The relationship of dietary cholesterol to serum low density lipoprotein cholesterol and confounding by reverse causality: the INTERLIPID study

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Title: The relationship of dietary cholesterol to serum low density lipoprotein cholesterol and confounding by reverse causality: the INTERLIPID study
Authors: Okami, Y
Ueshima, H
Nakamura, Y
Okuda, N
Nakagawa, H
Sakata, K
Saitoh, S
Okayama, A
Yoshita, K
Choudhury, SR
Chan, Q
Elliott, P
Miura, K
Stamler, J
For the INTERMAP AND INTERLIPID Research Groups
Item Type: Journal Article
Abstract: im: The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population. Methods: A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40-59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an auto-analyzer. A standard questionnaire inquired about employment status and education years. Results: In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (P=0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β=+9.08, 95% confidence interval (CI)=+0.90-+17.27] and less educated men (β=+4.46, 95% CI=-0.97-+9.90), whereas an inverse association was observed in employed men (β=-3.02, 95% CI=-5.49--0.54) and more educated men (β=-3.66, 95% CI=-6.25--1.07). Conclusions: In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.
Issue Date: 2019
Date of Acceptance: 22-Apr-2018
URI: http://hdl.handle.net/10044/1/59983
DOI: http://doi.org/10.5551/jat.43075
ISSN: 1340-3478
Publisher: Japan Atherosclerosis Society
Start Page: 170
End Page: 182
Journal / Book Title: Journal of Atherosclerosis and Thrombosis
Volume: 26
Issue: 2
Copyright Statement: ©2018 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc-sa/3.0/)
Sponsor/Funder: National Institutes of Health
Medical Research Council (MRC)
Funder's Grant Number: 60024563 ICL
MR/L01341X/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Cholesterol
Employment
Education
Lifestyle modification
Reverse causality
ATHEROSCLEROTIC CARDIOVASCULAR-DISEASES
CORONARY-HEART-DISEASE
HIGHER BLOOD-PRESSURE
RISK-FACTORS
FATTY-ACIDS
CIGARETTE-SMOKING
EGG CONSUMPTION
LESS EDUCATION
ALCOHOL INTAKE
JAPAN
Cholesterol
Education
Employment
Lifestyle modification
Reverse causality
Adult
Biomarkers
Cholesterol, Dietary
Cholesterol, LDL
Coronary Disease
Cross-Sectional Studies
Education
Employment
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
INTERMAP and INTERLIPID Research Groups
Humans
Coronary Disease
Cholesterol, Dietary
Prognosis
Follow-Up Studies
Cross-Sectional Studies
Education
Adult
Middle Aged
Employment
Female
Male
Cholesterol, LDL
Biomarkers
Cardiovascular System & Hematology
Publication Status: Published online
Article Number: JAT/2017/043075
Online Publication Date: 2018-06-09
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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