Department of Food and Nutrition, Chung-Ang University, Anseong, Korea.
Epidemiol Health. 2023;45:e2023037. doi: 10.4178/epih.e2023037. Epub 2023 Mar 21.
This study assessed the association of dietary patterns with the incidence of chronic kidney disease (CKD) and kidney function decline among Korean adults.
Data were collected from the records of 20,147 men and 39,857 women who participated in the Health Examinees study. Principal component analysis was used to identify 3 dietary patterns (prudent, flour-based food and meat, and white rice-based), and CKD risk was defined using the Epidemiology Collaboration equation for estimated glomerular filtration rate: (eGFR) <60 mL/min/1.73 m2. A kidney function decline was defined as a >25% decrease in eGFR from baseline.
During the 4.2-year follow-up, 978 participants developed CKD and 971 had a 25% decline in kidney function. After adjusting for potential impact variables, compared with the lowest quartile of the prudent dietary pattern, participants in the highest quartile had a 37% lower risk of kidney function decline among men (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.47 to 0.85); while higher adherence to the flour-based food and meat dietary pattern was associated with an increased risk of CKD in both men (HR, 1.63; 95% CI, 1.22 to 2.19) and women (HR, 1.47; 95% CI, 1.05 to 2.05) as well as a decline in kidney function in both men (HR, 1.49; 95% CI, 1.07 to 2.07) and women (HR, 1.77; 95% CI, 1.33 to 2.35).
Although a higher adherence to the prudent dietary pattern was inversely associated with the risk of kidney function decline in men, there was no association with CKD risk. In addition, a higher adherence to the flour-based food and meat dietary pattern increased the risk of CKD and kidney function decline. Further clinical trials are needed to confirm these associations.
本研究旨在评估膳食模式与韩国成年人慢性肾脏病（CKD）和肾功能下降的发病风险之间的关联。
数据来自参与健康体检研究的 20147 名男性和 39857 名女性的记录。采用主成分分析方法识别 3 种膳食模式（谨慎、面类食物和肉类、米饭为主），并采用肾脏病合作研究组的肾小球滤过率估计方程（eGFR）＜60mL/min/1.73m2 定义 CKD 风险。肾功能下降定义为 eGFR 较基线下降＞25%。
在 4.2 年的随访期间，978 名参与者发生 CKD，971 名参与者 eGFR 下降＞25%。在调整潜在影响因素后，与谨慎膳食模式最低四分位相比，男性中最高四分位的参与者肾功能下降风险降低 37%（风险比[HR]，0.63；95%置信区间[CI]，0.47 至 0.85）；而较高的面类食物和肉类膳食模式的依从性与男性（HR，1.63；95%CI，1.22 至 2.19）和女性（HR，1.47；95%CI，1.05 至 2.05）的 CKD 发病风险以及男性（HR，1.49；95%CI，1.07 至 2.07）和女性（HR，1.77；95%CI，1.33 至 2.35）的肾功能下降风险均相关。
虽然较高的谨慎膳食模式依从性与男性肾功能下降风险呈负相关，但与 CKD 风险无关。此外，较高的面类食物和肉类膳食模式依从性增加了 CKD 和肾功能下降的风险。需要进一步的临床试验来证实这些关联。
