Luo Yuanyuan, Bai Ruojing
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.
Department of Geriatric Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Ren Fail. 2025 Dec;47(1):2479573. doi: 10.1080/0886022X.2025.2479573. Epub 2025 Mar 24.
Given the significant impact of diabetic kidney disease (DKD) on morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) and the potential preventive role of dietary factors, particularly dietary fiber, this study aimed to investigate the relationship between dietary fiber intake and the risk of DKD in adults with T2DM.
The medical records and other relevant data from patients with T2DM were retrieved from the United States National Health and Nutrition Examination Surveys (U.S. NHANES) from 2009 to 2018. Multivariate logistic regression and restricted cubic spline (RCS) regression were employed to investigate the relationship between dietary fiber intake and the risk of DKD in adult T2DM patients.
The study involved 4,520 T2DM patients with a mean age of 59.16 years, consisting of 2,346 male patients (51.9%) and 2,174 female patients (48.1%). The prevalence of T2DM patients with DKD was 37.92% in the overall population. Regression analyses, after adjusting for confounders, showed that dietary fiber intake was negatively correlated with the prevalence of DKD. RCS analysis demonstrated a nonlinear negative correlation between the level of dietary fiber intake and the prevalence of DKD, with a threshold inflection point of 13.96 g/day. Subgroup analyses revealed that age, gender, race, smoking status, body mass index, hypertension, diabetes duration, glycosylated hemoglobin, and ACEI/ARB medication use did not significantly affect the negative correlations ( > 0.05).
Dietary fiber intake was negatively correlated with the prevalence of DKD in T2DM patients.
鉴于糖尿病肾病（DKD）对2型糖尿病（T2DM）患者的发病率和死亡率有重大影响，且饮食因素尤其是膳食纤维具有潜在的预防作用，本研究旨在探讨T2DM成年患者膳食纤维摄入量与DKD风险之间的关系。
从2009年至2018年的美国国家健康和营养检查调查（U.S. NHANES）中检索T2DM患者的病历和其他相关数据。采用多变量逻辑回归和受限立方样条（RCS）回归来研究成年T2DM患者膳食纤维摄入量与DKD风险之间的关系。
该研究纳入了4520例T2DM患者，平均年龄为59.16岁，其中男性患者2346例（51.9%），女性患者2174例（48.1%）。总体人群中DKD的T2DM患者患病率为37.92%。在调整混杂因素后的回归分析表明，膳食纤维摄入量与DKD患病率呈负相关。RCS分析显示膳食纤维摄入量水平与DKD患病率之间存在非线性负相关，阈值拐点为13.96克/天。亚组分析显示，年龄、性别、种族、吸烟状况、体重指数、高血压、糖尿病病程、糖化血红蛋白以及使用ACEI/ARB药物均未显著影响这种负相关（P>0.05）。
T2DM患者的膳食纤维摄入量与DKD患病率呈负相关。
