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韩国人群中微量营养素与慢性肾脏病发生的孟德尔随机化研究。

Mendelian randomization study of micronutrients and development of CKD in a Korean population.

作者信息

Lee Juyeon, Lee Sangjun, Oh Kook-Hwan, Park Sue K

机构信息

Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul, Republic of Korea.

Cancer Research Institute, Seoul National University, 103 Daehak-Ro, Jongnogu, Seoul, Republic of Korea.

出版信息

Nutr J. 2025 Jun 13;24(1):90. doi: 10.1186/s12937-025-01160-2.

Abstract

BACKGROUND

Although dietary intake is a key modifiable risk factor in the development of chronic kidney disease (CKD), the optimal consumption levels to prevent CKD and the intake levels that pose the least risk remain unclear. Building on the findings from our previous cohort study, this research aims to use genetic variants as instrumental variables to clarify the complex relationship between micronutrient status and the pathogenesis of CKD.

METHODS

Of 5,078 participants with a baseline estimate glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m and who were not diagnosed with CKD, we ascertained 708 new CKD cases over 12 year follow-up periods. Mendelian randomization analyses were conducted using genetic instrumental variables to examine the causal relationships between dietary micronutrients (Phosphorus, Vitamin B2, B6 and C) levels and the development of CKD.

RESULTS

In Mendelian randomization study, using the inverse variance-weighted (IVW) radial method, dietary vitamin B6 (β = -4.016, p-value = 8.72E-05) and C (β = 2.573, p = 1.41E-05) intake levels demonstrated significant associations with the development of CKD. However, there was no significant association observed for dietary phosphorus and vitamin B2 intake levels with the development of CKD (p > 0.05).

CONCLUSIONS

This study found a weak causal link to genetically predicted levels of vitamins B6 and C on CKD development. Given potential residual pleiotropy and biological limitations, findings should be cautiously interpreted yet highlight the possible role of balanced micronutrient intake in kidney health.

摘要

背景

尽管饮食摄入是慢性肾脏病(CKD)发生发展过程中一个关键的可改变风险因素,但预防CKD的最佳摄入量以及风险最小的摄入量仍不明确。基于我们之前队列研究的结果,本研究旨在使用基因变异作为工具变量,以阐明微量营养素状态与CKD发病机制之间的复杂关系。

方法

在5078名基线估计肾小球滤过率(eGFR)≥60 mL/min/1.73 m²且未被诊断为CKD的参与者中,我们在12年的随访期内确定了708例新的CKD病例。使用基因工具变量进行孟德尔随机化分析,以检验饮食中微量营养素(磷、维生素B2、B6和C)水平与CKD发生之间的因果关系。

结果

在孟德尔随机化研究中,采用逆方差加权(IVW)径向法,饮食中维生素B6(β = -4.016,p值 = 8.72×10⁻⁵)和维生素C(β = 2.573,p = 1.41×10⁻⁵)的摄入量与CKD的发生显著相关。然而,饮食中磷和维生素B2的摄入量与CKD的发生没有显著关联(p > 0.05)。

结论

本研究发现基因预测的维生素B6和维生素C水平与CKD发展之间存在微弱的因果联系。鉴于潜在的残余多效性和生物学局限性,研究结果应谨慎解读,但突出了微量营养素均衡摄入在肾脏健康中的可能作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d679/12166562/fd966b915de2/12937_2025_1160_Fig1_HTML.jpg

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