Li Shaopeng, Yang Suqiong, Wang Yong, Lin Zongqi, Chen Fuyuan, Gao Qinghe, Cai Jiantong
Department of Urology, Shishi General Hospital, Quanzhou, China.
Department of Psychiatry, The Third Hospital of Quanzhou, Quanzhou, China.
Front Nutr. 2025 Mar 28;12:1552889. doi: 10.3389/fnut.2025.1552889. eCollection 2025.
The Albumin-Creatinine Ratio (ACR) is a key biomarker for early kidney disease detection and is predictive of chronic kidney disease (CKD) progression and associated cardiovascular risks. Antioxidant diets, indicated by the Composite Dietary Antioxidant Index (CDAI), may reduce oxidative stress and alter albumin urinary excretion rates. This study explores the relationship between CDAI and albuminuria.
Data on intake of vitamins A, C, E, zinc, selenium, and beta-carotene from the NHANES database (2007-2018) were used to compute CDAI scores. To measure urinary albumin, the ACR levels were assessed. The association between CDAI and ACR was analyzed through multivariate logistic regression, subgroup analysis, and interaction tests, incorporating a generalized additive model (GAM) to evaluate potential non-linear relationships.
A total of 28,601 participants were included with an average CDAI of 0.302 ± 3.895. Those in higher CDAI quartiles showed a reduced likelihood of elevated ACR. The prevalence of increased ACR decreased across the CDAI quartiles from 13.89% in Q1 to 10.11% in Q4. Higher CDAI scores were inversely related to ACR (OR: 0.99, 95% CI: 0.97-1.00), with a significant interaction effect by BMI ( = 0.0048). In males, a distinct L-shaped relationship was noted, with a negative correlation between CDAI and ACR to the left of the inflection point at 0.53 (OR: 0.95, 95% CI: 0.91-0.98).
Increasing CDAI is associated with lower ACR and reduced risk of albuminuria, suggesting that dietary antioxidants may benefit renal and cardiovascular health.
白蛋白-肌酐比值（ACR）是早期肾病检测的关键生物标志物，可预测慢性肾病（CKD）的进展及相关心血管风险。由综合膳食抗氧化指数（CDAI）表示的抗氧化饮食，可能会降低氧化应激并改变尿白蛋白排泄率。本研究探讨了CDAI与蛋白尿之间的关系。
利用美国国家健康与营养检查调查（NHANES）数据库（2007 - 2018年）中维生素A、C、E、锌、硒和β-胡萝卜素的摄入数据来计算CDAI得分。为测量尿白蛋白，评估了ACR水平。通过多变量逻辑回归、亚组分析和交互检验分析CDAI与ACR之间的关联，并采用广义相加模型（GAM）评估潜在的非线性关系。
共纳入28,601名参与者，平均CDAI为0.302±3.895。处于较高CDAI四分位数的参与者ACR升高的可能性降低。ACR升高的患病率在CDAI四分位数间从第一四分位数的13.89%降至第四四分位数的10.11%。较高的CDAI得分与ACR呈负相关（比值比：0.99，95%置信区间：0.97 - 1.00），且体重指数存在显著交互作用（P = 0.0048）。在男性中，观察到一种明显的L形关系，在拐点0.53左侧，CDAI与ACR呈负相关（比值比：0.95，95%置信区间：0.91 - 0.98）。
CDAI升高与较低的ACR及蛋白尿风险降低相关，表明膳食抗氧化剂可能有益于肾脏和心血管健康。
