Dietary cholesterol consumption may lead to subsequent type 2 diabetes

There appears to be a positive dose-response association between dietary cholesterol and type 2 diabetes mellitus (T2DM), where the higher the intake, the greater the incidence of T2DM especially in Western countries, according to a study.

Researchers conducted a systematic review and meta-analysis of prospective studies that examined the risk of T2DM in relation to dietary cholesterol intake. They searched multiple online databases for relevant studies.

The search yielded 11 prospective studies that involved a total of 355,230 individuals for inclusion in the meta-analysis. The researchers used random-effect model weighted by inverse variance in their meta-regression and subgroup analyses. They also applied restricted cubic splines regression models to estimate the dose-response relationship.

Pooled data showed that compared with the lowest dietary cholesterol consumption, the highest consumption level was conferred a significant increase in the risk of T2DM (relative risk [RR], 1.15, 95 percent confidence interval [CI], 1.03–1.28; p=0.012; I2=58.6 percent, p_{heterogeneity}=0.003).

Of note, the risk increase for T2DM associated with higher dietary cholesterol intake was more pronounced in Western countries than in Eastern countries (RR, 1.19, 95 percent CI, 1.06–1.36 vs RR, 1.34, 95 percent CI, 0.84–1.29; p=0.02).

For each 100-mg/d increment in dietary cholesterol intake, the pooled RR was 1.05 (95 percent CI, 1.04–1.07; p_linearity=0.000, p_nonlinearity=0.02) for the incidence of T2DM overall, 1.06 (95 percent CI, 1.04–1.07; p_linearity=0.000) in Western countries specifically, and 1.01 (95 percent CI, 0.98–1.05; p_linearity=0.525) in Eastern countries.