Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil.
Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil.
Braz J Med Biol Res. 2020 Oct 30;53(12):e10230. doi: 10.1590/1414-431X202010230. eCollection 2020.
Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A cross-sectional study using the ELSA-Brasil baseline data was carried out. DP ("traditional", "fruits and vegetables", "bakery", and "low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFR<60 mL·min-1·(1.73 m2)-1 and MA≥3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between "bakery" and "fruits and vegetables", and both were associated with decreased eGFR and albuminuria in both genders, compared with "traditional" and "low sugar/low fat" patterns in the general population. There was a direct association of the "bakery" pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The "fruits and vegetables" pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The "fruits and vegetables" and "bakery" DPs were associated with renal dysfunction. The only independent, direct association was between "bakery" DP and MA in men, raising concerns about DP and renal damage in men.
先前对巴西成人健康纵向研究(ELSA-Brasil)的分析确定了四种主要的饮食模式(DP)。本研究旨在探讨先前定义的 DP 与肾功能(RF)之间的关系。本研究采用 ELSA-Brasil 基线数据进行了一项横断面研究。评估了 DP(“传统”、“水果和蔬菜”、“面包店”和“低糖/低脂”)、使用联合临时声明标准的代谢综合征(MS)、微量白蛋白尿(MA)和通过 CKD-EPI 方程的肾小球滤过率(eGFR)。异常 RF 定义为 eGFR<60 mL·min-1·(1.73 m2)-1 和 MA≥3.0 mg/dL。确定了与 RF 相关的因素,并进行了中介分析,以调查 DP、MS 和 RF 之间的关系。共纳入 15105 名参与者,平均年龄 52±9 岁;8134 名参与者(54%)为女性。中介分析确定了“面包店”和“水果和蔬菜”之间的间接关联,与“传统”和“低糖/低脂”模式相比,这两种模式在两性中均与 eGFR 和白蛋白尿降低有关。“面包店”模式与男性 MA 之间存在直接关联(OR:1.17,95%CI:1.92-1.48)。“水果和蔬菜”模式在女性中也与 eGFR 降低有直接关联(OR:1.65,95%CI:1.28-2.12),尽管调整后无显著性差异。“水果和蔬菜”和“面包店”DP 与肾功能障碍有关。唯一的独立、直接关联是“面包店”DP 与男性 MA 之间的关联,这引起了人们对 DP 和男性肾脏损害的关注。