Relationship between egg consumption and atherosclerosis in high-cardiovascular-risk population in Jiangsu Province
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摘要:
目的 探讨江苏省心血管病高危人群蛋类摄入与动脉粥样硬化之间的关联。 方法 以江苏省心血管病高危人群早期筛查与综合干预项目筛查出的11 392位心血管病高危人群作为研究对象，进行食物频率问卷（food frequency questionnaire，FFQ）调查、身体测量、实验室检测以及颈动脉超声检测，获得蛋类摄入频率及颈动脉斑块（carotid plaques，CP）资料。通过二分类Logistic回归分析模型以及多分类Logistic回归分析模型分析蛋类摄入频率与CP之间的关系。 结果 < 1 d/w组（2 293人）、1~3 d/w组（4 890人）、4~6 d/w组（2 239人）、7 d/w（1 970人）CP发生率分别为40.7%、33.3%、37.7%、39.6%。在调整混杂因素后，与摄入频率为 < 1 d/w相比，男性和女性每周1~3 d摄入蛋类CP发生风险的比值比（OR）及95%置信区间（95%CI）分别为0.790（0.629~0.992）和0.772（0.642~0.927）。根据斑块数量分组后，男性和女性1~3 d/w组颈动脉斑块多发的OR值及95%CI分别为0.702（0.515~0.958）和0.682（0.517~0.901）。 结论 在心血管病高危人群中，中低频率的蛋类摄入与颈动脉斑块发生呈负相关，且这种关联性在斑块多发者中更显著 Abstract:Objective To explore the relationship between egg consumption and atherosclerosis in high-cardiovascular-risk population in Jiangsu Province. Methods Based on China patient-centered evaluative assessment of cardiac events million persons project (China PEACE MPP), we recruited 11 392 high-cardiovascular-risk participants in our cross-sectional study. We measured their egg consumption frequency and presence of carotid plaque (CP) by food frequency questionnaire, body measurements, laboratory tests, and carotid ultrasound. The relationship between egg consumption frequency and carotid plaque were assessed by binary Logistic regression and multinomial Logistic regression. Results Plaque prevalence in < 1 d/w group (2 293 people), 1-3 d/w group (4 890 people), 4-6 d/w group (2 239 people), 7 d/w group (1 970 people) were 40.7%, 33.3%, 37.7%, and 39.6%, respectively. After adjustment for demographic characteristics, cardiovascular risk factors and other dietary factors, compared with the group with the lowest frequency of egg intake (< 1 d/w), the odds ratio (OR) and 95% confidence interval (95% CI) for the risk of consuming egg of 1-3 d/w for male and female were 0.790 (0.629~0.992) and 0.772 (0.642~0.927). After grouped by the number of CP, the OR and 95% CI of multiple CPs were 0.702 (0.515~0.958) for male and 0.682 (0.517~0.901) for female when the egg consumption frequency was 1-3 d/w. Conclusions Among Chinese population with high CVD risk, low to moderate frequency of egg consumption is inversely related to carotid atherosclerosis, and the relationship is stronger among those with multiple plaques. -
Key words:
- Carotid plaque /
- Cardiovascular disease /
- Atherosclerosis /
- Egg consumption
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表 1 不同蛋类摄入水平组研究对象的基本特征及血管危险因素情况[M(P25，P75)]
