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含糖饮料的摄入与动脉粥样硬化多民族研究(MESA)中慢性肾脏病的进展。

Sugar-sweetened beverage consumption and the progression of chronic kidney disease in the Multi-Ethnic Study of Atherosclerosis (MESA).

机构信息

Department of Medicine, Division of Nephrology, Columbia University Medical Center, New York, NY 10032, USA.

出版信息

Am J Clin Nutr. 2009 Nov;90(5):1172-8. doi: 10.3945/ajcn.2009.28111. Epub 2009 Sep 9.

Abstract

BACKGROUND

Recent studies have examined sugar-sweetened soda consumption in relation to early markers of kidney disease, but to date there have been no investigations of whether sugar-sweetened beverage consumption affects preexistent chronic kidney disease (CKD).

OBJECTIVE

This prospective cohort study of 447 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with preexistent CKD examined the association between sugar-sweetened beverage consumption (<1 drink/wk, 1-6 drinks/wk, and > or =1 drink/d) and progression of CKD.

DESIGN

beta-Coefficients for continuous outcomes of changes in estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR) were calculated by using linear regression. Odds ratios for binary outcomes of accelerated decline in eGFR, defined as >2 mL x min(-1) x 1.73 m(-2) per year, and clinically significant progression of albuminuria (defined as attainment of UACR > or =30 mg/g for participants without microalbuminuria at visit 1 or a > or =25% increase in UACR for participants with baseline microalbuminuria) were evaluated by using logistic regression.

RESULTS

The mean (+/-SD) baseline eGFR was 52 +/- 6 mL x min(-1) x 1.73 m(-2) per year, and median baseline UACR was 6.3 mg/g (interquartile range: 3.5-17.6). Univariate and multivariate analyses showed no association between sugar-sweetened beverage consumption and rate of eGFR decline or changes in urinary albumin to creatinine ratio. The multivariate odds ratios comparing participants who drank > or =1 sugary beverage daily with those who drank < or =1 beverage weekly were 0.62 (95% CI: 0.27, 1.41) for accelerated eGFR decline and 1.51 (95% CI: 0.49, 4.62) for clinically significant progression of albuminuria.

CONCLUSION

A higher consumption of sugar-sweetened beverages was not associated with disease progression, on the basis of either eGFR or the urinary albumin to creatinine ratio, in MESA participants with preexistent CKD.

摘要

背景

最近的研究已经检查了含糖苏打水的消费与肾脏疾病早期标志物之间的关系,但迄今为止,还没有关于含糖饮料的消费是否会影响已存在的慢性肾脏病(CKD)的调查。

目的

这项对动脉粥样硬化多民族研究(MESA)中 447 名已存在 CKD 的参与者的前瞻性队列研究,调查了含糖饮料的消费(<1 份/周、1-6 份/周和>或=1 份/天)与 CKD 进展之间的关系。

设计

通过线性回归计算估计肾小球滤过率(eGFR)和尿白蛋白与肌酐比(UACR)连续变化的β系数。通过逻辑回归评估 eGFR 加速下降(定义为>2 mL x min(-1) x 1.73 m(-2) 每年)和白蛋白尿的临床显著进展(定义为在第一次就诊时无微量白蛋白尿的参与者中 UACR >或=30 mg/g,或在基线时已有微量白蛋白尿的参与者中 UACR 增加>或=25%)的二元结果的比值比。

结果

平均(+/-SD)基线 eGFR 为 52 +/- 6 mL x min(-1) x 1.73 m(-2) 每年,中位数基线 UACR 为 6.3 mg/g(四分位距:3.5-17.6)。单变量和多变量分析显示,含糖饮料的消费与 eGFR 下降的速度或尿白蛋白与肌酐比的变化之间没有关联。与每周饮用<或=1 份饮料的参与者相比,每天饮用>或=1 份含糖饮料的参与者,在 eGFR 加速下降方面的多变量比值比为 0.62(95%CI:0.27,1.41),在白蛋白尿的临床显著进展方面的比值比为 1.51(95%CI:0.49,4.62)。

结论

在 MESA 参与者中,与 eGFR 或尿白蛋白与肌酐比相比,较高的含糖饮料消费与已存在的 CKD 并无疾病进展相关。

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