncarriers and an HR of 0.93 (95% CI: 0.50, 1.72) in the ApoE4 carriers (P-interaction = 0.34). Each 100-mg/d higher cholesterol intake was associated with an HR of 1.04 (95% CI: 0.89, 1.22) in the ApoE4 noncarriers and an HR of 0.95 (95% CI: 0.73, 1.25) in the ApoE4 carriers (P-interaction = 0.81). Egg or cholesterol intakes were also not associated with increased CCA-IMT. CONCLUSION: Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals). SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26864369/Associations_of_egg_and_cholesterol_intakes_with_carotid_intima_media_thickness_and_risk_of_incident_coronary_artery_disease_according_to_apolipoprotein_E_phenotype_in_men:_the_Kuopio_Ischaemic_Heart_Disease_Risk_Factor_Study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.122317 DB - PRIME DP - Unbound Medicine ER -