{"id":16966,"date":"2019-04-09T23:00:21","date_gmt":"2019-04-09T15:00:21","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=16966"},"modified":"2019-06-02T06:37:56","modified_gmt":"2019-06-01T22:37:56","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%a5%ae%e9%a3%9f%e4%b8%ad%e8%83%86%e5%9b%ba%e9%86%87%e6%88%96%e9%b8%a1%e8%9b%8b","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=16966","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6216\u9e21\u86cb\u6d88\u8017\u91cf\u4e0e\u5fc3\u8840\u7ba1\u75c5\u53d1\u75c5\u7387\u53ca\u6b7b\u4ea1\u7387\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

Original Investigation|March 19, 2019<\/h3>\n\n\n\n

Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality<\/h1>\n\n\n\n

Victor W. Zhong, Linda Van Horn, Marilyn C. Cornelis, et al<\/h3>\n\n\n\n

JAMA. <\/em>2019;321(11):1081-1095. doi:10.1001\/jama.2019.1572<\/h3>\n\n\n\n

Importance<\/strong>\u00a0\u00a0\u80cc\u666f<\/h2>\n\n\n\n

Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg consumption is associated with cardiovascular disease (CVD) and mortality remains controversial.<\/p>\n\n\n\n

\u80c6\u56fa\u9187\u662f\u4eba\u7c7b\u996e\u98df\u4e2d\u5e38\u89c1\u7684\u8425\u517b\u6210\u5206\uff0c\u9e21\u86cb\u662f\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u7684\u4e3b\u8981\u6765\u6e90\u3002\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6216\u9e21\u86cb\u6d88\u8017\u662f\u5426\u4e0e\u5fc3\u8840\u7ba1\u75c5(CVD)\u53d1\u751f\u53ca\u6b7b\u4ea1\u7387\u76f8\u5173\u5c1a\u4e0d\u6e05\u695a\u3002<\/p>\n\n\n\n

Objective<\/strong>\u00a0\u00a0\u76ee\u7684<\/h2>\n\n\n\n

To determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality.<\/p>\n\n\n\n

\u786e\u5b9a\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6216\u9e21\u86cb\u6d88\u8017\u4e0eCVD\u53d1\u75c5\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\u7684\u76f8\u5173\u6027\u3002<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>\u00a0\u00a0\u8bbe\u8ba1\u3001\u573a\u666f\u53ca\u7814\u7a76\u5bf9\u8c61<\/h2>\n\n\n\n

Individual participant data were pooled from 6 prospective US cohorts using data collected between March 25, 1985, and August 31, 2016. Self-reported diet data were harmonized using a standardized protocol.<\/p>\n\n\n\n

\u4ece\u7f8e\u56fd6\u9879\u524d\u77bb\u961f\u5217\u7814\u7a76\u4e2d\u6536\u96c61985\u5e743\u670825\u65e5\u81f32016\u5e748\u670831\u65e5\u4e4b\u95f4\u6bcf\u4f4d\u60a3\u8005\u7684\u6570\u636e\u3002\u91c7\u7528\u6807\u51c6\u5316\u65b9\u6848\u603b\u7ed3\u81ea\u8bc9\u996e\u98df\u6570\u636e\u3002<\/p>\n\n\n\n

Exposures<\/strong>\u00a0\u00a0\u66b4\u9732\u56e0\u7d20<\/h2>\n\n\n\n

Dietary cholesterol (mg\/day) or egg consumption (number\/day).<\/p>\n\n\n\n

\u996e\u98df\u4e2d\u80c6\u56fa\u9187(mg\/d)\u6216\u9e21\u86cb\u6d88\u8017\uff08\u6bcf\u65e5\u6570\u91cf\uff09<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>\u00a0\u00a0\u4e3b\u8981\u7814\u7a76\u7ed3\u5c40\u6307\u6807<\/h2>\n\n\n\n

Hazard ratio (HR) and absolute risk difference (ARD) over the entire follow-up for incident CVD (composite of fatal and nonfatal coronary heart disease, stroke, heart failure, and other CVD deaths) and all-cause mortality, adjusting for demographic, socioeconomic, and behavioral factors.<\/p>\n\n\n\n

\u5728\u6574\u4e2a\u968f\u8bbf\u671f\u95f4\uff0c\u6839\u636e\u4eba\u53e3\u7edf\u8ba1\u5b66\u3001\u793e\u4f1a\u7ecf\u6d4e\u53ca\u884c\u4e3a\u56e0\u7d20\u8fdb\u884c\u6821\u6b63\u7684CVD\u53d1\u75c5\uff08\u81f4\u547d\u6027\u53ca\u975e\u81f4\u547d\u6027\u51a0\u5fc3\u75c5\u3001\u5352\u4e2d\u3001\u5fc3\u529f\u80fd\u8870\u7aed\u53ca\u5176\u4ed6CVD\u6b7b\u4ea1\uff09\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\u7684\u98ce\u9669\u6bd4(HR)\u53ca\u7edd\u5bf9\u98ce\u9669\u5dee\u5f02(ARD)\u3002<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0\u7ed3\u679c<\/h2>\n\n\n\n

