scholarly journals Egg and Dietary Cholesterol Consumption and Mortality Among Hypertensive Patients: Results From a Population-Based Nationwide Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Fei Wu ◽  
Pan Zhuang ◽  
Yiju Zhang ◽  
Chuchu Zhan ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Cox Regression ◽  
Dietary Cholesterol ◽  
Total Mortality ◽  
Final Analysis ◽  
Population Based ◽  
Lower Mortality ◽  
Nutrition Survey ◽  
Hypertensive Patients ◽  
Cholesterol Intake ◽  
Whole Egg

Background: Hypertensive patients are sensitive to the amount of dietary cholesterol intake, especially cholesterol from the whole eggs. Whether whole egg and dietary cholesterol consumption are suitable for hypertensive patients is still controversial.Aim: The objective of the study was to examine the associations of intake of eggs as well as the dietary cholesterol with total mortality in a Chinese nationwide cohort.Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1991 to 2015. Cumulative averages of egg and cholesterol intake were calculated to represent the consumption of the long-term diet of the participants in each available round of the survey. Cox regression models were employed to estimate the effects of eggs and dietary cholesterol from the different sources on mortality among hypertensive patients.Results: A total of 8,095 participants were included in the final analysis and followed up for a mean of 11.4 years. Finally, 927 cases of death were detected. After adjustment for the multivariate factors, consuming more than seven eggs per week was related to 29% lower mortality among the hypertensive patients compared with the consumers with not more than two eggs per week [hazard ratio (HR): 0.71; 95% CI: 0.59–0.85; P < 0.001]. Similarly, the egg-sourced cholesterol intake was inversely associated with mortality (P = 0.002) whereas intake of the dietary cholesterol from the non-egg sources was significantly related to the higher mortality (P < 0.001). However, total cholesterol intake was not related to mortality among hypertensive patients. Substituting eggs for an equivalent amount of non-egg-sourced protein-abundant foods was also associated with lower mortality.Conclusion: Higher consumption of eggs and egg-sourced dietary cholesterol was associated with lower mortality among the enrolled Chinese hypertensive patients but non-egg-sourced cholesterol intake was related to higher mortality. Therefore, our findings do not support the view that hypertensive patients should avoid whole egg consumption for the purpose of restricting dietary cholesterol intake.

scholarly journals Threshold-Effect Association of Dietary Cholesterol Intake with Dyslipidemia in Chinese Adults: Results from the China Health and Nutrition Survey in 2015

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2885 ◽  
Author(s):  
Qiumin Huang ◽  
Hongru Jiang ◽  
Bing Zhang ◽  
Huijun Wang ◽  
Xiaofang Jia ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Dietary Cholesterol ◽  
Density Lipoprotein ◽  
Threshold Effect ◽  
Chinese Adults ◽  
Nutrition Survey ◽  
Chinese Adult ◽  
Health And Nutrition ◽  
Intake Level ◽  
Cholesterol Intake

