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Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study.
Am J Clin Nutr. 2019 Jul 01; 110(1):169-176.AJ

Abstract

BACKGROUND

Epidemiologic studies suggest inverse associations between consumption of egg, a major source of dietary cholesterol, and stroke. However, the evidence of the relation remains limited, especially among carriers of apolipoprotein E4 (apoE4), which influences cholesterol metabolism.

OBJECTIVE

The aim of this study was to investigate associations of egg and cholesterol intakes with risk of stroke and with the major stroke risk factor, blood pressure, in middle-aged and older men from eastern Finland and whether apoE phenotype could modify these associations.

METHODS

A total of 1950 men aged 42-60 y in 1984-1989 were included at the baseline examinations of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on apoE phenotype were available for 1015 men. Dietary intakes were assessed with 4-d food records at baseline and incident stroke events were assessed by record linkage to hospital discharge registries. Cox proportional hazards regression analyses were used to estimate associations with stroke risk. Associations with baseline blood pressure were evaluated with ANCOVA.

RESULTS

During the mean ± SD follow-up of 21.2 ± 7.2 y, there were 217 incidences of any stroke: 166 of ischemic stroke and 55 of hemorrhagic stroke. Comparing the highest egg intake quartile with the lowest, the multivariable-adjusted HRs were 0.81 for total stroke (95% CI: 0.54, 1.23; P-trend = 0.32), 0.84 for ischemic stroke (95% CI: 0.53, 1.34; P-trend = 0.44), and 0.75 for hemorrhagic stroke (95% CI: 0.32, 1.77; P-trend = 0.40). The respective HRs for the highest cholesterol intake quartile compared with the lowest were 0.86 (95% CI: 0.57, 1.32; P-trend = 0.42), 0.74 (95% CI: 0.46, 1.20; P-trend = 0.32), and 1.10 (95% CI: 0.45, 2.66; P-trend = 0.75). Diastolic blood pressure was 1.6 mm Hg (P-trend = 0.04) lower in the highest egg intake quartile compared with the lowest, but there were no associations with systolic blood pressure or with cholesterol intake. ApoE phenotype (32% had apoE4 phenotype) did not modify the associations.

CONCLUSION

Neither egg nor cholesterol intakes were associated with stroke risk in this cohort, regardless of apoE phenotype.This trial was registered at www.clinicaltrials.gov as NCT03221127.

Authors+Show Affiliations

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.The 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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31095282

Citation

Abdollahi, Anna M., et al. "Egg Consumption, Cholesterol Intake, and Risk of Incident Stroke in Men: the Kuopio Ischaemic Heart Disease Risk Factor Study." The American Journal of Clinical Nutrition, vol. 110, no. 1, 2019, pp. 169-176.
Abdollahi AM, Virtanen HEK, Voutilainen S, et al. Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2019;110(1):169-176.
Abdollahi, A. M., Virtanen, H. E. K., Voutilainen, S., Kurl, S., Tuomainen, T. P., Salonen, J. T., & Virtanen, J. K. (2019). Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, 110(1), 169-176. https://doi.org/10.1093/ajcn/nqz066
Abdollahi AM, et al. Egg Consumption, Cholesterol Intake, and Risk of Incident Stroke in Men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2019 Jul 1;110(1):169-176. PubMed PMID: 31095282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. AU - Abdollahi,Anna M, AU - Virtanen,Heli E K, AU - Voutilainen,Sari, AU - Kurl,Sudhir, AU - Tuomainen,Tomi-Pekka, AU - Salonen,Jukka T, AU - Virtanen,Jyrki K, PY - 2018/11/30/received PY - 2019/03/28/accepted PY - 2019/5/17/pubmed PY - 2019/5/17/medline PY - 2019/5/17/entrez KW - apolipoprotein e4 KW - cholesterol KW - eggs KW - prospective study KW - stroke SP - 169 EP - 176 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 110 IS - 1 N2 - BACKGROUND: Epidemiologic studies suggest inverse associations between consumption of egg, a major source of dietary cholesterol, and stroke. However, the evidence of the relation remains limited, especially among carriers of apolipoprotein E4 (apoE4), which influences cholesterol metabolism. OBJECTIVE: The aim of this study was to investigate associations of egg and cholesterol intakes with risk of stroke and with the major stroke risk factor, blood pressure, in middle-aged and older men from eastern Finland and whether apoE phenotype could modify these associations. METHODS: A total of 1950 men aged 42-60 y in 1984-1989 were included at the baseline examinations of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on apoE phenotype were available for 1015 men. Dietary intakes were assessed with 4-d food records at baseline and incident stroke events were assessed by record linkage to hospital discharge registries. Cox proportional hazards regression analyses were used to estimate associations with stroke risk. Associations with baseline blood pressure were evaluated with ANCOVA. RESULTS: During the mean ± SD follow-up of 21.2 ± 7.2 y, there were 217 incidences of any stroke: 166 of ischemic stroke and 55 of hemorrhagic stroke. Comparing the highest egg intake quartile with the lowest, the multivariable-adjusted HRs were 0.81 for total stroke (95% CI: 0.54, 1.23; P-trend = 0.32), 0.84 for ischemic stroke (95% CI: 0.53, 1.34; P-trend = 0.44), and 0.75 for hemorrhagic stroke (95% CI: 0.32, 1.77; P-trend = 0.40). The respective HRs for the highest cholesterol intake quartile compared with the lowest were 0.86 (95% CI: 0.57, 1.32; P-trend = 0.42), 0.74 (95% CI: 0.46, 1.20; P-trend = 0.32), and 1.10 (95% CI: 0.45, 2.66; P-trend = 0.75). Diastolic blood pressure was 1.6 mm Hg (P-trend = 0.04) lower in the highest egg intake quartile compared with the lowest, but there were no associations with systolic blood pressure or with cholesterol intake. ApoE phenotype (32% had apoE4 phenotype) did not modify the associations. CONCLUSION: Neither egg nor cholesterol intakes were associated with stroke risk in this cohort, regardless of apoE phenotype.This trial was registered at www.clinicaltrials.gov as NCT03221127. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/31095282/Egg_consumption_cholesterol_intake_and_risk_of_incident_stroke_in_men:_the_Kuopio_Ischaemic_Heart_Disease_Risk_Factor_Study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqz066 DB - PRIME DP - Unbound Medicine ER -
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