Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Eur J Nutr. 2024 Jun;63(4):1373-1385. doi: 10.1007/s00394-024-03355-5. Epub 2024 Mar 2.
We examined the relation between diet quality, its components and kidney function decline in post-myocardial infarction (MI) patients, and we explored differences by genetic risk of chronic kidney disease (CKD).
We analysed 2169 patients from the Alpha Omega Cohort (aged 60-80 years, 81% male). Dietary intake was assessed at baseline (2002-2006) using a validated food-frequency questionnaire and diet quality was defined using the Dutch Healthy Diet Cardiovascular Disease (DHD-CVD) index. We calculated 40-months change in estimated glomerular filtration rate (eGFR, mL/min per 1.73m). We constructed a weighted genetic risk score (GRS) for CKD using 88 single nucleotide polymorphisms previously linked to CKD. Betas with 95%-confidence intervals (CIs) were obtained using multivariable linear regression models for the association between DHD-CVD index and its components and eGFR change, by GRS.
The average DHD-CVD index was 79 (SD 15) points and annual eGFR decline was 1.71 (SD 3.86) mL/min per 1.73 m. The DHD-CVD index was not associated with annual eGFR change (per 1-SD increment in adherence score: -0.09 [95% CI -0.26,0.08]). Results for adherence to guidelines for red meat showed less annual eGFR decline (per 1-SD: 0.21 [0.04,0.38]), whereas more annual eGFR decline was found for legumes and dairy (per 1-SD: -0.20 [-0.37,-0.04] and - 0.18 [-0.34,-0.01]). Generally similar results were obtained in strata of GRS.
The DHD-CVD index for overall adherence to Dutch dietary guidelines for CVD patients was not associated with kidney function decline after MI, irrespective of genetic CKD risk. The preferred dietary pattern for CKD prevention in CVD patients warrants further research.
我们研究了心梗（MI）后患者的饮食质量及其组成与肾功能下降之间的关系，并探讨了其与慢性肾脏病（CKD）遗传风险的差异。
我们分析了来自 Alpha Omega 队列的 2169 名患者（年龄 60-80 岁，81%为男性）。在基线（2002-2006 年）时使用经过验证的食物频率问卷评估饮食摄入情况，并使用荷兰健康饮食心血管疾病（DHD-CVD）指数来定义饮食质量。我们计算了 40 个月时估算肾小球滤过率（eGFR，每 1.73m2 毫升/分钟）的变化。我们使用先前与 CKD 相关的 88 个单核苷酸多态性构建了 CKD 的加权遗传风险评分（GRS）。使用多变量线性回归模型，通过 GRS 获得了 DHD-CVD 指数及其组成与 eGFR 变化之间的关联的贝塔系数（95%置信区间）。
平均 DHD-CVD 指数为 79（标准差 15）分，eGFR 每年下降 1.71（标准差 3.86）毫升/分钟/每 1.73m2。DHD-CVD 指数与 eGFR 每年的变化无关（每增加一个依从性评分的 1-SD：-0.09[95%CI-0.26，0.08]）。遵守红肉指南的患者 eGFR 每年的下降幅度较小（每 1-SD：0.21[0.04，0.38]），而豆类和奶制品的患者 eGFR 每年的下降幅度较大（每 1-SD：-0.20[-0.37，-0.04]和-0.18[-0.34，-0.01]）。在 GRS 分层中得到了大致相似的结果。
对于 MI 后肾功能下降，总体上遵守荷兰 CVD 患者饮食指南的 DHD-CVD 指数与遗传 CKD 风险无关。预防 CVD 患者 CKD 的首选饮食模式值得进一步研究。
