title: 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.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals).
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and jyrki.virtanen@uef.fi.
authors: Jyrki K
authors: JK
authors: Virtanen
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
authors: Jaakko
authors: J
authors: Mursu
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
authors: Heli Ek
authors: HE
authors: Virtanen
authors: Faculty of Agriculture and Forestry, Department of Food and Environmental Sciences, and.
authors: Mikael
authors: M
authors: Fogelholm
authors: Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.
authors: Jukka T
authors: JT
authors: Salonen
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
authors: Timo T
authors: TT
authors: Koskinen
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
authors: Sari
authors: S
authors: Voutilainen
authors: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and.
authors: Tomi-Pekka
authors: TP
authors: Tuomainen
mesh_terms: D001057:Apolipoproteins E / Q000378:metabolism*; D002340:Carotid Artery Diseases / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000187:drug effects*; D059168:Carotid Intima-Media Thickness; D002791:Cholesterol, Dietary / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003324:Coronary Artery Disease / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D004032:Diet; D004531:Eggs / Q000009:adverse effects; D005387:Finland; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E; D002791:Cholesterol, Dietary
keywords: apolipoproteins; atherosclerosis; cholesterol; coronary heart disease; diet