Heo G Y, Kim H J, Kalantar D, Jung C Y, Kim H W, Park J T, Chang T I, Yoo T H, Kang S W, Rhee C M, Kalantar-Zadeh K, Han S H
Seung Hyeok Han, MD, Ph.D. Yonsei University, Institute of Kidney Disease Research, College of Medicine, Department of Internal Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea, Phone: 82-2-2228-1984; Fax: 82-2-393-6884; E-mail:
J Nutr Health Aging. 2023;27(11):1018-1027. doi: 10.1007/s12603-023-1998-6.
Dietary fiber intake is associated with a lower risk of diabetes, cardiovascular disease, and cancer. However, it is unknown whether dietary fiber has a beneficial effect on preventing the development of chronic kidney disease (CKD).
DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Using the UK Biobank prospective cohort, 110,412 participants who completed at least one dietary questionnaire and had an estimated glomerular filtration rate ≥60 mL/min/1.73 m2, urinary albumin-to-creatinine ratio <30 mg/g, and no history of CKD were included. The primary exposure was total dietary fiber density, calculated by dividing the absolute amount of daily total fiber intake by total energy intake (g/1,000 kcal). We separately examined soluble and insoluble fiber densities as additional predictors. The primary outcome was incident CKD based on diagnosis codes.
A total of 3,507 (3.2%) participants developed incident CKD during a median follow-up of 9.9 years. In a multivariable cause-specific model, the adjusted hazard ratios (aHRs; 95% confidence intervals [CIs]) for incident CKD were 0.85 (0.77-0.94), 0.78 (0.70-0.86), and 0.76 (0.68-0.86), respectively, for the second, third, and highest quartiles of dietary fiber density (reference: lowest quartile). In a continuous model, the aHR for each +∆1.0g/1,000 kcal increase in dietary fiber density was 0.97 (95% CI, 0.95-0.99). This pattern of associations was similar for both soluble and insoluble fiber densities and did not differ across subgroups of sex, age, body mass index, hypertension, diabetes, smoking, and inflammation.
Increased fiber intake was associated with a lower risk of CKD in this large well-characterized cohort.
膳食纤维摄入量与患糖尿病、心血管疾病和癌症的风险较低相关。然而，膳食纤维对预防慢性肾脏病（CKD）的发展是否具有有益作用尚不清楚。
设计、地点、参与者和测量方法：利用英国生物银行前瞻性队列，纳入了110412名完成至少一份饮食问卷且估计肾小球滤过率≥60 mL/min/1.73 m²、尿白蛋白与肌酐比值<30 mg/g且无CKD病史的参与者。主要暴露因素是总膳食纤维密度，通过将每日总纤维摄入量的绝对量除以总能量摄入量计算得出（g/1000 kcal）。我们分别将可溶性和不可溶性纤维密度作为额外的预测因素进行了研究。主要结局是基于诊断编码的新发CKD。
在中位随访9.9年期间，共有3507名（3.2%）参与者发生了新发CKD。在多变量病因特异性模型中，膳食纤维密度第二、第三和最高四分位数组发生新发CKD的校正风险比（aHRs；95%置信区间[CIs]）分别为0.85（0.77 - 0.94）、0.78（0.70 - 0.86）和0.76（0.68 - 0.86）（参考：最低四分位数组）。在连续模型中，膳食纤维密度每增加+∆1.0 g/1000 kcal，aHR为0.97（95% CI，0.95 - 0.99）。可溶性和不可溶性纤维密度的这种关联模式相似，且在性别、年龄、体重指数、高血压、糖尿病、吸烟和炎症等亚组中无差异。
在这个特征明确的大型队列中，膳食纤维摄入量增加与CKD风险降低相关。
