观察性或遗传预测的较高蔬菜摄入量与肾功能损害：基于人群的综合横断面分析和孟德尔随机化研究。

Observational or Genetically Predicted Higher Vegetable Intake and Kidney Function Impairment: An Integrated Population-Scale Cross-Sectional Analysis and Mendelian Randomization Study.

机构信息

Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Armed Forces Capital Hospital, Gyeonggi-do, Korea.

出版信息

J Nutr. 2021 May 11;151(5):1167-1174. doi: 10.1093/jn/nxaa452.

DOI:10.1093/jn/nxaa452

PMID:33693791

Abstract

BACKGROUND

Further exploration of the possible effects of vegetable intake on kidney function is warranted.

OBJECTIVE

We aimed to study the causality of the association between vegetable intake and kidney function by implementing Mendelian randomization (MR) analysis.

METHODS

This study comprised a cross-sectional dietary investigation using UK Biobank data and MR analysis. For the cross-sectional investigation, 432,732 participants aged 40-69 y from the UK Biobank cohort were included. Self-reported vegetable intake was the exposure, and the outcomes were the estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD). Next, we included 337,138 participants of white British ancestry in the UK Biobank, and a genome-wide association study (GWAS) was performed to generate a genetic instrument. For MR, we first performed polygenic score (PGS)-based 1-sample MR. In addition, 2-sample MR was performed with CKDGen GWAS for kidney function traits, and the inverse variance weighted method was the main MR method.

RESULTS

Higher vegetable intake was cross-sectionally associated with a higher eGFR (per heaped tablespoon increase; β: 0.154; 95% CI: 0.144, 0.165) and lower odds of CKD (OR: 0.975; 95% CI: 0.968, 0.982). A PGS for vegetable intake was significantly associated with a higher eGFR [per ordinal category increase (0, 1-3, 4-6, ≥7 tablespoons per day); β: 4.435; 95% CI: 2.337, 6.533], but the association with CKD remained nonsignificant (OR: 0.468; 95% CI: 0.143, 1.535). In the 2-sample MR, the causal estimates indicated that a higher genetically predicted vegetable intake was associated with a higher eGFR (percent change; β: 3.071; 95% CI: 0.602, 0.560) but nonsignificantly associated with the risk of CKD (OR: 0.560; 95% CI: 0.289, 1.083) in the European ancestry data from the CKDGen.

CONCLUSIONS

This study suggests that higher vegetable intake may have a causal effect on higher eGFRs in the European population.

摘要

背景

进一步探索蔬菜摄入对肾功能的可能影响是合理的。

目的

我们旨在通过实施孟德尔随机化（MR）分析来研究蔬菜摄入与肾功能之间关联的因果关系。

方法

本研究采用英国生物库的数据进行了横断面饮食调查和 MR 分析。对于横断面研究，纳入了来自英国生物库队列的 432732 名 40-69 岁的参与者。蔬菜摄入量是暴露因素，结局是估算肾小球滤过率（eGFR）和慢性肾脏病（CKD）。接下来，我们纳入了英国生物库中 337138 名白种英国人种的参与者，并进行了全基因组关联研究（GWAS）以产生遗传工具。对于 MR，我们首先进行了基于多基因评分（PGS）的 1 样本 MR。此外，还对肾功能特征进行了 CKDGen GWAS 的 2 样本 MR，主要的 MR 方法是逆方差加权法。

结果

较高的蔬菜摄入量与较高的 eGFR（每增加一汤匙堆积；β：0.154；95%CI：0.144，0.165）和较低的 CKD 风险相关（OR：0.975；95%CI：0.968，0.982）。蔬菜摄入量的 PGS 与较高的 eGFR 显著相关[每增加一个有序类别（0、1-3、4-6、≥7 汤匙/天）；β：4.435；95%CI：2.337，6.533]，但与 CKD 的关联仍无统计学意义（OR：0.468；95%CI：0.143，1.535）。在 2 样本 MR 中，因果估计表明，较高的遗传预测蔬菜摄入量与较高的 eGFR 相关（百分比变化；β：3.071；95%CI：0.602，0.560），但与 CKD 风险无显著关联（OR：0.560；95%CI：0.289，1.083），这是来自 CKDGen 的欧洲人群的遗传数据。