Gao Yuhang, Yue Xinghai, Zhao Wanchao, Yuan Fang
The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
The Second Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Front Nutr. 2024 Oct 23;11:1440896. doi: 10.3389/fnut.2024.1440896. eCollection 2024.
Observational studies have identified an association between dried fruit intake and kidney function. However, these studies have limitations such as vulnerability to confounders and reverse causality bias. Therefore, this study aimed to explore the potential causal relationship between dried fruit intake and kidney function.
A two-sample Mendelian randomization (MR) study was conducted using a large-scale genome-wide association study dataset to investigate the causal relationship between dried fruit intake and kidney function markers (blood urea nitrogen (BUN), creatinine (CR), uric acid (UA), cystatin C (CyC), hematuria, microalbuminuria). The main analytical method was inverse variance weighting. In addition, we applied the MR Egger and weighted median to assess the robustness of the results. Finally, Multivariate Mendelian randomization (MVMR) was used to estimate the direct effect of dried fruit intake on kidney function markers.
The univariate MR analysis showed that increased dried fruit intake was associated with lower kidney function markers, including BUN (: -0.171, 95% confidence interval (CI): -0.239 to -0.102, = 1.063 × 10), CR (: -0.205, 95% CI: -0.311 to -0.099, = 1.455 × 10), UA ( = -0.317, 95% CI: -0.384 to -0.249, = 4.439 × 10), and CysC ( = -0.323, 95% CI: -0.384 to -0.249, = 1.074 × 10); however, it was unrelated to hematuria and microalbuminuria. Causality persisted after performing MVMR analysis; however, with the addition of alcohol consumption and smoking as exposure factors, the causality for UA ( = -0.296, 95% CI: -0.523 to -0.068, = 1.094 × 10) and CysC ( = -0.238, 95% CI: -0.465 to -0.011, = 4.024× 10) weakened, while the causality for BUN ( = -0.038, 95% CI: -0.215 to 0.138, = 6.698 × 10) and CR ( = -0.038, 95% CI: -0.431 to 0.046, = 1.347 × 10) disappeared.
Increased dried fruit intake was associated with lower kidney function markers (BUN, CR, UA, and CysC) in the absence of smoking and alcohol consumption; however, the causal relationship between dried fruit intake and BUN and CR disappeared in the presence of smoking and alcohol consumption. These results provide a promising avenue for delaying the course of chronic kidney disease.
观察性研究已确定了果干摄入量与肾功能之间的关联。然而，这些研究存在局限性，如易受混杂因素影响和反向因果关系偏差。因此，本研究旨在探讨果干摄入量与肾功能之间潜在的因果关系。
使用大规模全基因组关联研究数据集进行两样本孟德尔随机化（MR）研究，以调查果干摄入量与肾功能指标（血尿素氮（BUN）、肌酐（CR）、尿酸（UA）、胱抑素C（CyC）、血尿、微量白蛋白尿）之间的因果关系。主要分析方法为逆方差加权。此外，我们应用MR-Egger和加权中位数来评估结果的稳健性。最后，使用多变量孟德尔随机化（MVMR）来估计果干摄入量对肾功能指标的直接影响。
单变量MR分析显示，果干摄入量增加与较低的肾功能指标相关，包括BUN（β：-0.171，95%置信区间（CI）：-0.239至-0.102，P = 1.063×10⁻¹²）、CR（β：-0.205，95%CI：-0.311至-0.099，P = 1.455×10⁻¹²）、UA（β = -0.317，95%CI：-0.384至-0.249，P = 4.43×10⁻²⁰）和CysC（β = -0.323，95%CI：-0.384至-0.249，P = 1.074×10⁻¹⁹）；然而，它与血尿和微量白蛋白尿无关。进行MVMR分析后因果关系仍然存在；然而，将饮酒和吸烟作为暴露因素加入后，UA（β = -0.296，95%CI：-0.523至-0.068，P = 1.094×10⁻⁰²）和CysC（β = -0.238，95%CI：-0.465至-0.011，P = 4.024×10⁻⁰²）的因果关系减弱，而BUN（β = -0.038，95%CI：-0.215至0.138，P = 6.698×10⁻⁰¹）和CR（β = -0.038，95%CI：-0.431至0.046，P = 1.347×10⁻⁰¹）的因果关系消失。
在不吸烟和不饮酒的情况下，果干摄入量增加与较低的肾功能指标（BUN、CR、UA和CysC）相关；然而，并在吸烟和饮酒的情况下，果干摄入量与BUN和CR之间的因果关系消失。这些结果为延缓慢性肾病病程提供了一条有前景的途径。
