Rebholz Casey M, Tin Adrienne, Liu Yang, Kuczmarski Marie Fanelli, Evans Michele K, Zonderman Alan B, Crews Deidra C
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md., USA.
Am J Nephrol. 2016;44(5):381-387. doi: 10.1159/000450861. Epub 2016 Oct 22.
Prior studies suggest that certain aspects of the diet related to magnesium intake, such as dietary acid load, protein intake and dietary patterns rich in fruits and vegetables, may impact kidney disease risk. We hypothesized that lower dietary magnesium intake would be prospectively associated with more rapid kidney function decline.
Among participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 at baseline (2004-2009), dietary magnesium intake was calculated from two 24-hour dietary recalls. Rapid decline was defined as ≥3% eGFR decline per year.
Median (25th-75th percentile) dietary magnesium intake was 116 (96-356) mg/1,000 kcal. Among 1,252 participants, those with lower dietary magnesium intake were younger, and were more likely to be African-American men. A total of 177 participants (14.1%) experienced rapid eGFR decline over a median follow-up of 5 years. Lower dietary magnesium intake was significantly associated with a greater odds of rapid eGFR decline (OR for tertile 1 vs. 3: 2.02, 95% CI 1.05-3.86, p value for trend across tertiles = 0.02) in analyses adjusted for sociodemographics (age, sex, race, education level, health insurance status, poverty status), kidney disease risk factors (smoking status, diabetes, hemoglobin A1c, hypertension, body mass index), baseline eGFR and dietary factors (total energy intake; diet quality; dietary intake of fiber, sodium, calcium, potassium and phosphorus).
In this urban population, lower dietary magnesium intake was independently associated with greater odds of rapid kidney function decline.
先前的研究表明,与镁摄入相关的某些饮食方面,如饮食酸负荷、蛋白质摄入以及富含水果和蔬菜的饮食模式,可能会影响肾病风险。我们推测,较低的饮食镁摄入量可能与肾功能下降更快存在前瞻性关联。
在“全生命周期多元社区健康老龄化”研究的参与者中,那些在基线期(2004 - 2009年)估算肾小球滤过率(eGFR)≥60 ml/min/1.73 m² 的人群,其饮食镁摄入量通过两次24小时饮食回顾来计算。快速下降定义为每年eGFR下降≥3%。
饮食镁摄入量的中位数(第25 - 75百分位数)为116(96 - 356)mg/1000千卡。在1252名参与者中,饮食镁摄入量较低的人群更年轻,且更有可能是非洲裔美国男性。在中位随访5年期间,共有177名参与者(14.1%)经历了eGFR的快速下降。在对社会人口统计学因素(年龄、性别、种族、教育水平、健康保险状况、贫困状况)、肾病风险因素(吸烟状况、糖尿病、糖化血红蛋白、高血压、体重指数)、基线eGFR和饮食因素(总能量摄入;饮食质量;膳食纤维、钠、钙、钾和磷的饮食摄入量)进行调整后的分析中,较低的饮食镁摄入量与eGFR快速下降的几率显著相关(三分位数1与三分位数3相比的比值比:2.02,95%置信区间1.05 - 3.86,三分位数间趋势的p值 = 0.02)。
在这个城市人群中,较低的饮食镁摄入量与肾功能快速下降的几率增加独立相关。