Association of dietary cholesterol intake with the risk of fatal cardiovascular events in individuals with type 2 diabetes

BACKGROUND: Nutrition is one of the factors affecting the health of a population. One of the nutritional components in the diet is dietary cholesterol, which comes from meat products and eggs. To date, there is no unequivocal answer about the presence of a relationship between cholesterol consumption and the risk of cardiovascular diseases, which determines the relevance of the study of this issue.

AIM: To study the association of dietary cholesterol with the risk of fatal outcomes from cardiovascular disease (CVD) in individuals with type 2 diabetes mellitus (DM2).

MATERIALS AND METHODS: The baseline study was carried out within the framework of the HAPIEE project in 2003-2005. The period of observation of the cohort, incl. for persons with DM2 lasted from 2003- 2005 to December 31, 2018 and averaged 12.8 years, the average age for both sexes was 58.1±6.6 years. Data on actual nutrition were obtained from a survey of 678 participants using a questionnaire to assess the frequency of food intake and included information on 147 products. Statistical data processing was carried out using the SPSS v.13.0 application package. To compare independent paired groups of variables, the nonparametric Mann-Whitney U test was used. The risk ratio (HR) was estimated using Cox regression. The critical level of statistical significance of differences was taken at p<0.05.

RESULTS: It was found that in individuals with DM2, the risk of a fatal outcome from CVD in the maximum tertile of dietary cholesterol intake/1000 kcal increased by 56% compared with controls (p=0.009). An analysis of the consumption of chicken eggs/1000 kcal in the diet showed an increase in the risk of death from CVD in the maximum tertile of by 52% (p=0.003). Consumption of meat products/1000 kcal was not associated with the risk of death from CVD (p = 0.361).

CONCLUSION: In the surveyed cohort of Novosibirsk residents with a history of DM2, high dietary cholesterol levels (505 mg/day in the maximum tertile) in the diet were significantly associated with an increased risk of death from CVD. The results of this study may suggest a possible association of high-cholesterol foods with an increased risk of death in people with type 2 diabetes, pointing to the need for people with diabetes to control their dietary cholesterol levels and more optimal type of diet for this population.

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