Department of Hygiene and Public Health, Teikyo University School of Medicine.
Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.
J Atheroscler Thromb. 2024 Apr 1;31(4):461-477. doi: 10.5551/jat.64423. Epub 2023 Oct 17.
Although physiological effects of hydrophilic- (H-) and lipophilic- (L-) antioxidant capacities (AOCs) are suggested to differ, the association of an antioxidant-rich diet and chronic kidney disease (CKD) incidence has not been examined. We therefore explored the association between the H- or L-AOC of a whole Japanese diet and CKD risk in a general population.
A total of 922 individuals without CKD (69.2% women; mean age, 59.5 years old) from Ohasama Town, Japan, were examined. CKD incidence was defined as the presence of proteinuria and/or an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73 m. Consumption of H-/L-AOC was determined based on the oxygen radical absorbance capacity in a specially developed Japanese food AOC database. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for new-onset CKD using a Cox proportional hazards model.
During the median follow-up of 9.7 years, 137 CKD incidents were recorded. After adjusting for potential confounding variables, the highest quartile of L-AOC was significantly associated with a 51% reduced CKD risk among only women. An increased L-AOC intake was more effective in preventing eGFR reduction than in preventing proteinuria in women. These associations were not seen for H-AOC intake in both sexes and L-AOC intake in men.
A high intake of lipophilic antioxidants may be associated with a reduced CKD risk. The balance between dietary antioxidant intake and pro-oxidants induced by unhealthy lifestyles may be crucial for preventing future kidney deterioration.
尽管亲水(H-)和疏水性(L-)抗氧化能力(AOC)的生理效应不同,但富含抗氧化剂的饮食与慢性肾脏病(CKD)发病之间的关联尚未得到研究。因此,我们在一般人群中探讨了整个日本饮食的 H-或 L-AOC 与 CKD 风险之间的关联。
在日本大相模镇,共检查了 922 名无 CKD(69.2%为女性;平均年龄 59.5 岁)的个体。CKD 发病定义为蛋白尿和/或估计肾小球滤过率(eGFR)<60 ml/min/1.73 m。根据专门开发的日本食物 AOC 数据库中的氧自由基吸收能力确定 H-/L-AOC 的消耗。使用 Cox 比例风险模型计算新发生 CKD 的风险比(HR)和 95%置信区间(CI)。
在中位随访 9.7 年期间,记录了 137 例 CKD 事件。在调整了潜在混杂变量后,仅女性中 L-AOC 最高四分位数与 CKD 风险降低 51%显著相关。与预防蛋白尿相比,增加 L-AOC 摄入更能有效预防女性 eGFR 下降。在两性中均未观察到 H-AOC 摄入和男性中 L-AOC 摄入与这些关联。
高摄入量的疏水性抗氧化剂可能与降低 CKD 风险相关。饮食中抗氧化剂摄入与不健康生活方式引起的促氧化剂之间的平衡可能对预防未来的肾脏恶化至关重要。