超加工食品消费与代谢综合征老年人群肾功能的关系。

Associations between ultra-processed food consumption and kidney function in an older adult population with metabolic syndrome.

机构信息

Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició, Desenvolupament i Salut Mental ANUT-DSM, 43201 Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain.

出版信息

Clin Nutr. 2023 Dec;42(12):2302-2310. doi: 10.1016/j.clnu.2023.09.028. Epub 2023 Oct 2.

DOI:10.1016/j.clnu.2023.09.028

PMID:37852024

Abstract

BACKGROUND & AIMS: Ultra-processed food (UPF) consumption has increased dramatically over the last decades worldwide. Although it has been linked to some cardiometabolic comorbidities, there is limited evidence regarding kidney function. This study aimed to cross-sectionally and longitudinally assess the association between UPF consumption and estimated-glomerular filtration rate (eGFR) based on Cystatin C (CysC).

METHODS

Older adults (mean age 65 ± 5.0 years, 46% women) with overweight/obesity and metabolic syndrome (MetS) who had available data of CysC at baseline (n = 1909), at one-year and at 3-years of follow-up (n = 1700) were analyzed. Food consumption was assessed using a validated 143-item semi-quantitative food frequency questionnaire and UPF consumption (% of g/d) at baseline and changes after one-year of follow-up were estimated according to NOVA classification system. Multivariable-adjusted linear and logistic regression models were performed to evaluate the cross-sectional associations between UPF consumption with eGFR levels and decreased kidney function (eGFR <60 ml/min/1.73 m2) at baseline. Multivariable-adjusted mixed-effects linear regression models were fitted to investigate the associations between one-year changes in UPF and eGFR over 3-years of follow-up.

RESULTS

Individuals with the highest baseline UPF consumption showed lower eGFR (β: -3.39 ml/min/1.73 m; 95% CI: -5.59 to -1.20) and higher odds of decreased kidney function (OR: 1.64; 95% CI: 1.21 to 2.22) at baseline, compared to individuals in the lowest tertile. Participants in the highest tertile of one-year changes in UPF consumption presented a significant decrease in eGFR after one-year of follow-up (β: -1.45 ml/min/1.73 m; 95% CI: -2.90 to -0.01) as well as after 3-years of follow-up (β: -2.18 ml/min/1.73 m; 95% CI: -3.71 to -0.65) compared to those in the reference category.

CONCLUSIONS

In a Mediterranean population of older adults with overweight/obesity and MetS, higher UPF consumption at baseline and one-year changes towards higher consumption of UPF were associated with worse kidney function at baseline and over 3-years of follow-up, respectively.

CLINICAL TRIAL REGISTRY NUMBER

ISRCTN89898870.

摘要

背景与目的

在过去几十年中，超加工食品（UPF）的消费在全球范围内急剧增加。尽管它与一些心血管代谢合并症有关，但关于肾功能的证据有限。本研究旨在基于胱抑素 C（CysC），通过横断面和纵向评估 UPF 消费与估算肾小球滤过率（eGFR）之间的关联。

方法

超重/肥胖和代谢综合征（MetS）的老年人（平均年龄 65 ± 5.0 岁，46%为女性）在基线时（n = 1909）、一年时和三年时随访（n = 1700）有 CysC 的可用数据。使用经过验证的 143 项半定量食物频率问卷评估食物消耗，根据 NOVA 分类系统估计基线和一年随访后的 UPF 消费（g/d 的%）。进行多变量调整线性和逻辑回归模型，以评估 UPF 消费与基线时 eGFR 水平和肾功能下降（eGFR <60 ml/min/1.73 m 2）之间的横断面关联。拟合多变量调整的混合效应线性回归模型，以调查 3 年随访期间 UPF 一年变化与 eGFR 的关联。

结果

与最低三分位组相比，基线 UPF 消费最高的个体 eGFR 较低（β：-3.39 ml/min/1.73 m；95%CI：-5.59 至-1.20），肾功能下降的几率更高（OR：1.64；95%CI：1.21 至 2.22）。与参考组相比，UPF 消费一年变化最高的参与者在一年随访后 eGFR 显著下降（β：-1.45 ml/min/1.73 m；95%CI：-2.90 至-0.01），3 年随访后 eGFR 也显著下降（β：-2.18 ml/min/1.73 m；95%CI：-3.71 至-0.65）。