Longitudinal association between egg consumption and the risk of cardiovascular disease: interaction with type 2 diabetes mellitus

Abstract

Background/objectives: It remains unclear if high egg consumption has beneficial or adverse effects on cardiometabolic health. The present study prospectively evaluated the longitudinal association between egg-consumption levels and incident cardiovascular disease (CVD) among Korean adults. Subjects/methods: We conducted a prospective cohort study of 9248 Korean adults aged 40-69 years without CVD or cancer at the baseline from the Korean Genome and Epidemiology Study, Ansung-Ansan cohort, South Korea. The egg intake of the participants was estimated using a validated semiquantitative food frequency questionnaire at the baseline and the second follow-up examination and categorized into quartiles. CVD cases were identified using biennial questionnaires and confirmed through repeated in-depth personal interviews. Hazard ratios (HR) and 95% confidence interval (CI) were analyzed using Cox proportional hazard regression. Results: During the average follow-up of 7.3 years, 570 cases of CVD were newly diagnosed. After adjusting for multiple confounding variables, egg-intake levels were not associated with CVD incidence (HR: 1.14, 95% CI: 0.87-1.49, P for trend: 0.7). However, the association was modified by type 2 diabetes mellitus (T2DM) status. Egg consumption was significantly associated with an increased risk for incident CVD among participants with T2DM; individuals with the highest egg intake (4.2 +/- 0.04 eggs/week) had a 2.8 times higher incidence of CVD (HR: 2.81, 95% CI: 1.25-6.30, P for trend: 0.02) than those with the lowest egg intake (0.1 +/- 0.02 eggs/week). However, no association was observed among individuals without T2DM (HR: 1.03, 95% CI: 0.77-1.38, P for trend: 0.8). Conclusions: Higher egg consumption may increase the risk for CVD in Korean patients with T2DM. Our findings provide a basis for the development of an optimal dietary cholesterol intake guideline for the Korean population.