1Key State Laboratory of Molecular Developmental Biology,Institute of Genetics and Developmental Biology,Chinese Academy of Sciences, Chaoyang,People's Republic of China.
3Second Propedeutic Department of Internal Medicine,Medical School,Aristotle University of Thessaloniki,Hippokration Hospital,546 42 Thessaloniki,Greece.
Br J Nutr. 2019 Jun;121(11):1294-1302. doi: 10.1017/S0007114518003124. Epub 2018 Oct 30.
A growing number of studies suggest that diet and renal function are related. However, little is known about the link between both whole grain (WG) and refined grain (RG) consumption and kidney function parameters. Thus, we investigated the association of WG and RG with urinary albumin to creatinine ratio (ACR) and prevalent chronic kidney disease (CKD). Data from participants of the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2010 were collected. Estimated glomerular filtration rate (eGFR) was calculated by the CKD Epidemiology Collaboration equation. Survey design and sample weights were taken into consideration for statistical analyses. Finally, we included 16 325 participants from NHANES, 6·9 % of whom had prevalent CKD. In models adjusted for age, sex, race, fasting blood glucose, blood pressure, adiposity, hypertension and diabetes status, mean eGFR significantly increased across increasing quartiles of WG (Q1: 88·2 v. Q4: 95·4 ml/min per 1·73 m2, P<0·001), whereas it significantly decreased across increasing quartiles of RG (Q1: 97·2 v. Q4: 88·4 ml/min per 1·73 m2, P<0·001). Furthermore, serum uric acid levels and ACR significantly decreased across quartiles of WG (both P<0·001). In multivariable-adjusted logistic regression models, the likelihood of prevalent CKD was 21 % lower in the highest WG quartile compared with the lowest one. In conclusion, our results shed light on the beneficial impact of WG on kidney function and CKD, whereas RG is adversely associated with eGFR.
越来越多的研究表明，饮食与肾功能有关。然而，人们对全谷物（WG）和精制谷物（RG）的消耗与肾功能参数之间的联系知之甚少。因此，我们研究了 WG 和 RG 与尿白蛋白与肌酐比值（ACR）和现患慢性肾脏病（CKD）之间的关系。本研究数据来自 2005 年至 2010 年国家健康和营养调查（NHANES）的参与者。通过 CKD 流行病学合作方程计算估计肾小球滤过率（eGFR）。在进行统计分析时，考虑了调查设计和样本权重。最终，我们纳入了来自 NHANES 的 16325 名参与者，其中 6.9%的参与者患有现患 CKD。在调整年龄、性别、种族、空腹血糖、血压、肥胖、高血压和糖尿病状态的模型中，WG 四分位数（Q1：88.2；Q4：95.4 ml/min/1.73 m2，P<0.001）的平均 eGFR 随着 Q1 到 Q4 逐渐增加而显著增加，而 RG 四分位数（Q1：97.2；Q4：88.4 ml/min/1.73 m2，P<0.001）的 eGFR 随着 Q1 到 Q4 逐渐增加而显著降低。此外，血清尿酸水平和 ACR 随着 WG 四分位数的增加而显著降低（均 P<0.001）。在多变量调整的逻辑回归模型中，与最低四分位数相比，最高四分位数的现患 CKD 发生的可能性低 21%。总之，我们的研究结果表明 WG 对肾功能和 CKD 有益，而 RG 与 eGFR 呈负相关。