The association of dietary cholesterol intake with dyslipidemia and subtypes is controversial. This study aimed to examine the association of dietary cholesterol intake with dyslipidemia and subtypes in Chinese adults. Using data from the China Health and Nutrition Survey (CHNS) in 2015, the present study selected 4383 participants aged 18–59 years who were free of diabetes, apoplexy, and myocardial infarction disease. Information was obtained on dietary intake, anthropometric measurements, and blood laboratory measurements. Dietary cholesterol intake was calculated based on the data collected by consecutive 3 days 24 h recalls combined with the weighing of household seasonings and categorized by 11 levels: The first 10 levels in ranges of 50 mg/day and the 11th level at ≥500 mg/day. Dyslipidemia, hypercholesterolemia, hypertriglyceridemia, low-density lipoprotein (LDL)-hypercholesterolemia, and high-density lipoprotein (HDL)-hypocholesterolemia were defined based on the Chinese adult dyslipidemia prevention guide (2016 edition). Multivariable logistic regressions were performed to examine the association of dietary cholesterol intake levels with dyslipidemia and subtypes. The prevalence of dyslipidemia was 37.5% among Chinese adults in 2015 (hypercholesterolemia 9.6%, HDL-hypocholesterolemia 21.1%, LDL-hypercholesterolemia 12.7%, and hypertriglyceridemia 15.2%). The lowest prevalence of hypercholesterolemia and LDL-hypercholesterolemia was 6.7% and 9.4%, respectively, which was relative to a dietary cholesterol intake level of 100.0 to <150.0 mg/day. After adjusting for all potential confounders, adults with the highest dietary cholesterol intake level of ≥500 mg/day compared with the dietary cholesterol intake of 100.0 to <150.0 mg/day showed one-time higher odds of hypercholesterolemia (odds ratios (OR) 2.0, 95% confidence intervals (CI) 1.3–3.3), as well as LDL-hypercholesterolemia (OR 2.0, 95% CI 1.3–3.0), but a null association of dietary cholesterol intake with dyslipidemia, hypertriglyceridemia, and HDL-hypocholesterolemia. The study suggested that a dietary cholesterol intake level of 500 mg/day and above may be a threshold point for high odds of hypercholesterolemia and LDL-hypercholesterolemia.

scholarly journals Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Women and Men

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 226-226
Author(s):  
Xiaoran Liu ◽  
Marta Liu Guasch-Ferré ◽  
Deirdre Liu ◽  
Yanping Li
Keyword(s):  
Life Expectancy ◽  
Cox Regression ◽  
Total Mortality ◽  
Premature Death ◽  
Population Based ◽  
Dietary Quality ◽  
Health Study ◽  
Funding Sources ◽  
Specific Mortality

Abstract Objectives We aim to 1) examine the association between walnut consumption and subsequent total and cause-specific mortality; 2) to estimate life expectancy that would be potentially gained by varying intake of walnuts in U.S. women and men. Methods Walnut consumption was assessed using validated food frequency questionnaires in 1998 (baseline year) and updated every 4 years. We included data from 68,308 women of the Nurses’ Health Study (1998–2016) and 26,760 men of the Health Professionals Follow-up Study (1998–2016) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models adjusting for confounders to estimate mortality risk associated with walnut consumption stratified by sex and dietary quality. We used population based multistate life tables to calculate the differences in life expectancy and years lived in relation to walnut consumption. Results During up to 18 years of follow-up, we documented 30,502 deaths from any cause. The multivariable-adjusted hazard ratios (HRs) for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.91 (95% confidence interval [CI], 0.89–0.94), for &lt;1 serving/week, 0.87 (95% CI, 0.83–0.92) for 1 serving/week, 0.79 (95% CI, 0.75–0.85), for 2–4 servings/week, and 0.77 (95% CI,: 0.71–0.81) for &gt;= 5 servings/week (P for trend &lt;0.0001). Per 0.5 serving/day walnut consumption was associated of a reduced risk of total mortality (HR: 0.82, 95% CI,: 0.77–0.88), CVD mortality (HR: 0.78, 95% CI,: 0.67–0.33), and cancer mortality (HR: 0.93, 95% CI:, 0.81–1.07) in participants with a suboptimal diet (AHEI score &lt;60% of cohort distribution). A greater life expectancy of 1.78 years in women and 1.94 years in men was observed among those who consumed walnuts more than 5 servings/week, compared to non-consumers at age 60. Conclusions Higher walnut consumption was associated with lower risk for total mortality and longer estimated life expectancy among U.S. men and women of two prospective cohort studies. Our results provide evidence on the potential role of walnut in the prevention of premature death. Funding Sources UM1 CA186107, UM1 CA176726, UM1 CA167552 Y.L. was partly funded by the California Walnut Commission. The funders have no roles in the design and conduct of the study.

scholarly journals Childbearing and mortality among women with personality disorders: nationwide registered-based cohort study