Table 1. Demographic and risk factor characteristics of the study population across egg consumption frequencies[M(P25, P75)]
变量 蛋类摄入频率(d/w) 合计(n=11 392) χ2/H值 P值 < 1(n=2 293) 1~(n=4 890) 4~(n=2 239) 7(n=1 970) 男性[n(%)]a 792(34.5) 2 119(43.3) 997(44.5) 913(46.3) 4 821(42.3) 76.468 < 0.001 年龄(岁)b 61(53, 67) 61(53, 66) 60(52, 66) 60(53, 66) 61(53, 66) 13.508 0.004 文化程度[n(%)]a 184.518 < 0.001 小学及以下 1 423(62.1) 2 953(60.4) 1 226(54.8) 889(45.1) 6 491(57.0) 中学 769(33.5) 1 729(35.4) 865(38.6) 914(46.4) 4 277(37.5) 大学 101(4.4) 208(4.2) 148(6.6) 167(8.5) 624(5.5) 家庭年收入(万元)a 256.305 < 0.001 < 1 525(22.9) 875(17.9) 360(16.1) 198(10.1) 1 958(17.2) 1~ 1 309(57.1) 2 434(49.8) 1194(53.3) 1 268(64.4) 6 205(54.5) ≥5 459(20.0) 1 581(32.3) 685(30.6) 504(25.6) 3 229(28.3) 吸烟[n(%)]a 408(17.8) 1 149(23.5) 512(22.9) 466(23.7) 2 535(22.3) 33.460 < 0.001 饮酒[n(%)]a 567(24.7) 1 412(28.9) 675(30.1) 704(35.7) 3 358(29.5) 63.344 < 0.001 高血压[n(%)]a 2 065(90.1) 4 464(91.3) 2 015(90.0) 1 757(89.2) 10 301(90.4) 8.527 0.036 糖尿病[n(%)]a 581(25.3) 1 238(25.3) 565(25.3) 563(28.6) 2 947(25.9) 9.093 0.028 血脂异常[n(%)]a 1 274(55.6) 2 656(54.3) 1 224(54.7) 1 089(55.3) 6 243(54.8) 1.198 0.753 BMI(kg/m2)b 26.36(24.22, 28.85) 26.02(23.80, 28.30) 26.13(24.10, 28.32) 26.32(24.18, 28.54) 26.18(24.02~28.43) 23.254 < 0.001 LDL-C(mmol/L)b 2.69(2.13, 3.49) 2.64(2.08, 3.37) 2.59(2.09, 3.31) 2.54(1.98, 3.17) 2.62(2.07, 3.34) 34.304 < 0.001 HDL-C(mmol/L)b 1.35(1.07, 1.64) 1.33(1.04, 1.64) 1.28(1.00, 1.60) 1.26(0.95, 1.57) 1.32(1.02, 1.62) 63.179 < 0.001 LDL-C/HDL-Cb 2.07(1.52, 2.74) 2.06(1.50, 2.72) 2.11(1.58, 2.74) 2.04(1.53, 2.67) 2.07(1.53, 2.73) 6.541 0.088 TG(mmol/L)b 1.40(1.04, 2.02) 1.45(1.03, 2.06) 1.42(1.02, 2.07) 1.42(1.02, 2.06) 1.42(1.03, 2.05) 0.519 0.915 CIMT(mm)b 0.73(0.65, 0.82) 0.73(0.65, 0.82) 0.74(0.67, 0.83) 0.72(0.65, 0.80) 0.73(0.65, 0.82) 21.017 < 0.001 颈动脉斑块[n(%)]a 73.920 < 0.001 无 1 359(59.3) 3 262(66.7) 1 394(62.3) 1 191(60.4) 7 206(63.2) 单发 545(23.8) 1 101(22.5) 535(23.9) 472(24.0) 2 653(23.3) 多发 389(16.9) 527(10.8) 310(13.8) 307(15.6) 1 533(13.5) 注:a表示采用Pearson χ2检验进行组间比较；b表示采用Kruskal-Wallis H检验进行组间比较。 
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表 2 男性不同蛋类摄入频率与颈动脉斑块二分类Logistic回归分析模型分析
Table 2. Binary Logistic regression analysis of the association between egg consumption frequencies and carotid plaque in male
蛋类摄入频率(d/w) 模型1a 模型2b 模型3c OR(95% CI)值 P值 OR(95% CI)值 P值 OR(95% CI)值 P值 < 1 1.000 < 0.001 1.000 < 0.001 1.000 0.005 1~ 0.732 (0.621~0.863) 0.732 (0.615~0.872) 0.790 (0.629~0.992) 4~ 0.805 (0.667~0.971) 0.857 (0.701~1.047) 0.943 (0.730~1.218) 7 0.982 (0.811~1.188) 1.036 (0.846~1.269) 1.111 (0.859~1.438) 注:a表示模型1未进行调整；b表示模型2调整年龄、家庭收入和教育水平；c表示模型3在模型2基础上增加调整吸烟、饮酒、BMI、高血压、糖尿病、HDL-C、LDL-C、TG，及禽肉、畜肉、水果、蔬菜摄入情况。
