Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
Yale School of Public Health, Yale University, New Haven, CT 06510-3201, USA.
Nutrients. 2022 Mar 14;14(6):1228. doi: 10.3390/nu14061228.
Insufficient fruit and vegetable intake (FVI) and low potassium intake are associated with many non-communicable diseases, but the association with early renal damage in children is uncertain. We aimed to identify the associations of early renal damage with insufficient FVI and daily potassium intake in a general pediatric population. We conducted four waves of urine assays based on our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We investigated FVI and other lifestyle status via questionnaire surveys and measured urinary potassium, β2-microglobulin (β2-MG), and microalbumin (MA) excretion to assess daily potassium intake and renal damage among 1914 primary school children. The prevalence of insufficient FVI (<4/d) was 48.6% (95% CI: 46.4%, 50.9%) and the estimated potassium intake at baseline was 1.63 ± 0.48 g/d. Short sleep duration, long screen time, lower estimated potassium intake, higher β2-MG and MA excretion were significantly more frequent in the insufficient FVI group. We generated linear mixed effects models and observed the bivariate associations of urinary β2-MG and MA excretion with insufficient FVI (β = 0.012, 95% CI: 0.005, 0.020; β = 0.717, 95% CI: 0.075, 1.359), and estimated potassium intake (β = −0.042, 95% CI: −0.052, −0.033; β = −1.778, 95% CI: −2.600, −0.956), respectively; after adjusting for age, sex, BMI, SBP, sleep duration, screen time and physical activity. In multivariate models, we observed that urinary β2-MG excretion increased with insufficient FVI (β = 0.011, 95% CI: 0.004, 0.018) and insufficient potassium intake (<1.5 g/d) (β = 0.031, 95% CI: 0.023, 0.038); and urinary MA excretion increased with insufficient FVI (β = 0.658, 95% CI: 0.017, 1.299) and insufficient potassium intake (β = 1.185, 95% CI: 0.492, 1.878). We visualized different quartiles of potassium intake showing different renal damage with insufficient FVI for interpretation and validation of the findings. Insufficient FVI and low potassium intake aggravate early renal damage in children and underscores that healthy lifestyles, especially adequate FVI, should be advocated.
水果和蔬菜摄入量不足（FVI）以及钾摄入量低与许多非传染性疾病有关，但与儿童早期肾损伤的关系尚不确定。我们旨在确定一般儿科人群中，FVI 不足和每日钾摄入量与早期肾损伤的关系。我们于 2018 年 10 月至 2019 年 11 月期间，在中国北京进行了基于儿童队列（PROC）研究的四次尿液检测。我们通过问卷调查调查了 FVI 和其他生活方式状况，并测量了尿钾、β2-微球蛋白（β2-MG）和微量白蛋白（MA）排泄量，以评估 1914 名小学生的日常钾摄入量和肾损伤。FVI 不足（<4/d）的患病率为 48.6%（95%CI：46.4%，50.9%），基线时估计的钾摄入量为 1.63±0.48g/d。FVI 不足组的短睡眠持续时间、长屏幕时间、低估计钾摄入量、高β2-MG 和 MA 排泄更为频繁。我们生成了线性混合效应模型，并观察到尿β2-MG 和 MA 排泄与 FVI 不足（β=0.012，95%CI：0.005，0.020；β=0.717，95%CI：0.075，1.359）和估计的钾摄入量（β=−0.042，95%CI：−0.052，−0.033；β=−1.778，95%CI：−2.600，−0.956）之间存在双变量关联；在调整了年龄、性别、BMI、SBP、睡眠持续时间、屏幕时间和身体活动后。在多变量模型中，我们观察到随着 FVI 不足（β=0.011，95%CI：0.004，0.018）和钾摄入不足（<1.5g/d）（β=0.031，95%CI：0.023，0.038），尿β2-MG 排泄增加；随着 FVI 不足（β=0.658，95%CI：0.017，1.299）和钾摄入不足（β=1.185，95%CI：0.492，1.878），尿 MA 排泄增加。我们可视化了不同钾摄入量四分位数的不同肾损伤情况，以解释和验证 FVI 不足的发现。FVI 不足和低钾摄入会加重儿童的早期肾损伤，这强调了应提倡健康的生活方式，尤其是摄入足够的 FVI。
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