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Efthymios Kouppis ◽  
Charlotte Björkenstam ◽  
Bengt Gerdin ◽  
Lisa Ekselius ◽  
Emma Björkenstam
Keyword(s):  
Cohort Study ◽  
Personality Disorder ◽  
Mortality Risk ◽  
Cox Regression ◽  
Population Based ◽  
Lower Mortality ◽  
Healthcare Use ◽  
Nulliparous Women ◽  
Hazard Ratios ◽  
Risk Of Mortality

Background People with a personality disorder have a higher mortality and reduced life expectancy than the general population. Childbearing is thought to have a protective effect on morbidity and mortality. Yet, there are no studies on whether childbearing is related to a lower mortality among women with personality disorder. Aims This study examined associations between childbearing and mortality among women with personality disorder. Our hypothesis was that parity would be associated with lower mortality. Method This register-based cohort study included 27 412 women treated for personality disorder in in-patient or specialised out-patient care between 1990 and 2015. We used nationwide population-based registers to obtain information on sociodemographics, child delivery, healthcare use and mortality. Mortality risk estimates were calculated as hazard ratios (HRs) with 95% CIs using Cox regression. Adjustments were made for year of birth, educational level, age at diagnosis, comorbidity and severity of personality disorder. Results Nulliparous women had a nearly twofold increased mortality risk (adjusted HR = 1.78, 95% CI 1.50–2.12) compared with parous women and over twofold mortality risk (adjusted HR = 2.29, 95% CI 1.72–3.04) compared with those giving birth after their first personality disorder diagnosis. Those giving birth before their first personality disorder diagnosis had a 1.5-fold higher risk of mortality than those giving birth after their first personality disorder diagnosis (adjusted HR = 1.48, 95% CI 1.06–2.07). There was a threefold risk of suicide in nulliparous women compared with those giving birth after their first personality disorder diagnosis (adjusted HR = 2.90, 95% CI 1.97–4.26). Conclusions Childbearing history should be an integral part of the clinical evaluation of women with personality disorder.

scholarly journals Egg and cholesterol intake and incident type 2 diabetes among French women

2015 ◽  
Vol 114 (10) ◽  
pp. 1667-1673 ◽  
Author(s):  
Martin Lajous ◽  
Anne Bijon ◽  
Guy Fagherazzi ◽  
Beverley Balkau ◽  
Marie-Christine Boutron-Ruault ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cox Regression ◽  
Dietary Cholesterol ◽  
Underlying Mechanism ◽  
Incident Type ◽  
Egg Consumption ◽  
Sweetened Beverages ◽  
Cholesterol Intake ◽  
Diet History Questionnaire

AbstractEgg consumption is a major source of dietary cholesterol, a nutrient that may disrupt glucose metabolism. We prospectively evaluated the relation between egg consumption and cholesterol-intake and diabetes in 65 364 French disease-free women who responded to a validated diet history questionnaire in 1993. Egg consumption included hardboiled eggs and eggs consumed in an omelette or a mixed dish, and dietary cholesterol was estimated using a French nutrient database. Over 14 years of follow-up, 1803 incident diabetes cases were identified through self-reports, supplementary questionnaires and drug reimbursement information. Multivariable Cox regression models were adjusted for age, education, menopause, menopausal hormone therapy, hypertension and hypercholesterolaemia, BMI, physical activity, smoking, alcohol, fruit, vegetables, processed red meat, coffee and sugar and artificially sweetened beverages. No association was observed between egg consumption and risk of type 2 diabetes. When comparing women who consumed at least five eggs per week with non-consumers, the multivariable hazard ratio (HR) was found to be 1·00 (95 % CI 0·78, 1·29; across categories, Ptrend=0·11). Women in the highest quintile of dietary cholesterol had a 40 % higher rate of diabetes compared with those in the lowest quintile (HR 1·40; 95 % CI 1·19, 1·63; across quintiles, Ptrend<0·0001). A 100 mg increase of dietary cholesterol per 4184 kJ (or 1000 kcal) was associated with a 14 % increase in the risk of diabetes (HR 1·14; 95 % CI 1·02, 1·26). In this large prospective cohort, we observed an association between dietary cholesterol and type 2 diabetes, but no association with egg consumption. In the absence of a clear underlying mechanism and potential residual confounding, these results should be interpreted with caution.

