Association Between Probiotic, Prebiotic, Synbiotics, and Yogurt Supplements and Diabetic Kidney Disease: The National Health and Nutrition Examination Survey 2007-2016.

OBJECTIVE

Diabetic kidney disease (DKD) is the most prevalent of chronic renal disease and the leading cause of end-stage renal disease worldwide, primarily attributed to the increasing prevalence of Type 2 diabetes mellitus (T2DM). We aimed to investigate potential associations between the consumption of probiotics, prebiotics, synbiotics, and yogurt and DKD, addressing a critical gap in current research concerning dietary interventions and renal health outcomes.

METHODS

We conducted a cross-sectional study among adults with T2DM in the National Health and Nutrition Examination Survey from 2007 to 2016. Weighted univariate logistic regression analysis, subgroup analysis, and interaction analysis were conducted to assess the relationship between probiotics, prebiotics, synbiotics, yogurt supplements and DKD. In addition, the restricted cubic spline analysis was applied to assess potential nonlinear relationships between yogurt supplements and DKD.

RESULTS

The study included 2,665 individuals, of whom 1,044 (39.2%) had a diagnosis of DKD. Multivariable logistic regression indicated an independent association between probiotic, prebiotic, synbiotic, or yogurt intake and a reduced risk of DKD after adjusting for covariates (odds ratio = 0.71, 95% confidence interval: 0.52-0.96, P = .03). Subgroup analysis results indicated inconsistencies in the correlations between DKD and probiotics, prebiotics, synbiotics, or yogurt. Interaction analysis showed that age, gender, urine albumin-to-creatinine ratio, estimated glomerular filtration rate, body mass index, hypertension, hyperlipidemia, or antibiotic therapy had no significantly influence on the positive correlation (all P > .05). The restricted cubic spline model indicated no nonlinear relationship between yogurt intake and DKD.

CONCLUSION

Our findings indicated significant inverse associations between probiotic, prebiotic, synbiotics, or yogurt supplements and DKD prevalence in T2DM patients. Further large-scale studies with extended follow-up periods are warranted to confirm these findings and develop evidence-based dietary guidelines for clinical practice.