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Am J Clin Nutr. 2016 Mar;103(3):895-901. doi: 10.3945/ajcn.115.122317. Epub 2016 Feb 10.

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.

Author information

1
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and jyrki.virtanen@uef.fi.
2
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
3
Faculty of Agriculture and Forestry, Department of Food and Environmental Sciences, and.
4
Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.

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).

KEYWORDS:

apolipoproteins; atherosclerosis; cholesterol; coronary heart disease; diet

PMID:
26864369
DOI:
10.3945/ajcn.115.122317
[Indexed for MEDLINE]

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