Pool Lindsay R, Kershaw Kiarri N, Gordon-Larsen Penny, Gutiérrez Orlando M, Reis Jared P, Isakova Tamara, Wolf Myles, Carnethon Mercedes R
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Ren Nutr. 2020 Nov;30(6):509-517. doi: 10.1053/j.jrn.2020.01.020. Epub 2020 Mar 6.
Food insecurity is associated with consumption of phosphate additive-laden processed food and beverage products, which could result in higher levels of fibroblast growth factor 23 (FGF23) to compensate for the increased dietary phosphate load. We sought to determine whether food insecurity is associated with higher levels of FGF23. We stratified analyses by race since differences may occur between food insecurity and diet quality across races.
The longitudinal community-based Coronary Artery Risk Development in Young Adults Study recruited from 4 US centers: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA, during the cohort inception in 1985/1986. This analysis included 3,421 black and white participants from Coronary Artery Risk Development in Young Adults follow-up years 20, 25, and 30 who were enrolled in the study between the ages of 18 and 30 years. Econometric fixed effects models stratified by race that adjust by design for all time-invariant covariates were used to model the longitudinal association of food insecurity, defined as the self-reported ability to afford desired quantity and quality of food. The main outcome of interest was changing to the highest quartile of plasma FGF-23 concentrations.
During follow-up, 29% of blacks and 14% of whites experienced change in food security. Developing food insecurity was associated with a 1.48 greater odds of increasing to the highest quartile of FGF23 (95% confidence interval 1.02-2.15) among blacks; however, there was no significant longitudinal association among whites (odds ratio = 1.14, 95% confidence interval 0.67-1.95).
Among blacks, food insecurity was associated with an increase in levels of FGF23. Although phosphate consumption was presumed to mediate the association between food insecurity and FGF23 levels, we were unable to directly test this pathway.
粮食不安全与食用富含磷酸盐添加剂的加工食品和饮料产品有关，这可能导致成纤维细胞生长因子23（FGF23）水平升高，以补偿饮食中磷酸盐负荷的增加。我们试图确定粮食不安全是否与较高水平的FGF23有关。我们按种族进行分层分析，因为不同种族在粮食不安全和饮食质量方面可能存在差异。
基于社区的纵向青年成人冠状动脉风险发展研究于1985/1986年队列起始期间从美国4个中心招募：阿拉巴马州伯明翰市；伊利诺伊州芝加哥市；明尼苏达州明尼阿波利斯市；加利福尼亚州奥克兰市。该分析纳入了3421名黑人和白人参与者，他们来自青年成人冠状动脉风险发展研究的第20、25和30年随访，入组时年龄在18至30岁之间。采用按种族分层的计量经济学固定效应模型，该模型在设计上对所有时间不变的协变量进行了调整，以模拟粮食不安全的纵向关联，粮食不安全定义为自我报告的购买所需数量和质量食物的能力。主要关注的结果是血浆FGF - 23浓度变化至最高四分位数。
在随访期间，29%的黑人以及14%的白人经历了粮食安全状况的变化。在黑人中，出现粮食不安全与FGF23升高至最高四分位数的几率高出1.48倍相关（95%置信区间1.02 - 2.15）；然而，在白人中未发现显著的纵向关联（优势比 = 1.14，95%置信区间0.67 - 1.95）。
在黑人中，粮食不安全与FGF23水平升高有关。尽管假定磷酸盐消费介导了粮食不安全与FGF23水平之间的关联，但我们无法直接检验这一途径。