This analysis included 29\u202f615 participants (mean [SD] age, 51.6 [13.5] years at baseline) of whom 13\u202f299 (44.9%) were men and 9204 (31.1%) were black. During a median follow-up of 17.5 years (interquartile range, 13.0-21.7; maximum, 31.3), there were 5400 incident CVD events and 6132 all-cause deaths. The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic (all\u00a0P<\/em>\u00a0values for nonlinear terms, .19-.83). Each additional 300 mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.17 [95% CI, 1.09-1.26]; adjusted ARD, 3.24% [95% CI, 1.39%-5.08%]) and all-cause mortality (adjusted HR, 1.18 [95% CI, 1.10-1.26]; adjusted ARD, 4.43% [95% CI, 2.51%-6.36%]). Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06 [95% CI, 1.03-1.10]; adjusted ARD, 1.11% [95% CI, 0.32%-1.89%]) and all-cause mortality (adjusted HR, 1.08 [95% CI, 1.04-1.11]; adjusted ARD, 1.93% [95% CI, 1.10%-2.76%]). The associations between egg consumption and incident CVD (adjusted HR, 0.99 [95% CI, 0.93-1.05]; adjusted ARD, \u22120.47% [95% CI, \u22121.83% to 0.88%]) and all-cause mortality (adjusted HR, 1.03 [95% CI, 0.97-1.09]; adjusted ARD, 0.71% [95% CI, \u22120.85% to 2.28%]) were no longer significant after adjusting for dietary cholesterol consumption.<\/p>\n\n\n\n

\u5206\u6790\u4f9b\u7eb3\u516529\u202f615\u540d\u7814\u7a76\u5bf9\u8c61\uff08\u5e73\u5747 [SD]\u57fa\u7ebf\u5e74\u9f84\uff0c 51.6 [13.5]\u5c81\uff09\uff0c\u5176\u4e2d13\u202f299\u540d (44.9%) \u4e3a\u7537\u6027\uff0c9204\u540d (31.1%) \u4e3a\u9ed1\u4eba\u3002\u4e2d\u4f4d\u968f\u8bbf\u65f6\u95f417.5\u5e74\uff08\u56db\u5206\u4f4d\u533a\u95f413.0-21.7\uff1b\u6700\u957f\u968f\u8bbf\u65f6\u95f4\uff0c31.3\uff09\u3002\u968f\u8bbf\u671f\u95f4\uff0c\u5171\u67095400\u4f8bCVD\u4e8b\u4ef6\uff0c6132\u4f8b\u5168\u56e0\u6b7b\u4ea1\u3002\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6216\u9e21\u86cb\u6d88\u8017\u4e0eCVD\u53d1\u75c5\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\u5448\u5355\u8c03\u578b\u76f8\u5173\uff08\u975e\u7ebf\u6027\u76f8\u5173\u6240\u6709P\u503c\uff0c.19-.83\uff09\u3002\u6bcf\u5929\u996e\u98df\u4e2d\u6bcf\u6d88\u8017300 mg\u80c6\u56fa\u9187\u4f34\u968fCVD\u53d1\u75c5\u98ce\u9669\uff08\u6821\u6b63HR, 1.17 [95% CI, 1.09-1.26]; \u6821\u6b63ARD, 3.24% [95% CI, 1.39%-5.08%]\uff09\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\uff08\u6821\u6b63HR, 1.18 [95% CI, 1.10-1.26]; \u6821\u6b63ARD, 4.43% [95% CI, 2.51%-6.36%]\uff09\u663e\u8457\u589e\u52a0\u3002\u6bcf\u5929\u6bcf\u6d88\u8017\u534a\u4e2a\u9e21\u86cb\u4f34\u968fCVD\u53d1\u75c5\u98ce\u9669\uff08\u6821\u6b63HR, 1.06 [95% CI, 1.03-1.10]; \u6821\u6b63ARD, 1.11% [95% CI, 0.32%-1.89%]\uff09\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\uff08\u6821\u6b63HR, 1.08 [95% CI, 1.04-1.11]; \u6821\u6b63ARD, 1.93% [95% CI, 1.10%-2.76%]\uff09\u663e\u8457\u589e\u52a0\u3002\u5bf9\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6d88\u8017\u8fdb\u884c\u6821\u6b63\u540e\uff0c\u9e21\u86cb\u6d88\u8017\u4e0eCVD\u53d1\u75c5\uff08\u6821\u6b63HR, 0.99 [95% CI, 0.93-1.05]; \u6821\u6b63ARD, \u22120.47% [95% CI, \u22121.83% to 0.88%]\uff09\u53ca\u5168\u56e0\u6b7b\u4ea1\u7387\uff08\u6821\u6b63HR, 1.03 [95% CI, 0.97-1.09]; \u6821\u6b63ARD, 0.71% [95% CI, \u22120.85% to 2.28%]\uff09\u4e0d\u518d\u5177\u6709\u663e\u8457\u76f8\u5173\u6027\u3002<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>\u00a0\u7ed3\u8bba\u4e0e\u610f\u4e49<\/h2>\n\n\n\n

Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.<\/p>\n\n\n\n

\u5728\u7f8e\u56fd\u6210\u5e74\u4eba\u4e2d\uff0c\u996e\u98df\u4e2d\u80c6\u56fa\u9187\u6216\u9e21\u86cb\u6d88\u8017\u8d8a\u9ad8\uff0c\u4f34\u968fCVD\u53d1\u75c5\u53ca\u5168\u56e0\u6b7b\u4ea1\u98ce\u9669\u8d8a\u9ad8\uff0c\u4e14\u5448\u5242\u91cf\u53cd\u5e94\u6027\u3002\u5728\u5236\u5b9a\u53ca\u66f4\u65b0\u996e\u98df\u6307\u5357\u65f6\uff0c\u5e94\u5f53\u8003\u8651\u8fd9\u4e9b\u7ed3\u679c\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation|March 19, 2019 Associa […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/16966"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16966"}],"version-history":[{"count":5,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/16966\/revisions"}],"predecessor-version":[{"id":16977,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/16966\/revisions\/16977"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16966"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16966"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16966"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}