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表 3 女性不同蛋类摄入频率与颈动脉斑块二分类Logistic回归分析模型分析
Table 3. Binary Logistic regression analysis of the association between egg consumption frequencies and carotid plaque in female
蛋类摄入频率(d/w) 模型1a 模型2b 模型3c OR (95% CI)值 P值 OR (95% CI)值 P值 OR (95% CI)值 P值 < 1 1.000 < 0.001 1.000 < 0.001 1.000 0.005 1~ 0.676 (0.592~0.772) 0.681 (0.591~0.784) 0.772 (0.642~0.927) 4~ 0.890 (0.761~1.041) 0.966 (0.817~1.141) 1.008 (0.817~1.244) 7 0.850 (0.721~1.002) 0.913 (0.765~1.090) 0.922 (0.742~1.146) 注:a表示模型1未进行调整；b表示模型2调整年龄、家庭收入和教育水平；c表示模型3在模型2基础上增加调整吸烟、饮酒、BMI、高血压、糖尿病、HDL-C、LDL-C、TG，及禽肉、畜肉、水果、蔬菜摄入情况。
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表 4 男性不同蛋类摄入频率与颈动脉斑块单发与多发多分类Logistic回归分析模型分析
Table 4. Multinomial Logistic regression analysis of the association between egg consumption frequencies and the number of carotid plaques in male
蛋类摄入频率(d/w) 模型1a 模型2 b 模型3 c 单发 P值 多发 P值 单发 P值 多发 P值 单发 P值 多发 P值 < 1 1.000 1.000 1.000 1.000 1.000 1.000 1~ 0.910 (0.746~ 1.109) 0.349 0.540 (0.435~0.670) < 0.001 0.901 (0.735~1.106) 0.319 0.534 (0.423~0.674) < 0.001 0.865 (0.666~1.123) 0.276 0.702 (0.515~0.958) 0.026 4~ 0.949 (0.757~ 1.190) 0.651 0.649 (0.506~0.831) 0.001 0.994 (0.788~1.254) 0.958 0.678 (0.519~0.886) 0.004 1.006 (0.751~1.348) 0.969 0.867 (0.611~1.229) 0.423 7 1.036 (0.821~1.306) 0.767 0.923 (0.724~1.176) 0.518 1.082 (0.852~1.373) 0.520 0.954 (0.733~1.242) 0.725 1.061 (0.788~1.428) 0.697 1.188 (0.842~1.676) 0.326 注:a表示模型1未进行调整；b表示模型2调整年龄、家庭收入、教育水平；c表示模型3在模型2基础上增加调整吸烟、饮酒、BMI、高血压、糖尿病、HDL-C、LDL-C、TG，及禽肉、畜肉、水果、蔬菜摄入情况。
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表 5 女性不同蛋类摄入频率与颈动脉斑块单发与多发多分类Logistic回归分析模型分析
Table 5. Multinomial Logistic regression analysis of the association between egg consumption frequencies and the number of carotid plaques in female
蛋类摄入频率(d/w) 模型1a 模型2b 模型3c 单发 P值 多发 P值 单发 P值 多发 P值 单发 P值 多发 P值 < 1 1.000 1.000 1.000 1.000 1~ 0.766 (0.657~0.893) 0.001 0.527 (0.431~0.645) < 0.001 0.764 (0.651~0.896) 0.001 0.539 (0.436~0.666) < 0.001 0.823 (0.669~1.011) 0.064 0.682 (0.517~0.901) 0.007 4~ 0.930 (0.775~1.155) 0.432 0.825 (0.656~1.038) 0.100 0.993 (0.821~1.199) 0.938 0.929 (0.730~1.184) 0.554 1.041 (0.822~1.319) 0.739 0.970 (0.709~1.328) 0.851 7 0.916 (0.757~1.108) 0.365 0.739 (0.578~0.946) 0.016 0.960 (0.787~1.172) 0.688 0.802 (0.617~1.043) 0.100 0.974 (0.764~1.243) 0.834 0.809 (0.582~1.125) 0.207 注:a表示模型1未进行调整；b表示模型2调整年龄、家庭收入、教育水平；c表示模型3在模型2基础上增加调整吸烟、饮酒、BMI、高血压、糖尿病、HDL-C、LDL-C、TG，及禽肉、畜肉、水果、蔬菜摄入情况。
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