不吃早餐与日本一般人群慢性肾脏病的进展：以动脉硬化与慢性肾脏病流行病学研究（ISSA-CKD）为基础的磐城市研究。

Skipping Breakfast and Progression of Chronic Kidney Disease in the General Japanese Population: The Iki City Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA-CKD).

机构信息

Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

出版信息

Kidney Blood Press Res. 2024;49(1):472-479. doi: 10.1159/000539653. Epub 2024 Jun 7.

DOI:10.1159/000539653

PMID:38852587

Abstract

INTRODUCTION

Breakfast-skipping habits are associated with adverse health outcomes including coronary heart disease, metabolic syndrome, and diabetes mellitus. However, it remains uncertain whether skipping breakfast affects chronic kidney disease (CKD) risk. This study aimed to examine the association between skipping breakfast and progression of CKD.

METHODS

We retrospectively conducted a population-based cohort study using the data from the Iki City Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA-CKD). Between 2008 and 2019, we included 922 participants aged 30 years or older who had CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or proteinuria) at baseline. Breakfast skippers were defined as participants who skipped breakfast more than 3 times per week. The outcome was CKD progression defined as a decline of at least 30% in the estimated glomerular filtration rate (eGFR) from the baseline status. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD progression, adjusted for other CKD risk factors.

RESULTS

During a follow-up period with a mean of 5.5 years, CKD progression occurred in 60 (6.5%) participants. The incidence rate (per 1,000 person-years) of CKD progression was 21.5 in the breakfast-skipping group and 10.7 in the breakfast-eating group (p = 0.029), respectively. The multivariable-adjusted HR (95% CI) for CKD progression was 2.60 (95% CI: 1.29-5.26) for the breakfast-skipping group (p = 0.028) compared with the group eating breakfast. There were no clear differences in the association of skipping breakfast with CKD progression in subgroup analyses by sex, age, obesity, hypertension, diabetes mellitus, baseline eGFR, and baseline proteinuria.

CONCLUSION

Skipping breakfast was significantly associated with higher risk of CKD progression in the general Japanese population.

摘要

简介

不吃早餐的习惯与包括冠心病、代谢综合征和糖尿病在内的不良健康结果有关。然而，目前尚不确定不吃早餐是否会影响慢性肾脏病（CKD）的风险。本研究旨在探讨不吃早餐与 CKD 进展之间的关系。

方法

我们使用来自伊吹市动脉粥样硬化和慢性肾脏病的流行病学研究（ISSA-CKD）的数据，进行了一项基于人群的回顾性队列研究。在 2008 年至 2019 年间，我们纳入了 922 名基线时患有 CKD（肾小球滤过率估计值＜60 mL/min/1.73 m2 和/或蛋白尿）的年龄在 30 岁或以上的参与者。不吃早餐者定义为每周超过 3 次不吃早餐的参与者。结局是 CKD 进展，定义为肾小球滤过率（eGFR）从基线状态下降至少 30%。使用 Cox 比例风险模型计算 CKD 进展的风险比（HR）和 95%置信区间（CI），并调整了其他 CKD 风险因素。

结果

在平均 5.5 年的随访期间，60 名（6.5%）参与者发生 CKD 进展。在不吃早餐组，CKD 进展的发生率（每 1000 人年）为 21.5，在吃早餐组为 10.7（p=0.029）。与吃早餐组相比，多变量调整后的 CKD 进展风险比（95%CI）为 2.60（95%CI：1.29-5.26）不吃早餐组（p=0.028）。在按性别、年龄、肥胖、高血压、糖尿病、基线 eGFR 和基线蛋白尿进行的亚组分析中，不吃早餐与 CKD 进展的关联没有明显差异。