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.
Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Nutrients. 2023 Jun 14;15(12):2744. doi: 10.3390/nu15122744.
Adherence to healthy dietary patterns is associated with a reduced risk of kidney dysfunction. Nevertheless, the age-related mechanisms that underpin the relationship between diet and kidney function remain undetermined. This study aimed to investigate the mediating role of serum α-Klotho, an anti-aging protein, in the link between a healthy diet and kidney function. A cross-sectional study was conducted on a cohort of 12,817 individuals aged between 40 and 79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. For each participant, the Healthy Eating Index 2015 (HEI-2015) score was calculated as a measure of a healthy dietary pattern. Creatinine-based estimated glomerular filtration rate (eGFR) was used to assess kidney function. Multivariable regression models were used to analyze the association between the standardized HEI-2015 score and eGFR after adjusting for potential confounders. Causal mediation analysis was performed to assess whether serum α-Klotho influenced this association. The mean (±SD) eGFR of all individuals was 86.8 ± 19.8 mL/min per 1.73 m. A high standardized HEI-2015 score was associated with a high eGFR (β [95% CI], 0.94 [0.64-1.23]; < 0.001). The mediation analysis revealed that serum α-Klotho accounted for 5.6-10.5% of the association of standardized overall HEI-2015 score, total fruits, whole fruits, greens and beans, and whole grain with eGFR in the NHANES. According to the results from the subgroup analysis, serum α-Klotho exerted a mediating effect in the participants aged 60-79 years and in males. A healthy diet may promote kidney function by up-regulating serum anti-aging α-Klotho. This novel pathway suggests important implications for dietary recommendations and kidney health.
坚持健康的饮食模式与降低肾功能障碍的风险有关。然而，支持饮食与肾功能之间关系的与年龄相关的机制仍未确定。本研究旨在探讨血清α-Klotho（一种抗衰老蛋白）在健康饮食与肾功能之间的联系中的中介作用。本研究对 2007 年至 2016 年参加国家健康和营养检查调查（NHANES）的年龄在 40 至 79 岁的 12817 名个体进行了横断面研究。对于每个参与者，使用基于肌酐的估算肾小球滤过率（eGFR）来评估肾功能。使用多变量回归模型分析标准化 HEI-2015 评分与调整潜在混杂因素后的 eGFR 之间的关联。进行因果中介分析以评估血清α-Klotho 是否影响这种关联。所有个体的平均（±SD）eGFR 为 86.8 ± 19.8 mL/min/1.73 m。高标准化 HEI-2015 评分与高 eGFR 相关（β[95%CI]，0.94[0.64-1.23]；<0.001）。中介分析显示，血清α-Klotho 占标准化整体 HEI-2015 评分、总水果、全水果、绿色蔬菜和豆类以及全谷物与 NHANES 中 eGFR 关联的 5.6-10.5%。根据亚组分析的结果，血清α-Klotho 在 60-79 岁的参与者和男性中发挥了中介作用。健康的饮食可能通过上调血清抗衰老α-Klotho 来促进肾功能。这条新途径对饮食建议和肾脏健康具有重要意义。
