Association of dietary manganese intake with new-onset chronic kidney disease in participants with diabetes

Background

We explored the association of dietary manganese (Mn) with new-onset chronic kidney disease (CKD) in participants with diabetes on different glycemia control status and potential mechanisms.

Methods

The study included 7248 adults with diabetes from the UK Biobank who had complete dietary data and were free of CKD at baseline. Dietary information was collected by the online 24-h diet recall questionnaires. The primary outcome was new-onset CKD.

Results

565 (7.8 %) participants developed new-onset CKD during a median follow-up of 11.96 years. Overall, there was a significantly inverse relationship of dietary Mn intake with new-onset CKD in individuals with diabetes at glycated hemoglobin (HbA1c) ≥6.5 % (per SD increment, HR [95%CI]: 0.79 [0.68-0.91]), but not in people with diabetes at HbA1c <6.5 % (per SD increment, HR [95%CI]: 1.07 [0.90-1.29]; P for interaction = 0.004). In individuals with diabetes at HbA1c ≥6.5 %, body mass index and waist circumference significantly mediated the association between dietary Mn intake and new-onset CKD, with mediated proportions of 17.5 % and 17.4 %, respectively.

Conclusions

Higher dietary Mn intake was significantly associated with a lower new-onset CKD risk in participants with diabetes at poor glycemic control status. The inverse association was mainly mediated by obesity. If further confirmed, our findings underscore the importance of maintaining adequate dietary Mn intake for the primary prevention of new-onset CKD in patients with diabetes, especially those with poor glycemic control.