scholarly journals Evaluation of dietary cholesterol intake in elderly Chinese: a longitudinal study from the China Health and Nutrition Survey

BMJ Open ◽  
2016 ◽  
Vol 6 (8) ◽  
pp. e011074 ◽  
Author(s):  
Xiaofang Jia ◽  
Chang Su ◽  
Zhihong Wang ◽  
Huijun Wang ◽  
Hongru Jiang ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Dietary Cholesterol ◽  
Nutrition Survey ◽  
Health And Nutrition ◽  
Elderly Chinese ◽  
Cholesterol Intake

scholarly journals Lipid-Mediated Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 1169-1169
Author(s):  
Pauline van Paridon ◽  
Marina Panova-Noeva ◽  
Rene van Oerle ◽  
Andreas Schulz ◽  
Jürgen Prochaska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tissue Factor ◽  
Regression Models ◽  
Tissue Factor Pathway Inhibitor ◽  
Cox Regression ◽  
Large Population ◽  
Total Mortality ◽  
Population Based ◽  
Activity Levels ◽  
Tissue Factor Pathway

Abstract Background: Tissue factor pathway inhibitor (TFPI), a Kunitz-type serine protease, is a potent anticoagulant protein in the extrinsic coagulation pathway and acts by inhibiting both the FXa and the Tissue Factor-FVIIa complex. In contrast to total and free TFPI antigen levels, the reference values and clinical determinants of total TFPI activity have not yet been studied in detail in the general population. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and investigate its association with cardiovascular disease (CVD) and total mortality, in a population at large. Methods: For this study, the first 4779 subjects of the population-based Gutenberg Health Study were examined in a highly standardized setting. Total TFPI activity was assessed in platelet poor plasma by the Actichrome TFPI activity assay (American Diagnostica, Stamford, CT, USA). Sex-specific nomograms were developed to demonstrate the relation of total TFPI activity with age. Multivariable regression analysis was performed to assess the determinants of total TFPI activity and to evaluate the association with CVD. Cox-regression models, adjusted for age, sex, cardiovascular risk factors (CVRFs) and CVD, were calculated to investigate the association between total TFPI activity and total mortality. Results: The multivariable linear regression analysis identified smoking (β, 0.0952 [0.0541 to 0.136],) as a positive determinant for total TFPI activity, while diabetes (β, -0.0716 [-0.134 to -0.00905],), obesity (β, -0.0627 [-0.101 to -0.024],) and history of coronary artery disease (CAD) were negatively associated with TFPI activity, independent of age, sex and the remaining CVRFs. After adjustment for high-density lipoprotein levels (HDL), low-density lipoproteins (LDL) and triglycerides, the association between TFPI activity levels and obesity and CAD was lost. The analysis additionally reveals a strong positive association between TFPI activity levels and LDL (β, 0.221 [0.204 to 0.237],). The Cox regression models revealed that a higher TFPI activity, above 97.5th percentile of the reference group, was associated with an increased mortality risk (HR = 2.58, [95% CI: 1.49/4.47], p=0.00074) independent of age, sex, CVRFs, CVD, oral contraceptives and hormonal replacement therapy. After additional adjustment for LDL levels, this relation became stronger. Conclusion: To the best of our knowledge, this is the first large, epidemiological study of the general population, revealing an increased mortality risk in individuals with higher TFPI activity, independent of CVRFs and CVD and emphasized by LDL-levels. Additionally, it demonstrates the negative association between total TFPI activity levels and CVD, particularly CAD. Furthermore, an association between TFPI activity and obesity, mediated through lipoprotein particles is explored. Lastly, it describes the age- and sex-related reference range of total TFPI activity levels in a large population-based data set. Disclosures No relevant conflicts of interest to declare.

Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

2015 ◽  
Vol 24 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Petra A. Golovics ◽  
Laszlo Lakatos ◽  
Michael D. Mandel ◽  
Barbara D. Lovasz ◽  
Zsuzsanna Vegh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cox Regression ◽  
Diagnostic Procedures ◽  
Population Based ◽  
Disease Course ◽  
Inception Cohort ◽  
Disease Extent ◽  
Cox Regression Analysis ◽  
Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

Fracture Risk in Patients with Myasthenia Gravis: A Population-Based Cohort Study

2021 ◽  
pp. 1-8
Author(s):  
Charles Kassardjian ◽  
Jessica Widdifield ◽  
J. Michael Paterson ◽  
Alexander Kopp ◽  
Chenthila Nagamuthu ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Lower Risk ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Osteoporosis Prevention ◽  
Inception Cohort ◽  
Hazard Ratios ◽  
Multiple Covariates ◽  
Region Of Residence

Background: Prednisone is a common treatment for myasthenia gravis (MG), and osteoporosis is a known potential risk of chronic prednisone therapy. Objective: Our aim was to evaluate the risk of serious fractures in a population-based cohort of MG patients. Methods: An inception cohort of patients with MG was identified from administrative health data in Ontario, Canada between April 1, 2002 and December 31, 2015. For each MG patient, we matched 4 general population comparators based on age, sex, and region of residence. Fractures were identified through emergency department and hospitalization data. Crude overall rates and sex-specific rates of fractures were calculated for the MG and comparator groups, as well as rates of specific fractures. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression. Results: Among 3,823 incident MG patients (followed for a mean of 5 years), 188 (4.9%) experienced a fracture compared with 741 (4.8%) fractures amongst 15,292 matched comparators. Crude fracture rates were not different between the MG cohort and matched comparators (8.71 vs. 7.98 per 1000 patient years), overall and in men and women separately. After controlling for multiple covariates, MG patients had a significantly lower risk of fracture than comparators (HR 0.74, 95% CI 0.63–0.88). Conclusions: In this large, population-based cohort of incident MG patients, MG patients were at lower risk of a major fracture than comparators. The reasons for this finding are unclear but may highlight the importance osteoporosis prevention.

Sibling Alcohol Use Disorder Is Associated With Increased Risk for Suicide Attempt

2021 ◽  
pp. 216770262110250
Author(s):  
Mallory E. Stephenson ◽  
Sara Larsson Lönn ◽  
Jessica E. Salvatore ◽  
Jan Sundquist ◽  
Kenneth S. Kendler ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Suicide Attempt ◽  
Alcohol Use Disorder ◽  
Cox Regression ◽  
Population Based ◽  
Swedish Population ◽  
Sibling Pairs ◽  
Increased Risk ◽  
Using Data ◽  
Shared Genetic

The association between having a sibling diagnosed with alcohol use disorder (AUD) and risk for suicide attempt may be attributable to shared genetic liability between AUD and suicidal behavior, effects of environmental exposure to a sibling’s AUD, or both. To distinguish between these alternatives, we conducted a series of Cox regression models using data derived from Swedish population-based registers with national coverage. Among full sibling pairs (656,807 males and 607,096 females), we found that, even after we accounted for the proband’s AUD status, the proband’s risk for suicide attempt was significantly elevated when the proband’s sibling was affected by AUD. Furthermore, the proband’s risk for suicide attempt was consistently higher when the sibling’s AUD registration had occurred more recently. Our findings provide evidence for exposure to sibling AUD as an environmental risk factor for suicide attempt and suggest that clinical outreach may be warranted following a sibling’s diagnosis with AUD.

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