Eurac Research, Institute for Biomedicine (Affiliated to the University of Lübeck), Via Volta 21, 39100, Bolzano, Italy.
Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia.
J Nephrol. 2023 Jan;36(1):103-114. doi: 10.1007/s40620-022-01409-7. Epub 2022 Aug 5.
Diet is known to affect kidney function. However, population-based studies provide contrasting evidence, resulting in a poor understanding of the effect of proteins from specific foods on kidney health.
We analyzed the effect of total daily protein intake (TDPI) and source-specific daily protein intake (DPI) on fasting serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) in the Cooperative Health Research In South Tyrol (CHRIS) cross-sectional study (n = 5889), using the GALEN food frequency questionnaire for TDPI and DPI estimation. We fitted multivariable adjusted mixed models of SCr and eGFR on TDPI and DPI quartiles (Q1-Q4) in the overall sample, and after removing individuals with known hypertension, diabetes or chronic kidney disease (CKD).
Higher TDPI as well as DPI from overall animal sources, fish, and poultry, were associated with higher SCr (trend test p, p < 0.01), with larger effect after excluding individuals with known hypertension, diabetes or CKD. The eGFR was lower at higher TDPI (Q4 vs Q1: - 1.6 ml/min/1.73 m; 95% CI - 2.5, - 0.7; p = 3e-4) and DPI from fish (Q4 vs Q1: - 2.1 ml/min/1.73 m; 95% CI - 2.9, - 1.20; p = 4.3e-6), overall animal source (Q4 vs Q1: - 1.6 ml/min/1.73 m; 95% CI -2.5, - 0.8), processed meat (Q4 vs Q1: - 1.4 ml/min/1.73 m; p = 0.027), red meat, offal and processed meat (Q4 vs Q1: - 1.4 ml/min/1.73 m; p = 0.015) and poultry (Q4 vs Q1: - 0.9 ml/min/1.73 m; p = 0.015).
TDPI and DPI from specific animal sources were positively associated with SCr and negatively associated with eGFR. Lacking an alternative marker of kidney function, confounding involving muscle mass metabolism cannot be fully excluded.
饮食已知会影响肾功能。然而，基于人群的研究提供了相互矛盾的证据，导致人们对特定食物蛋白质对肾脏健康的影响知之甚少。
我们分析了总日蛋白摄入量（TDPI）和特定食物日蛋白摄入量（DPI）对空腹血清肌酐（SCr）和肾小球滤过率（eGFR）的影响，使用 GALEN 食物频率问卷来估计 TDPI 和 DPI。我们对总体样本中的 SCr 和 eGFR 进行了 TDPI 和 DPI 四分位（Q1-Q4）的多变量调整混合模型拟合，并在剔除已知患有高血压、糖尿病或慢性肾脏病（CKD）的个体后进行了分析。
更高的 TDPI 以及来自于整体动物源、鱼和禽肉的 DPI 与更高的 SCr 相关（趋势检验 p，p<0.01），在剔除已知患有高血压、糖尿病或 CKD 的个体后，影响更大。更高的 TDPI（Q4 比 Q1：-1.6ml/min/1.73m；95%CI -2.5，-0.7；p=3e-4）和来自于鱼的 DPI（Q4 比 Q1：-2.1ml/min/1.73m；95%CI -2.9，-1.20；p=4.3e-6）、整体动物源（Q4 比 Q1：-1.6ml/min/1.73m；95%CI -2.5，-0.8）、加工肉类（Q4 比 Q1：-1.4ml/min/1.73m；p=0.027）、红色肉类、动物内脏和加工肉类（Q4 比 Q1：-1.4ml/min/1.73m；p=0.015）和禽肉（Q4 比 Q1：-0.9ml/min/1.73m；p=0.015）与 eGFR 呈负相关。由于缺乏肾脏功能的替代标志物，无法完全排除涉及肌肉代谢的混杂因素。
