Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
De Feng Academy, Southern Medical University, Guangzhou, China.
Endocrine. 2024 Sep;85(3):1154-1161. doi: 10.1007/s12020-024-03819-y. Epub 2024 May 17.
The current study investigated the correlation between dietary iron intake and diabetic kidney disease among diabetic adults.
This cross-sectional study enrolled 8118 participants who suffered from diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Dietary iron intake was obtained from 24 h recall interviews, and diabetic kidney disease was defined as eGFR < 60 mL/min per 1.73 m or albumin creatinine ratio (ACR) ≥ 30 mg/g. Three weighted logistic regression models were utilized to investigate odd ratio (OR) and 95% CIs for diabetic kidney disease. Stratified analyses were performed by gender, age, BMI, HbA1c, hypertension status, and smoking status, and diabetes types.
Among 8118 participants (51.6% male, mean age 61.3 years), 40.7% of participants suffered from diabetic kidney disease. With the adjustment of potential covariates, we found that ≥ 12.59 mg of dietary iron was related to a lower risk of diabetic kidney disease (OR = 0.78, 95% CI: 0.63 to 0.96; OR = 0.79, 95% CI: 0.63 to 0.98). In stratified analyses, higher iron intake was negatively related to diabetic kidney disease, especially among those who were male, < 60 years, those with hypertension, those with HbA1c < 7.0%, and those who were ex-smokers. The result remained robust in sensitivity analyses.
We found that ≥ 12.59 mg of dietary iron is associated with a lower risk of diabetic kidney disease, especially in those who were male, younger, heavier weight, have better blood sugar control, and those who were ex-smokers.
本研究旨在探讨糖尿病患者膳食铁摄入量与糖尿病肾病之间的相关性。
本横断面研究纳入了 1999 年至 2018 年期间来自全国健康与营养调查（NHANES）的 8118 名患有糖尿病的参与者。膳食铁摄入量通过 24 小时回顾性访谈获得，糖尿病肾病定义为 eGFR < 60 mL/min/1.73 m 或白蛋白肌酐比（ACR）≥ 30 mg/g。利用三个加权逻辑回归模型来研究糖尿病肾病的比值比（OR）和 95%置信区间（CI）。通过性别、年龄、BMI、HbA1c、高血压状态和吸烟状态以及糖尿病类型进行分层分析。
在 8118 名参与者中（51.6%为男性，平均年龄为 61.3 岁），40.7%的参与者患有糖尿病肾病。在调整了潜在的混杂因素后，我们发现，≥ 12.59mg 的膳食铁摄入量与较低的糖尿病肾病风险相关（OR=0.78，95%CI：0.63 至 0.96；OR=0.79，95%CI：0.63 至 0.98）。在分层分析中，较高的铁摄入量与糖尿病肾病呈负相关，尤其是在男性、< 60 岁、高血压、HbA1c<7.0%和曾经吸烟者中。敏感性分析结果仍然稳健。
我们发现，≥ 12.59mg 的膳食铁摄入量与较低的糖尿病肾病风险相关，尤其是在男性、年轻、体重较重、血糖控制较好和曾经吸烟者中。
