School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei City 11031, Taiwan.
Department of Dietetics, Taoyuan Armed Forces General Hospital, Taoyuan, Taoyuan City 32551, Taiwan.
Nutrients. 2022 May 21;14(10):2148. doi: 10.3390/nu14102148.
Nephropathy caused by diabetes mellitus (DM) is the main cause of end-stage renal disease (ESRD). To understand the association of dietary intake with renal function indicators among patients with diabetic nephropathy (DN), this cross-sectional study was conducted at the dietetic consultation clinic of the Taoyuan Armed Forces General Hospital in Taiwan. In total, 317 participants were recruited for this study. Patients with diabetes who had a urinary albumin-creatinine ratio (UACR) of ≥30 mg/g were defined as having DN. The anthropometric characteristics, blood biochemistry, and renal function of the participants were assessed. Furthermore, a semiquantitative food frequency questionnaire (SQFFQ) was administered to investigate the dietary intake of the participants in the DM and DN groups. The result showed that participants in the DN group were older, had longer diabetes duration and poorer glycemic control and renal function than those in the DM group. Logistic regression models revealed that intake of high-fat marine fishes had the lowest odds ratio (OR) for DN risk compared with other fishes (OR: 0.868; 95% CI: 0.781-0.965, = 0.009). Shellfish, soybean products, and skim milk also provided better protective effects to decrease the risk of DN. A further analysis of polyunsaturated fatty acids revealed that Σn-3 PUFAs significantly reduced DN risk, while Σn-6 PUFAs did not, especially EPA (OR: 0.821; 95% CI: 0.688-0.979, = 0.029) and DHA (OR: 0.903; 95% CI: 0.823-0.992, = 0.033) regardless of whether the variables were adjusted, including diabetes duration, age, and HbA1c. Our findings suggest that a diet that incorporates high-fat fish, shellfish, soybean products, and a lower Σn-6/Σn-3 ratio can mitigate DN risk.
糖尿病（DM）引起的肾病是终末期肾病（ESRD）的主要原因。为了了解饮食摄入与糖尿病肾病（DN）患者肾功能指标的关系，本研究在台湾桃园三军总医院的营养咨询诊所进行了一项横断面研究。共有 317 名患者参加了这项研究。患有糖尿病且尿白蛋白肌酐比（UACR）≥30mg/g 的患者被定义为患有 DN。评估了参与者的人体测量特征、血液生化和肾功能。此外，还使用半定量食物频率问卷（SQFFQ）调查了 DM 和 DN 组参与者的饮食摄入情况。结果显示，DN 组患者年龄较大，糖尿病病程较长，血糖控制和肾功能较差。Logistic 回归模型显示，与其他鱼类相比，高脂肪海鱼的摄入对 DN 风险的比值比（OR）最低（OR：0.868；95%CI：0.781-0.965， = 0.009）。贝类、豆制品和脱脂牛奶也为降低 DN 风险提供了更好的保护作用。对多不饱和脂肪酸的进一步分析表明，Σn-3PUFAs 显著降低了 DN 风险，而 Σn-6PUFAs 则没有，特别是 EPA（OR：0.821；95%CI：0.688-0.979， = 0.029）和 DHA（OR：0.903；95%CI：0.823-0.992， = 0.033），无论是否调整变量，包括糖尿病病程、年龄和 HbA1c。我们的研究结果表明，摄入高脂肪鱼类、贝类、豆制品和降低 Σn-6/Σn-3 比值的饮食可以降低 DN 风险。
