1Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute,Shahid Beheshti University of Medical Sciences, 1416643931,Tehran,Iran.
2Nutrition and Endocrine Research Center,Research Institute for Endocrine Sciences,Shahid Beheshti University of Medical Sciences, 1985717413,Tehran,Iran.
Br J Nutr. 2018 Mar;119(5):479-485. doi: 10.1017/S0007114517003671. Epub 2018 Jan 21.
The purpose of this study was primarily to evaluate the association of total fibre intake with the risk of incident chronic kidney disease (CKD). We also evaluated the association of dietary fibre from fruits, vegetables, cereals and legumes with the incidence of CKD in a population-based prospective study. We followed up 1630 participants of the Tehran Lipid and Glucose Study for 6·1 years, who were initially free of CKD. Baseline diet was assessed by a valid and reliable FFQ. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation, and CKD was defined as eGFR <60 ml/min per 1·73 m2. OR using multivariable logistic regression was reported for the association of incident CKD with tertiles of dietary fibre intake. After adjustment for age, sex, smoking, total energy intake, physical activity, diabetes and using angiotensin-converting-enzyme inhibitor, the OR for subjects in the highest compared with the lowest tertile of total fibre intake was 0·47 (95 % CI 0·27, 0·86). In addition, for every 5 g/d increase in total fibre intake, the risk of incident CKD decreased by 11 %. After adjusting for potential confounders, OR for participants in the highest compared with the lowest tertile of fibre from vegetables was 0·63 (95 % CI 0·43, 0·93) and from legumes it was 0·68 (95 % CI 0·47, 0·98). We observed inverse associations between total fibre intake and risk of incident CKD, which demonstrate that high fibre intake, mainly from legumes and vegetables, may reduce the occurrence of CKD.
本研究的主要目的是评估总膳食纤维摄入量与慢性肾脏病（CKD）发病风险的相关性。我们还在一项基于人群的前瞻性研究中评估了来自水果、蔬菜、谷物和豆类的膳食纤维与 CKD 发病的相关性。我们对最初无 CKD 的 1630 名德黑兰血脂和血糖研究参与者进行了 6.1 年的随访。通过有效的、可靠的 FFQ 评估了基线饮食。使用肾脏病饮食改良研究方程估算肾小球滤过率（eGFR），将 eGFR <60 ml/min/1.73 m2 定义为 CKD。使用多变量逻辑回归报告了膳食纤维摄入量与新发 CKD 的相关性。在调整年龄、性别、吸烟、总能量摄入、体力活动、糖尿病和使用血管紧张素转换酶抑制剂后，与最低膳食纤维摄入量 tertile 相比，最高膳食纤维摄入量 tertile 的新发 CKD 的 OR 为 0.47（95%CI 0.27, 0.86）。此外，膳食纤维总摄入量每增加 5 g/d，新发 CKD 的风险降低 11%。在调整潜在混杂因素后，与最低膳食纤维 tertile 相比，蔬菜膳食纤维摄入量 tertile 最高的参与者的 OR 为 0.63（95%CI 0.43, 0.93），豆类膳食纤维摄入量 tertile 最高的参与者的 OR 为 0.68（95%CI 0.47, 0.98）。我们观察到总膳食纤维摄入量与新发 CKD 风险之间存在负相关关系，这表明高膳食纤维摄入量，主要来自豆类和蔬菜，可能降低 CKD 的发生。
