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女性膳食胰岛素负荷和膳食胰岛素指数与糖尿病肾病及肾功能减退的关联:一项病例对照研究。

Associations of dietary insulin load and dietary insulin index with diabetic nephropathy and reduced kidney function among women: a case-control study.

作者信息

Abaj Faezeh, Mirzababaei Atieh, Gholizadeh Mohammad, Aali Yasaman, Jadidi Paria, Amiri Khosroshahi Reza, Clark Cain C T, Mirzaei Khadijeh

机构信息

Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.

Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Health Popul Nutr. 2025 May 25;44(1):173. doi: 10.1186/s41043-025-00895-2.

Abstract

BACKGROUND

Increased insulin levels lead to hyperinsulinemia and insulin resistance (IR). IR is one of the main causes of the onset and progression of Diabetic Nephropathy (DN) and kidney failure in type 2 diabetic patients. The present case-control study sought to investigate the relationship between dietary insulin load (DIL) and index (DII) and the odds of DN and kidney function decline.

METHODS

At the Kowsar Diabetes Clinic in Semnan, Iran, we enrolled 105 eligible women with DN and 105 controls (30-65 years old). Dietary insulin load (DIL) and index (DII) were assessed using a 147-item food frequency questionnaire (FFQ). Using standard protocols, biochemical variables and anthropometric measurements were evaluated for all patients. To investigate potential associations, binary logistic regression was used.

RESULTS

We found that higher DII was associated with 2.72 times higher odds of albuminuria (OR: 2.77; 95% CI 1.16, 6.63) and 1.92 times higher odds of DN (OR: 1.92; 95% CI 1.11, 3.32) compared to lower adherence. Additionally, DIL was found to be statistically highly connected with mild to severe reduction of glomerular filtration rate (GFR) in participants and 1.82 times greater odds of DN (OR = 1.82; 95% CI 1.01, 3.30).

CONCLUSION

The findings from this research showed that a higher odds of DN were related to a higher level of adherence to DIL and DII. Increased adherence to DIL was strongly correlated with the likelihood of a decreased GFR. To clarify our findings, more prospective research is necessary.

摘要

背景

胰岛素水平升高会导致高胰岛素血症和胰岛素抵抗(IR)。IR是2型糖尿病患者糖尿病肾病(DN)发病和进展以及肾衰竭的主要原因之一。本病例对照研究旨在探讨饮食胰岛素负荷(DIL)和指数(DII)与DN几率及肾功能下降之间的关系。

方法

在伊朗塞姆南的科萨尔糖尿病诊所,我们招募了105名符合条件的DN女性患者和105名对照者(年龄在30至65岁之间)。使用147项食物频率问卷(FFQ)评估饮食胰岛素负荷(DIL)和指数(DII)。按照标准方案,对所有患者的生化变量和人体测量指标进行评估。为研究潜在关联,采用二元逻辑回归分析。

结果

我们发现,与依从性较低者相比,较高的DII与蛋白尿几率高2.72倍(比值比:2.77;95%置信区间1.16,6.63)以及DN几率高1.92倍(比值比:1.92;95%置信区间1.11,3.32)相关。此外,发现DIL与参与者肾小球滤过率(GFR)从轻度到重度降低在统计学上高度相关,且DN几率高1.82倍(比值比 = 1.82;95%置信区间1.01,3.30)。

结论

本研究结果表明,较高的DN几率与较高的DIL和DII依从水平相关。DIL依从性增加与GFR降低的可能性密切相关。为阐明我们的研究结果,有必要进行更多前瞻性研究。

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