499 基于社区的心肾保护性饮食干预对患有慢性肾病和高血压的非裔美国人的生理和代谢影响

IF 2.1 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Journal of Clinical and Translational Science Pub Date : 2024-04-03 DOI:10.1017/cts.2024.423
Meera J. Patel, Xuan Wang, Baylor Scott, White Health Teodoro Bottiglieri, Baylor Scott & White Health Heather Kitzman
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引用次数: 0

摘要

目的/目标:慢性肾脏病(CKD)影响着 15%的美国成年人,而非洲裔美国人(AA)受到的影响尤为严重,与白种人相比,他们患肾衰竭的风险高出 3 倍多。本研究评估了增加水果和蔬菜(F&V)对心肾风险因素的生理和代谢影响。方法/研究人群:这项试点试验采用前瞻性、两组随机研究设计,评估水果和蔬菜干预措施(N=46),与等待对照(WL)条件(N=45)相比,参与者接受规定量的新鲜、基本生产的水果和蔬菜。所有参与者均为非洲裔美国成年人(≥18 岁),自述患有高血压,并在筛查中接受了定点尿微量白蛋白检测,结果显示患有慢性肾脏病(1-3 期)。参与者在基线和干预后 6 周接受测量。收集了临床数据(即收缩压和舒张压、血脂组合、血红蛋白 A1C、BMI[体重指数]和白蛋白与肌酐比值)。采用 LC-MS/MS 和 FIA-MS/MS 进行了目标代谢组学定量分析。线性混合模型评估了分析物的表达和临床数据。结果/预期结果:AA 参与者(N=91)年龄为 58 ± 10.2 岁,66% 为女性,54% 收入低于 50,000 美元。通过 T 检验比较了各组之间的得分变化(从基线到 6 周)。F&V组的体重指数显著下降,为-4.7 ± 10.5 kg/m²,而WL组则增加了1.9 ± 8.3 kg/m²,p<.01。此外,F&V 组的总胆固醇降低了 -15.4 ± 58.8 mg/dL,而 WL 组增加了 17.7 ± 68.8 mg/dL,p<.05。F&V 组与 WL 组相比,血红蛋白 A1c 下降不明显。代谢组学分析表明,在 6 周时,WL 组与 F&V 组相比,存在明显差异,提示 CKD 恶化的关键生物标志物有所增加。讨论/意义:通过社区干预,仅饮用 2 杯 F&V 可降低患有慢性肾脏病和高血压的 AA 成人的心血管疾病风险因素,并导致分子/生化变化,从而改善长期肾脏健康。进一步的调查可能会开发出具有成本效益的饮食干预模式,以改善 AA 族人的 CKD 结果。
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499 Physiological and Metabolomic Effects of a Community-Based Cardiorenal Protective Diet Intervention in African Americans with Chronic Kidney Disease and Hypertension

OBJECTIVES/GOALS: Chronic kidney disease (CKD) impacts 15% of US adults and African American (AA) persons are disproportionately affected with more than 3 times higher risk of kidney failure when compared to Caucasian persons. This study evaluated the physiological and metabolomic effects of increased fruits and vegetables (F&V) on cardio-renal risk factors. METHODS/STUDY POPULATION: This pilot trial used a prospective, 2-group, randomized study design to evaluate a F&V intervention (N=46), where participants received a prescribed amount of fresh, base-producing F&V compared to a wait-list control (WL) condition (N=45). All participants were African American adults (≥18 years), had self-reported hypertension, and had CKD (Stage 1-3) on screening spot-urine microalbumin test. Participants were measured at baseline and 6 weeks post-intervention. Clinical data (i.e., systolic and diastolic blood pressure, lipid panel, hemoglobin A1C, BMI [body mass index], and albumin to creatinine ratio) were collected. Targeted metabolomic quantitative analysis was performed followed by LC-MS/MS and FIA-MS/MS. Linear mixed models evaluated analyte expression and clinical data. RESULTS/ANTICIPATED RESULTS: AA participants (N=91) were aged 58 ± 10.2 years, 66% female, and 54% had incomes ≤$50,000. T-tests compared change scores (baseline to 6-weeks) between groups. The F&V group demonstrated a significant reduction in BMI of -4.7 ± 10.5 kg/m² compared to a 1.9 ± 8.3 kg/m² increase in the WL group, p<.01. Further, the F&V group demonstrated a reduction in total cholesterol of -15.4 ± 58.8 mg/dL compared to a 17.7 ± 68.8 mg/dL increase in the WL group, p<.05. Non-significant reductions in hemoglobin A1c were found in the F&V versus the WL group. Metabolomic analysis indicated significant variation with an increase of suggestive key biomarkers for worse CKD in the WL versus F&V groups at 6-weeks. DISCUSSION/SIGNIFICANCE: Consumption of only 2 cups of F&V via a community-based intervention reduced CVD risk factors in AA adults with CKD and HTN and resulted in molecular/biochemical changes which may improve long-term kidney health. Further investigation may lead to development of cost-effective dietary intervention models to improve CKD outcomes in AA persons.

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来源期刊
Journal of Clinical and Translational Science
Journal of Clinical and Translational Science MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.80
自引率
26.90%
发文量
437
审稿时长
18 weeks
期刊最新文献
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