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在基于人群的纵向多廷赫姆研究中,全谷物、水果和蔬菜的摄入量与肾功能指标无关。

Consumption of whole grains, fruit and vegetables is not associated with indices of renal function in the population-based longitudinal Doetinchem study.

作者信息

Herber-Gast Gerrie-Cor M, Boersma Marijke, Verschuren W M Monique, Stehouwer Coen D A, Gansevoort Ron T, Bakker Stephan J L, Spijkerman Annemieke M W

机构信息

1Centre for Nutrition, Prevention and Health Services,National Institute of Public Health and the Environment,PO Box 1, 3720 BA Bilthoven,The Netherlands.

2Department of Internal Medicine and Cardiovascular Research Institute,Maastricht University Medical Center,PO Box 616, 6200 MD Maastricht,The Netherlands.

出版信息

Br J Nutr. 2017 Sep;118(5):375-382. doi: 10.1017/S0007114517001726.

Abstract

Emerging evidence suggests that diet and renal function are related. Little is known, however, about the association of consumption of whole grains, fruit and vegetables with urinary albumin:creatinine ratio (ACR) and changes in estimated glomerular filtration rate (eGFR). We investigated this in a population-based cohort aged 26-65 years. Data were from 3787 participants from the Doetinchem cohort study, who were examined ≥3 times, 5 years apart. Consumption of food groups was assessed at each round with a validated FFQ. GFR was estimated at each round from routinely measured cystatin C and creatinine using the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation. ACR was measured at the last round. Generalised estimated equation models were performed to examine associations with changes in eGFR. Linear regression was used to examine associations with ACR. Adjustments were made for covariates related to lifestyle, biological factors and diet. Mean baseline eGFR was 104·5 (sd 13·7) and mean annual decline was -0·95 (sd 0·67) ml/min per 1·73 m2 over a 15-year follow-up. A trend was observed towards slightly less annual decline in eGFR among those with higher consumption of whole grains (P=0·06). This association, however, was attenuated and no longer significant in multivariate models (P=0·29). Consumption of fruit and vegetables was not associated with changes in eGFR and urinary ACR. In conclusion, consumption of whole grains, fruit and vegetables is not associated with changes in eGFR and mean ACR. As this was the first longitudinal study into this association in the general population, and as results are only partially in line with related studies, further research is recommended.

摘要

新出现的证据表明饮食与肾功能有关。然而,关于全谷物、水果和蔬菜的摄入量与尿白蛋白肌酐比值(ACR)以及估计肾小球滤过率(eGFR)变化之间的关联,我们知之甚少。我们在一个年龄在26 - 65岁的人群队列中对此进行了调查。数据来自多廷赫姆队列研究的3787名参与者,他们接受了≥3次检查,每次间隔5年。每一轮都使用经过验证的食物频率问卷(FFQ)评估食物组的摄入量。每一轮都根据常规测量的胱抑素C和肌酐,使用慢性肾脏病流行病学(CKD - EPI)方程来估计肾小球滤过率。在最后一轮测量ACR。采用广义估计方程模型来检验与eGFR变化的关联。使用线性回归来检验与ACR的关联。对与生活方式、生物学因素和饮食相关的协变量进行了调整。在15年的随访中,平均基线eGFR为104.5(标准差13.7),平均每年下降速率为每1.73 m² - 0.95(标准差0.67)ml/min。在全谷物摄入量较高的人群中,观察到eGFR每年下降幅度略小的趋势(P = 0.06)。然而,在多变量模型中,这种关联减弱且不再显著(P = 0.29)。水果和蔬菜的摄入量与eGFR和尿ACR的变化无关。总之,全谷物、水果和蔬菜的摄入量与eGFR和平均ACR的变化无关。由于这是在普通人群中对这种关联进行的首次纵向研究,且结果仅部分与相关研究一致,建议进一步开展研究。

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