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膳食草酸钙平衡与高血压和慢性肾脏病的发病率:一项亚洲人群的前瞻性研究

Dietary oxalate-calcium balance and the incidence of hypertension and chronic kidney disease: a prospective study among an Asian population.

作者信息

Mirmiran Parvin, Bahadoran Zahra, Azizi Fereidoun

机构信息

Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., P.O. Box 19395-4763, Velenjak, Tehran, Iran.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Nutr Metab (Lond). 2022 Nov 3;19(1):74. doi: 10.1186/s12986-022-00709-w.


DOI:10.1186/s12986-022-00709-w
PMID:36329523
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9632065/
Abstract

BACKGROUND: The potential effects of dietary oxalate (Ox) intake on cardio-renal function have remained unestablished. We evaluated the effect of usual Ox intake and its interaction with dietary calcium (Ca) on incident hypertension (HTN) and chronic kidney disease (CKD). METHODS: Adult men and women, free of HTN and CKD at baseline (2006-2008), were recruited. Dietary intakes were assessed using a validated food frequency questionnaire, and the outcomes were documented up to 2014-2017. Multivariate Cox proportional hazard regression models were used to estimate the development of HTN and CKD in relation to Ox intakes. Repeated-measures generalized estimating equation (GEE) linear regression models were used to assess possible effect of Ox-intake on the estimated glomerular filtration rate (eGFR) and blood pressure levels over eight years. RESULTS: Dietary Ox intakes were positively associated with incident CKD (HR = 2.59, 95% CI = 1.46-4.64) and HTN (HR = 1.79, 95% CI = 1.05-3.04). Compared to high-Ca consumers, subjects who had lower Ca intakes (< 990 vs. 1580 mg/d) had a higher incidence of CKD and HTN (HR = 2.43, 95% CI = 1.06-5.55, and HR = 1.72, 95% CI = 0.76-3.78). Participants with higher intakes of Ox (> 220 vs. < 150 mg/d) had lower eGFR values (75.3, 95% CI = 75.0-76.5 vs. 77.3, 95% CI = 76.6-78.1 mL/min/1.73m, P = 0.004) and higher SBP levels (112, 95% CI = 111-113 vs. 109, 95% CI = 108-110 mmHg, P = 0.007) overtime. CONCLUSION: Higher dietary Ox intake may increase the risk of HTN and CKD. The relation between dietary Ox and risk of HTN and CKD seems to be varied by Ca intake, and subjects with lower Ca intakes may be more burdened by excessive amounts of dietary Ox.

摘要

背景:膳食草酸盐(Ox)摄入量对心肾功能的潜在影响尚未明确。我们评估了通常的Ox摄入量及其与膳食钙(Ca)的相互作用对高血压(HTN)和慢性肾脏病(CKD)发病的影响。 方法:招募了基线时(2006 - 2008年)无HTN和CKD的成年男性和女性。使用经过验证的食物频率问卷评估膳食摄入量,并记录至2014 - 2017年的结局。多变量Cox比例风险回归模型用于估计与Ox摄入量相关的HTN和CKD的发生情况。重复测量广义估计方程(GEE)线性回归模型用于评估Ox摄入量在八年内对估计肾小球滤过率(eGFR)和血压水平的可能影响。 结果:膳食Ox摄入量与CKD发病(风险比[HR] = 2.59,95%置信区间[CI] = 1.46 - 4.64)和HTN发病(HR = 1.79,95% CI = 1.05 - 3.04)呈正相关。与高钙摄入者相比,钙摄入量较低(< 990 vs. 1580 mg/d)的受试者CKD和HTN发病率更高(HR = 2.43,95% CI = 1.06 - 5.55,以及HR = 1.72,95% CI = 0.76 - 3.78)。Ox摄入量较高(> 220 vs. < 150 mg/d)的参与者随着时间推移eGFR值较低(75.3,95% CI = 75.0 - 76.5 vs. 77.3,95% CI = 76.6 - 78.1 mL/min/1.73m²,P = 0.004)且收缩压水平较高(112,95% CI = 111 - 113 vs. 109,95% CI = 108 - 110 mmHg,P = 0.007)。 结论:较高的膳食Ox摄入量可能增加HTN和CKD的风险。膳食Ox与HTN和CKD风险之间的关系似乎因钙摄入量而异,钙摄入量较低的受试者可能因过量的膳食Ox而负担更重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444c/9632065/d1ca6d66eea1/12986_2022_709_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444c/9632065/09660629f641/12986_2022_709_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444c/9632065/d1ca6d66eea1/12986_2022_709_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444c/9632065/09660629f641/12986_2022_709_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444c/9632065/d1ca6d66eea1/12986_2022_709_Fig2_HTML.jpg

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[1]
Dietary oxalate-calcium balance and the incidence of hypertension and chronic kidney disease: a prospective study among an Asian population.

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引用本文的文献

[1]
Balancing Stone Prevention and Kidney Function: A Therapeutic Dilemma.

J Clin Med. 2025-5-23

[2]
Mendelian randomization analyses explore the effects of micronutrients on different kidney diseases.

Front Nutr. 2024-9-13

[3]
Oxalate Homeostasis in Non-Stone-Forming Chronic Kidney Disease: A Review of Key Findings and Perspectives.

Biomedicines. 2023-6-7

本文引用的文献

[1]
Hyperoxalemia Leads to Oxidative Stress in Endothelial Cells and Mice with Chronic Kidney Disease.

Kidney Blood Press Res. 2021

[2]
Dietary Oxalate Loading Impacts Monocyte Metabolism and Inflammatory Signaling in Humans.

Front Immunol. 2021

[3]
Calciphylaxis or vascular oxalosis?

Clin Kidney J. 2020-1-18

[4]
Dietary Oxalate Intake and Kidney Outcomes.

Nutrients. 2020-9-2

[5]
Calcium Oxalate Monohydrate is Associated with Endothelial Cell Toxicity But Not with Reactive Oxygen Species Accumulation.

Cardiovasc Toxicol. 2020-12

[6]
Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets.

Nutrients. 2020-3-15

[7]
Oxalates, urinary stones and risk of cardiovascular diseases.

Med Hypotheses. 2020-4

[8]
The Handling of Oxalate in the Body and the Origin of Oxalate in Calcium Oxalate Stones.

Urol Int. 2020

[9]
Mitochondria Permeability Transition versus Necroptosis in Oxalate-Induced AKI.

J Am Soc Nephrol. 2019-7-11

[10]
Association of Urinary Oxalate Excretion With the Risk of Chronic Kidney Disease Progression.

JAMA Intern Med. 2019-4-1

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