Positive dose-response association between dietary cholesterol, type 2 diabetes incidence
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Researchers observed a positive dose-response association between dietary cholesterol and type 2 diabetes incidence, particularly in Western countries, according to a meta-analysis of prospective cohort studies.
“Dietary cholesterol is a very common nutrient in our daily life, containing in various foods such as animal viscera, red meat, egg yolk, butter, edible oil and so on,” Yuehua Li, MD, from the department of cardiology at the State Key Laboratory of Cardiovascular Disease at Fuwai Hospital at the National Center for Cardiovascular Disease at the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, and colleagues wrote. “Experimental studies have indicated that high cholesterol level impairs pancreatic beta-cell function, thereby impairing glycemic metabolism.”
This meta-analysis, published in Nutrition, Metabolism and Cardiovascular Diseases, included 11 prospective studies with data from a total of 355,230 people with type 2 diabetes as the endpoint from PubMed, Embase and the Cochrane Library database. Researchers used the random-effect model weighted by inverse variance and conducted meta-regression and subgroup analyses to explore potential heterogeneity sources by specified study characteristics.
Highest dietary cholesterol consumption was associated with an increased risk for type 2 diabetes compared with lowest dietary cholesterol consumption (RR = 1.15; 95% CI, 1.03-1.28; P = .012). This positive association was more evident in Western countries (RR = 1.19; 95% CI, 1.06-1.36) compared with Eastern countries (RR = 1.34; 95% CI, 0.84-1.29) in the subgroup analyses (P = .03). This association remained higher in studies with lower Newcastle-Ottawa quality assessment scale points compared with those with higher points in Western countries (RR = 1.33; 95% CI, 1.22-1.45) compared with Eastern countries (RR = 1.07; 95% CI, 0.93-1.22) and in studies with longer follow-up periods in Western countries (RR = 1.21; 95% CI, 1.04-1.39) compared with Eastern countries (RR = 1.09; 95% CI, 0.92-1.28).
In addition, for every 100 mg per day increment in dietary cholesterol intake, the pooled RR was 1.05 for type 2 diabetes incidence, 1.06 for Western countries and 1.01 for Eastern countries.
According to the researchers, these findings indicate that lower dietary cholesterol intake should be recommended to prevent type 2 diabetes, especially among high-risk populations with fat, hypertension, hyperlipidemia or family history of type 2 diabetes.
“Our results advise low intake of dietary cholesterol for the prevention of type 2 diabetes, especially for the population with high cardiovascular risk,” the researchers wrote.
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