Mansouri Fatemeh, Shateri Zainab, Jahromi Shahrokh Ezzatzadegan, Mahmudi-Zadeh Melika, Nouri Mehran, Babajafari Siavash
Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Nutrition and Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
J Health Popul Nutr. 2024 Jul 31;43(1):110. doi: 10.1186/s41043-024-00606-3.
Chronic kidney disease (CKD) is characterized by structural abnormalities in nephrons, loss of functional nephrons, and impaired renal excretory function. A pro-vegetarian dietary pattern (PDP) is a gradual and progressive approach to vegetarianism. The current study aimed to assess the association between PDP and the odds of protein-energy wasting (PEW) and sarcopenia in patients with CKD.
The present cross-sectional study was conducted on kidney disease patients (n = 109) referred to two clinics in Shiraz, Iran. The diagnosis of sarcopenia and PEW was made according to the guidelines of the Asian Working Group for Sarcopenia (AWGS) and the International Society of Renal Nutrition and Metabolism (ISRNM) criteria, respectively. The participants' dietary intake was evaluated using a 168-item semi-quantitative food frequency questionnaire (FFQ). For PDP index calculation, plant and animal food sources were categorized into 12 subgroups. The association between sarcopenia and PEW with PDP was evaluated using logistic regression.
The PDP was significantly associated with a lower risk of PEW in the second tertile compared to the first in the crude model (odds ratio (OR) = 0.225; confidence interval (CI): 0.055-0.915; p-value = 0.037). After adjusting for potential confounders, lower significant odds of PEW were observed in the second and last tertiles of PDP compared to the first (T: OR = 0.194; CI: 0.039-0.962; p-value = 0.045, and T: OR = 0.168; CI: 0.030-0.950; p-value = 0.044). In contrast, no significant relationship was observed between PDP and the odds of sarcopenia (p-value ˃ 0.05).
Overall, the findings indicated that greater adherence to PDP was negatively associated with the odds of PEW. Additionally, the results showed no association between PDP and the odds of sarcopenia. Further studies are needed to support these findings.
慢性肾脏病（CKD）的特征是肾单位结构异常、功能性肾单位丧失以及肾脏排泄功能受损。纯素食饮食模式（PDP）是一种逐渐推进的素食方式。本研究旨在评估PDP与CKD患者蛋白质能量消耗（PEW）及肌肉减少症发生几率之间的关联。
本横断面研究针对转诊至伊朗设拉子两家诊所的肾病患者（n = 109）开展。分别根据亚洲肌肉减少症工作组（AWGS）和国际肾脏营养与代谢学会（ISRNM）的标准诊断肌肉减少症和PEW。使用一份包含168个条目的半定量食物频率问卷（FFQ）评估参与者的饮食摄入量。为计算PDP指数，将植物性和动物性食物来源分为12个亚组。采用逻辑回归评估肌肉减少症和PEW与PDP之间的关联。
在粗模型中，与第一三分位数相比，第二三分位数的PDP与较低的PEW风险显著相关（比值比（OR）= 0.225；置信区间（CI）：0.055 - 0.915；p值 = 0.037）。在对潜在混杂因素进行调整后，与第一三分位数相比，PDP的第二和最后三分位数中观察到较低的PEW显著几率（第二三分位数：OR = 0.194；CI：0.039 - 0.962；p值 = 0.045，最后三分位数：OR = 0.168；CI：0.030 - 0.950；p值 = 0.044）。相比之下，未观察到PDP与肌肉减少症几率之间存在显著关系（p值＞0.05）。
总体而言，研究结果表明对PDP的更高依从性与PEW几率呈负相关。此外，结果显示PDP与肌肉减少症几率之间无关联。需要进一步研究来支持这些发现。
