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膳食维生素 E 和生育酚异构体与慢性肾脏病发病的关系:一项从青年到中年长达 30 年的随访研究。

Dietary vitamin E and tocopherol isoforms and incident chronic kidney disease: A 30-y follow-up study from young adulthood to midlife.

机构信息

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.

出版信息

Free Radic Biol Med. 2022 Sep;190:284-291. doi: 10.1016/j.freeradbiomed.2022.08.023. Epub 2022 Aug 23.

Abstract

BACKGROUND

The relationship of dietary vitamin E intake with incident chronic kidney disease (CKD) was not clear as yet. We aimed to examine the associations of dietary total vitamin E and tocopherol isoforms intakes with incident CKD in a 30-year follow-up study from young adulthood to midlife.

METHODS

A total of 4038 American adults aged 18-30 years and without reduced estimated glomerular filtration rate (eGFR) were enrolled from Coronary Artery Risk Development in Young Adults study. Diet was evaluated by a validated dietary-history questionnaire at baseline, and after 7 and 20 years later. The study outcome was incident CKD, defined as an eGFR<60 mL/min/1.73 m or a urinary albumin to creatinine ratio ≥30 mg/g.

RESULTS

During a 30-year follow-up, 642 (15.9%) participants developed incident CKD. Overall, there was a L-shaped relationship between dietary total vitamin E intake and incident CKD (P for non-linearity<0.001). When total vitamin E intake was assessed as quartiles, compared with those in the first quartile (<4.35 mg α-TE/1000 kcal), the adjusted HRs (95%CI) of incident CKD for participants in the fourth quartile (≥9.61 mg α-TE/1000 kcal) was 0.55 (0.40, 0.75). Moreover, higher intakes of beta-tocopherol and gamma-tocopherol were significantly associated with a lower incident CKD. Higher intake of delta-tocopherol was significantly related to a higher incident CKD. And there was no obvious association of alpha-tocopherol intake with incident CKD.

CONCLUSIONS

There were inverse associations of total vitamin E, beta-tocopherol and gamma-tocopherol intakes, a positive association of delta-tocopherol intake, and no obvious association of alpha-tocopherol intake, with incident CKD among American adults.

摘要

背景

膳食维生素 E 摄入量与慢性肾脏病(CKD)的关系尚不清楚。我们旨在通过一项为期 30 年的随访研究,从年轻人到中年,研究膳食总维生素 E 和生育酚异构体摄入量与 CKD 发病的关系。

方法

共纳入 4038 名年龄在 18-30 岁且肾小球滤过率(eGFR)无降低的美国成年人,来自冠状动脉风险发展中的年轻人研究。饮食通过基线时和 7 年后和 20 年后的验证饮食史问卷进行评估。研究结局为 CKD 发病,定义为 eGFR<60mL/min/1.73m 或尿白蛋白与肌酐比值≥30mg/g。

结果

在 30 年的随访期间,642 名(15.9%)参与者发生 CKD 发病。总的来说,膳食总维生素 E 摄入量与 CKD 发病之间存在 L 型关系(P 非线性<0.001)。当总维生素 E 摄入量被评估为四分位数时,与第 1 四分位数(<4.35mg α-TE/1000kcal)相比,第 4 四分位数(≥9.61mg α-TE/1000kcal)参与者的 CKD 发病调整后的 HR(95%CI)为 0.55(0.40,0.75)。此外,较高的β-生育酚和γ-生育酚摄入量与较低的 CKD 发病显著相关。较高的δ-生育酚摄入量与较高的 CKD 发病显著相关。而α-生育酚摄入量与 CKD 发病无明显关联。

结论

美国成年人膳食总维生素 E、β-生育酚和γ-生育酚摄入量与 CKD 发病呈负相关,δ-生育酚摄入量与 CKD 发病呈正相关,α-生育酚摄入量与 CKD 发病无明显关联。

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