Discipline of Medicine, University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide, Australia.
Discipline of Medicine, University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide, Australia.
Clin Nutr. 2018 Feb;37(1):276-284. doi: 10.1016/j.clnu.2016.12.025. Epub 2017 Jan 7.
BACKGROUND & AIMS: Almost one in ten Chinese adults has chronic kidney disease (CKD). However, the link between dietary patterns, dietary cadmium intake and CKD has not been studied in China.
Adults (n = 8429) in the China Health and Nutrition Survey who had at least one 3-day 24 h food record in combination with household food inventory in 1991, 1993, 1997, 2000, 2004, 2006, and 2009 and estimated glomerular filtration rate (eGFR) measured in 2009. Dietary pattern was identified using factor analysis. CKD was defined as eGFR <60 mL/min/1.73 m.
There were 641 (7.6%) cases of CKD in the sample. After adjustment for demographic, lifestyle factors (i.e. smoking, alcohol drinking, physical activity) and chronic conditions, the odds ratio (OR) for CKD was 4.05 (95%CI 2.91-5.63, p for trend <0.001) for extreme quartiles of estimated cumulative cadmium intake. A traditional southern dietary pattern (high intake of rice, pork, and vegetables, and low intake of wheat) was associated with more than four times increased prevalence of CKD (comparing extreme quartiles, OR 4.56, 95%CI 3.18-6.56). A modern dietary pattern (high intake of fruit, soy milk, egg, milk and deep fried products) was inversely associated with CKD (for extreme quartiles, OR 0.5, 95%CI 0.36-0.71). The association between dietary patterns and CKD were attenuated by cadmium intake.
Traditional southern dietary pattern is positively associated, and modern dietary pattern is inversely associated, with CKD among Chinese adults. However, these associations can be partly attributed to cadmium contamination in parts of the food supply.
中国近十分之一的成年人患有慢性肾脏病（CKD）。然而，在中国，饮食模式、饮食镉摄入量与 CKD 之间的联系尚未得到研究。
本研究纳入了中国健康与营养调查（CHNS）中的成年人（n=8429），他们在 1991 年、1993 年、1997 年、2000 年、2004 年、2006 年和 2009 年至少进行过一次为期 3 天的 24 小时食物记录，并结合家庭食物库存进行调查，且于 2009 年测量了肾小球滤过率（eGFR）。使用因子分析来确定饮食模式。CKD 定义为 eGFR<60 mL/min/1.73 m。
在样本中，有 641 例（7.6%）CKD 病例。在校正了人口统计学、生活方式因素（即吸烟、饮酒、体力活动）和慢性疾病后，估计累积镉摄入量处于极端四分位数的 CKD 比值比（OR）为 4.05（95%CI 2.91-5.63，p<0.001）。传统的南方饮食模式（高摄入大米、猪肉和蔬菜，低摄入小麦）与 CKD 的患病率增加四倍以上有关（比较极端四分位数，OR 4.56，95%CI 3.18-6.56）。现代饮食模式（高摄入水果、豆浆、鸡蛋、牛奶和油炸产品）与 CKD 呈负相关（对于极端四分位数，OR 0.5，95%CI 0.36-0.71）。饮食模式与 CKD 之间的关联在一定程度上可归因于部分食物供应中的镉污染。
传统的南方饮食模式与中国成年人的 CKD 呈正相关，而现代饮食模式与 CKD 呈负相关。然而，这些关联在一定程度上可归因于部分食物供应中的镉污染。
