Duan Qixin, Huang Han, Zhang Shuang, Wang Yang, Lu Dongming, Wan Lixin, Sun Yingming, Wu Yongyang
Department of Urology, Nanyang Central Hospital, Nanyang, Henan, China.
Department of Urology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China.
Front Nutr. 2024 May 22;11:1389714. doi: 10.3389/fnut.2024.1389714. eCollection 2024.
The high prevalence of kidney stones in adults worldwide has prompted research into potential interventions, one of which involves exploring the consumption of antioxidants that may confer protective effects. However, the relationship between the composite dietary antioxidant index (CDAI), a crucial measure used to assess an individual's overall antioxidant capacity from daily dietary intake, and kidney stones remains unclear. Therefore, we conducted cross-sectional analysis to examine the association between CDAI and kidney stone prevalence.
The analysis was conducted utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Antioxidant intake was derived from two 24-h dietary recalls surveys, while CDAI, a comprehensive measure that includes antioxidants like vitamins A, C, and E, zinc, selenium, and carotenoids, was calculated. Multivariate logistic regression and restricted cubic spline (RCS) regression were utilized to examine the association between CDAI and the prevalence of kidney stones.
The study included a total of 28,516 participants, with 2,748 individuals having a history of kidney stones. The median of CDAI was -0.01 (-2.02, 2.37). Individuals in the fourth quartile of CDAI exhibited a significantly lower prevalence of kidney stones compared to those in the first quartile (Odds Ratio [OR] = 0.769 [0.633-0.935]), even after adjusting for potential confounding factors (including age, sex, race, education level, poverty income ratio, smoking status, drinking status, body mass index (BMI), energy intake levels, physical activity level, serum calcium concentration, estimated glomerular filtration rate (eGFR), hypertension, diabetes and supplement use). The RCS analysis revealed a non-linear relationship between CDAI and kidney stone prevalence, with inflection points identified at 0.06 ( for non-linearity = 0.039). Subgroup analysis demonstrated consistent CDAI-kidney stone prevalence associations across all subsets. Furthermore, a significant inverse correlation was observed between CDAI and inflammatory markers.
This study provides evidence supporting a reciprocal correlation between adult dietary antioxidant intake, as measured by CDAI, and kidney stone prevalence. These findings emphasize the potential benefits of consuming dietary antioxidants in lowering the risk of kidney stone formation.
全球成年人肾结石的高发病率促使人们对潜在干预措施进行研究，其中之一是探索食用可能具有保护作用的抗氧化剂。然而，综合饮食抗氧化指数（CDAI）是用于评估个体从日常饮食摄入中获得的整体抗氧化能力的关键指标，其与肾结石之间的关系仍不明确。因此，我们进行了横断面分析，以研究CDAI与肾结石患病率之间的关联。
利用2007年至2018年美国国家健康与营养检查调查（NHANES）的数据进行分析。抗氧化剂摄入量来自两次24小时饮食回忆调查，同时计算CDAI，这是一项综合指标，包括维生素A、C和E、锌、硒以及类胡萝卜素等抗氧化剂。采用多变量逻辑回归和受限立方样条（RCS）回归来研究CDAI与肾结石患病率之间的关联。
该研究共纳入28,516名参与者，其中2,748人有肾结石病史。CDAI的中位数为-0.01（-2.02，2.37）。即使在调整了潜在混杂因素（包括年龄、性别、种族、教育水平、贫困收入比、吸烟状况、饮酒状况、体重指数（BMI）、能量摄入水平、身体活动水平、血清钙浓度、估计肾小球滤过率（eGFR）、高血压、糖尿病和补充剂使用情况）后，CDAI第四四分位数的个体肾结石患病率仍显著低于第一四分位数的个体（比值比[OR]=0.769[0.633-0.935]）。RCS分析显示CDAI与肾结石患病率之间存在非线性关系，拐点为0.06（非线性检验P值=0.039）。亚组分析表明，在所有亚组中CDAI与肾结石患病率的关联一致。此外，还观察到CDAI与炎症标志物之间存在显著的负相关。
本研究提供了证据，支持用CDAI衡量的成人饮食抗氧化剂摄入量与肾结石患病率之间存在相互关联。这些发现强调了食用饮食抗氧化剂在降低肾结石形成风险方面的潜在益处。
