总蛋白摄入量与随后发生慢性肾脏病的风险：社区动脉粥样硬化风险研究。
Total protein intake and subsequent risk of chronic kidney disease: the Circulatory Risk in Communities Study.
机构信息
Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention.
Faculty of Human Sciences, Tezukayama Gakuin University.
出版信息
Environ Health Prev Med. 2023;28:32. doi: 10.1265/ehpm.22-00247.
BACKGROUND
Whether dietary protein intake worsens renal function in the general population has been discussed but not yet determined. We aimed to examine the longitudinal association between dietary protein intake and risk of incident chronic kidney disease (CKD).
METHODS
We conducted a 12-year follow-up study with 3,277 Japanese adults (1,150 men and 2,127 women) aged 40-74 years, initially free from CKD, who participated in cardiovascular risk surveys from two Japanese communities under the Circulatory Risk in Communities Study. The development of CKD was defined by the estimated glomerular filtration rate (eGFR) during the follow-up period. Protein intake was measured at baseline by using the brief-type self-administered diet history questionnaire. We estimated sex-, age-, community- and multivariate-adjusted hazard ratios (HR) for incident CKD were calculated using the Cox proportional hazards regression models according to quartiles of percentage of energy (%energy) from protein intake.
RESULTS
During 26,422 person-years of follow-up, 300 participants developed CKD (137 men and 163 women). The sex-, age-, and community-adjusted HR (95% confidence interval, CI) for the highest (≥16.9%energy) versus lowest (≤13.4%energy) quartiles of total protein intake was 0.66 (0.48-0.90), p for trend = 0.007. The multivariable HR (95%CI) was 0.72 (0.52-0.99), p for trend = 0.016 after further adjustment for body mass index, smoking status, alcohol drinking status, diastolic blood pressure, antihypertensive medication use, diabetes mellitus, serum total cholesterol levels, cholesterol-lowering medication use, total energy intake, and baseline eGFR. The association did not vary by sex, age, and baseline eGFR. When examining animal and vegetable protein intake separately, the respective multivariable HRs (95%CIs) were 0.77 (0.56-1.08), p for trend = 0.036, and 1.24 (0.89-1.75), p for trend = 0.270.
CONCLUSIONS
Higher protein intake, more specifically animal protein intake was associated with a lower risk of CKD.
背景
关于膳食蛋白质摄入是否会使普通人群的肾功能恶化，人们一直存在争议，但尚未得出定论。我们旨在研究膳食蛋白质摄入与慢性肾脏病（CKD）发病风险之间的纵向关联。
方法
我们对来自两个日本社区的心血管风险调查的 3277 名年龄在 40-74 岁、无 CKD 的日本成年人（男性 1150 名，女性 2127 名）进行了为期 12 年的随访研究。在随访期间，通过估算肾小球滤过率（eGFR）来定义 CKD 的发生。基线时，通过使用简短的自我管理饮食史问卷来测量蛋白质的摄入量。我们根据蛋白质摄入量占能量的百分比（%energy）的四分位数，使用 Cox 比例风险回归模型计算出发生 CKD 的性别、年龄、社区和多变量调整后的风险比（HR）。
结果
在 26422 人年的随访期间，有 300 名参与者发生了 CKD（男性 137 名，女性 163 名）。最高（≥16.9%energy）与最低（≤13.4%energy）四分位数的总蛋白摄入的性别、年龄和社区调整后的 HR（95%置信区间，CI）为 0.66（0.48-0.90），p 趋势=0.007。进一步调整体重指数、吸烟状况、饮酒状况、舒张压、降压药物使用、糖尿病、血清总胆固醇水平、降脂药物使用、总能量摄入和基线 eGFR 后，多变量 HR（95%CI）为 0.72（0.52-0.99），p 趋势=0.016。这种关联不因性别、年龄和基线 eGFR 而变化。当分别检查动物蛋白和植物蛋白的摄入量时，相应的多变量 HR（95%CI）分别为 0.77（0.56-1.08），p 趋势=0.036 和 1.24（0.89-1.75），p 趋势=0.270。
结论
较高的蛋白质摄入，特别是动物蛋白摄入与 CKD 的风险降低有关。
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