Sanchis Pilar, Buades Juan Manuel, Berga Francisco, Gelabert Miguel Mas, Molina Marilisa, Íñigo María Victoria, García Susana, Gonzalez Jorge, Bernabeu Maria Rosario, Costa-Bauzá Antonia, Grases Felix
Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain; Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS-IdISPa), Department of Chemistry, University of Balearic Islands, Palma of Mallorca, Spain.
Nephrology Department, Research Unit, Institute of Health Sciences Research (IUNICS-IdISPa), Hospital Son Llàtzer, Palma of Mallorca, Spain.
J Ren Nutr. 2016 Jul;26(4):226-36. doi: 10.1053/j.jrn.2016.01.010. Epub 2016 Mar 12.
The aim of this study was to evaluate the relationship between physiological levels of myo-inositol hexaphosphate (phytate) and cardiovascular (CV) calcification in patients with chronic kidney disease (CKD).
This was a prospective cross-sectional study conducted from December 2012 to June 2013.
Sixty-nine consecutive patients with CKD who were not undergoing renal replacement therapy.
All subjects were given lateral lumbar X-rays to quantify abdominal aortic calcification (AAC). Clinical laboratory analyses and phytate food frequency questionnaires were also performed.
Phytate urinary excretion, estimated phytate consumption (based on food frequency questionnaire) and AAC score. Patients were divided into two groups based on median abdominal aortic calcification (AAC) score: no/mild AAC (AAC ≤ 6, n = 35) and moderate/severe AAC (AAC > 6, n = 34).
Patients with no/mild AAC were younger, had lower pulse pressure, greater dietary intake of phytate, greater urinary phytate and the prevalence of prior CV disease was significantly lower compared to patients with moderate/severe AAC. Among the top 10 phytate-rich foods, lentil consumption was significantly greater in patients with no/mild AAC than in those with moderate/severe AAC. Multivariate logistic regression analysis indicated that age, prior CV disease, urinary phytate (or lentil consumption) were independently associated to AAC.
Our results suggest that adequate consumption of phytate can prevent AAC in patients with CKD. Further prospective studies must be performed to elucidate the benefits of a phytate-rich diet and the associated risk of phosphorus bioavailability in these patients.
本研究旨在评估慢性肾脏病（CKD）患者中肌醇六磷酸（植酸盐）的生理水平与心血管（CV）钙化之间的关系。
这是一项于2012年12月至2013年6月进行的前瞻性横断面研究。
69例未接受肾脏替代治疗的连续性CKD患者。
所有受试者均接受腰椎侧位X线检查以量化腹主动脉钙化（AAC）。还进行了临床实验室分析和植酸盐食物频率问卷调查。
植酸盐尿排泄量、估计的植酸盐摄入量（基于食物频率问卷）和AAC评分。根据腹主动脉钙化（AAC）评分中位数将患者分为两组：无/轻度AAC（AAC≤6，n = 35）和中度/重度AAC（AAC>6，n = 34）。
与中度/重度AAC患者相比，无/轻度AAC患者更年轻，脉压更低，植酸盐饮食摄入量更高，尿植酸盐更高，既往心血管疾病患病率显著更低。在富含植酸盐的前10种食物中，无/轻度AAC患者的小扁豆摄入量显著高于中度/重度AAC患者。多因素逻辑回归分析表明，年龄、既往心血管疾病、尿植酸盐（或小扁豆摄入量）与AAC独立相关。
我们的结果表明，充足的植酸盐摄入可以预防CKD患者的AAC。必须进行进一步的前瞻性研究以阐明富含植酸盐饮食的益处以及这些患者中磷生物利用度的相关风险。
