饮食质量更好与老年人患 CKD 的可能性降低有关。
A better diet quality is associated with a reduced likelihood of CKD in older adults.
机构信息
Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Westmead Hospital, Hawkesbury Rd, Westmead, NSW 2145, Australia.
出版信息
Nutr Metab Cardiovasc Dis. 2013 Oct;23(10):937-43. doi: 10.1016/j.numecd.2012.07.003. Epub 2012 Aug 16.
BACKGROUND AND AIMS
Studies of diet in relation to chronic kidney disease (CKD) have focused on individual nutrients. The relationship between overall patterns of food intake and renal function has not been well explored. We aimed to investigate the associations between diet quality with the prevalence, incidence and progression of CKD in a cohort of older adults.
METHODS AND RESULTS
1952 participants aged ≥50 years at baseline were examined between 1992-1994 and 2002-2004. Dietary data were collected using a semi-quantitative food frequency questionnaire. A modified version of the Healthy Eating Index for Australians was developed to determine total diet scores (TDS). Baseline biochemistry including serum creatinine was measured. CKD was defined as MDRD estimated glomerular filtration rate (eGFR) <60 mL min⁻¹·1.73 m⁻². Participants in the highest quartile of mean TDS compared to those in the first quartile (reference), had a 41% reduced likelihood of having eGFR <60 mL min⁻¹·1.73 m⁻², [multivariable-adjusted odds ratio, OR, 0.59 (95% confidence intervals, CI, 0.41-0.85), P-trend = 0.005]. Each unit increase in TDS was associated with a 15% decrease in the odds of having prevalent CKD, multivariable-adjusted OR 0.85 (95% CI 0.74-0.97). A non-significant, inverse association between TDS and CKD incidence was observed (P-trend = 0.10).
CONCLUSION
Older adults with better diet quality had a reduced likelihood of having eGFR <60 mL min⁻¹·1.73 m⁻². Adherence to dietary guidelines were not prospectively associated with CKD incidence or progression. Further studies with adequate power are warranted to assess the longitudinal association between diet quality and CKD.
背景与目的
研究饮食与慢性肾脏病（CKD）的关系主要集中在个别营养素上。食物摄入的整体模式与肾功能之间的关系尚未得到很好的探讨。我们旨在调查饮食质量与老年人群中 CKD 的患病率、发病率和进展之间的关系。
方法和结果
在 1992-1994 年至 2002-2004 年期间，对 1952 名年龄≥50 岁的基线参与者进行了检查。使用半定量食物频率问卷收集饮食数据。开发了澳大利亚健康饮食指数的一个修正版本来确定总饮食评分（TDS）。测量了基线生化指标，包括血清肌酐。CKD 的定义为 MDRD 估计肾小球滤过率（eGFR）<60 mL min⁻¹·1.73 m⁻²。与第一四分位数（参考）相比，TDS 平均值最高四分位数的参与者发生 eGFR<60 mL min⁻¹·1.73 m⁻²的可能性降低了 41%，[多变量调整后的优势比，OR，0.59（95%置信区间，CI，0.41-0.85），P 趋势=0.005]。TDS 每增加一个单位，发生现有 CKD 的几率降低 15%，多变量调整后的 OR 为 0.85（95%CI 0.74-0.97）。TDS 与 CKD 发病率之间存在非显著的负相关（P 趋势=0.10）。
结论
饮食质量较好的老年人发生 eGFR<60 mL min⁻¹·1.73 m⁻²的可能性较低。饮食指南的依从性与 CKD 的发病率或进展没有前瞻性关联。需要进一步进行具有足够效力的研究来评估饮食质量与 CKD 之间的纵向关联。
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