Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans.
Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans.
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作者：
Pan XF;Yang JJ;Lipworth LP;Shu XO;Cai H;Steinwandel MD;Blot WJ;Zheng W;Yu D
我们研究了中国人和低收入美国黑人和白色人的膳食胆固醇和鸡蛋摄入量与心血管代谢和全因死亡率的关系。入组时年龄在40-79岁的47，789名黑人、20，360名白人和134，280名中国人。采用限制性三次样条的多变量考克斯模型，以150 mg胆固醇/天和1个鸡蛋/周的摄入量作为参考，估计死亡率结局的风险比（HR）和95%置信区间（CI）。在美国黑人中，胆固醇摄入量与全因死亡率增加呈非线性相关，与心血管代谢死亡率增加呈线性相关：300和600 mg/天与150 mg/天相关的HR（95% CI）为1.07（1.03-1.11）和1.13（1.05-1.21）全因死亡率（P线性= 0.04，P非线性= 0.002，P总体< 0.001）和1.10（1.03-1.16）和1.21（1.08-1.36）（P-线性= 0.007，P-非线性= 0.07，P-总体= 0.005）。在白色美国人中观察到与全因死亡率或心血管代谢死亡率的显著相关性（P-线性≥ 0.13，P-非线性≥ 0.06，P-总体≥ 0.05）。在中国人中观察到非线性负相关：300与150 mg/天的HR（95% CI）为0.94全因死亡率为0.92-0.97，（0.87-0.95），但胆固醇摄入量> 500 mg/d时，（P-线性≥ 0.12; P-非线性≤ 0.001; P-总体< 0.001）。同样，我们观察到鸡蛋摄入量与美国黑人的全因死亡率呈正相关，但在白色美国人中为零相关，在中国人中为非线性负相关。总之，胆固醇和鸡蛋摄入量与心血管代谢和全因死亡率的关系可能在不同饮食模式和心血管代谢风险特征的种族之间存在差异。然而，仍然可能存在残余混杂。
We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.
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DOI：
10.1016/s0140-6736(18)32203-7
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Causes of Death Collaborators
通讯作者：
GBD 2017 Causes of Death Collaborators
DOI：
10.1016/s0140-6736(14)60613-9
发表时间：
2014-06-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Ley SH;Hamdy O;Mohan V;Hu FB
通讯作者：
Hu FB
DOI：
10.1136/heartjnl-2017-312651
发表时间：
2018-11
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Qin C;Lv J;Guo Y;Bian Z;Si J;Yang L;Chen Y;Zhou Y;Zhang H;Liu J;Chen J;Chen Z;Yu C;Li L;China Kadoorie Biobank Collaborative Group
通讯作者：
China Kadoorie Biobank Collaborative Group
影响因子：
5
作者：
Banna JC;McCrory MA;Fialkowski MK;Boushey C
通讯作者：
Boushey C
影响因子：
5.9
作者：
Soliman GA
通讯作者：
Soliman GA