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西式饮食:肾功能障碍和慢性肾脏病的主要危险因素。

The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease.

机构信息

Div. of Molecular and Systems Toxicology, Dept. of Pharmaceutical Sciences, Univ. of Basel, Klingelbergstrasse 50, CH-4056 Basel, Switzerland.

出版信息

Am J Physiol Renal Physiol. 2011 Nov;301(5):F919-31. doi: 10.1152/ajprenal.00068.2011. Epub 2011 Aug 31.

Abstract

The Western-style diet is characterized by its highly processed and refined foods and high contents of sugars, salt, and fat and protein from red meat. It has been recognized as the major contributor to metabolic disturbances and the development of obesity-related diseases including type 2 diabetes, hypertension, and cardiovascular disease. Also, the Western-style diet has been associated with an increased incidence of chronic kidney disease (CKD). A combination of dietary factors contributes to the impairment of renal vascularization, steatosis and inflammation, hypertension, and impaired renal hormonal regulation. This review addresses recent progress in the understanding of the association of the Western-style diet with the induction of dyslipidemia, oxidative stress, inflammation, and disturbances of corticosteroid regulation in the development of CKD. Future research needs to distinguish between acute and chronic effects of diets with high contents of sugars, salt, and fat and protein from red meat, and to uncover the contribution of each component. Improved therapeutic interventions should consider potentially altered drug metabolism and pharmacokinetics and be combined with lifestyle changes. A clinical assessment of the long-term risks of whole-body disturbances is strongly recommended to reduce metabolic complications and cardiovascular risk in kidney donors and patients with CKD.

摘要

西方饮食的特点是高度加工和精制的食物,以及高糖、高盐、高脂肪和来自红色肉类的蛋白质。它已被认为是导致代谢紊乱和肥胖相关疾病发展的主要因素,包括 2 型糖尿病、高血压和心血管疾病。此外,西方饮食与慢性肾脏病 (CKD) 的发病率增加有关。饮食因素的组合导致肾脏血管化、脂肪变性和炎症、高血压以及肾脏激素调节受损。这篇综述讨论了最近在理解西方饮食与诱导血脂异常、氧化应激、炎症和 CKD 中皮质类固醇调节紊乱的关联方面取得的进展。未来的研究需要区分高糖、高盐、高脂肪和来自红色肉类的蛋白质饮食的急性和慢性影响,并揭示每个成分的贡献。改善治疗干预措施应考虑潜在改变的药物代谢和药代动力学,并与生活方式改变相结合。强烈建议对全身紊乱的长期风险进行临床评估,以降低肾供体和 CKD 患者的代谢并发症和心血管风险。

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