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 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 510515, China.
Diabetes Metab. 2023 Jul;49(4):101456. doi: 10.1016/j.diabet.2023.101456. Epub 2023 Jun 6.
Whether diabetes and genetic susceptibility of kidney diseases modifies the relationship between ultra-processed foods (UPF) consumption and incident chronic kidney disease (CKD) remains uncertain. We aimed to investigate the association between UPF consumption and new-onset CKD in participants with and without diabetes, and explore whether genetic risks of kidney diseases may modify the association.
153,985 participants who were free of CKD at baseline and provided 24-h dietary recalls in the UK Biobank were included. UPF was defined according to the NOVA classification. The energy contribution of UPF was calculated by dividing the energy intake of UPF by the total energy intake. The study outcome was new-onset CKD, ascertained by self-report data and data linkage with primary care, hospital admissions, and death registry records.
During a median follow-up of 12.1 years, 4,058 participants developed new-onset CKD. There was a significant positive association between UPF consumption and new-onset CKD in total participants (per 10% increment, adjusted hazard ratio (HR) 1.04; 95% confidence interval (CI) [1.01;1.06]. The positive association between UPF consumption and risk of new-onset CKD was significantly stronger in participants with diabetes (per 10% increment, adjusted HR 1.11 [1.05;1.17]) than in those without diabetes (per 10% increment, adjusted HR 1.03 [1.00;1.05]; P-interaction = 0.005). Genetic risks of kidney diseases did not significantly modify the positive association in those with or without diabetes (all P-interactions > 0.05).
There was a significantly stronger positive association between UPF consumption and new-onset CKD in participants with diabetes compared with those without diabetes.
糖尿病和肾脏疾病的遗传易感性是否会改变超加工食品(UPF)的摄入与新发慢性肾脏病(CKD)之间的关系尚不确定。我们旨在调查 UPF 摄入与基线时无 CKD 的参与者新发 CKD 之间的关联,并探讨肾脏疾病的遗传风险是否可能改变这种关联。
纳入英国生物库中 153985 名基线时无 CKD 且提供 24 小时膳食回忆的参与者。根据 NOVA 分类定义 UPF。通过将 UPF 的能量摄入量除以总能量摄入量来计算 UPF 的能量贡献。研究结果为新发 CKD,通过自我报告数据和与初级保健、住院和死亡登记记录的数据链接确定。
在中位随访 12.1 年期间,4058 名参与者发生新发 CKD。在所有参与者中,UPF 摄入与新发 CKD 呈显著正相关(每增加 10%,调整后的危险比(HR)1.04;95%置信区间(CI)[1.01;1.06])。在患有糖尿病的参与者中(每增加 10%,调整后的 HR 为 1.11[1.05;1.17]),UPF 摄入与新发 CKD 风险之间的正相关关系明显强于无糖尿病的参与者(每增加 10%,调整后的 HR 为 1.03[1.00;1.05];P 交互作用=0.005)。在患有或不患有糖尿病的参与者中,肾脏疾病的遗传风险均未显著改变这种正相关关系(所有 P 交互作用>0.05)。
与无糖尿病的参与者相比,糖尿病参与者中 UPF 摄入与新发 CKD 之间存在更显著的正相关关系。