总蛋白质摄入量与慢性肾脏疾病的风险:社区循环风险研究

IF 4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Environmental Health and Preventive Medicine Pub Date : 2023-01-01 DOI:10.1265/ehpm.22-00247

Sachimi Kubo, Hironori Imano, Isao Muraki, Akihiko Kitamura, Hiroyuki Noda, Renzhe Cui, Koutatsu Maruyama, Kazumasa Yamagishi, Mitsumasa Umesawa, Yuji Shimizu, Mina Hayama-Terada, Masahiko Kiyama, Takeo Okada, Hiroyasu Iso

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引用次数: 0

摘要

背景:在一般人群中，膳食蛋白质摄入是否会使肾功能恶化已被讨论过，但尚未确定。我们旨在研究膳食蛋白质摄入量与慢性肾脏疾病(CKD)发生风险之间的纵向关联。方法:我们对3277名年龄在40-74岁之间的日本成年人(1150名男性和2127名女性)进行了一项为期12年的随访研究，这些成年人最初没有CKD，他们参加了来自两个日本社区的心血管风险调查。在随访期间，通过肾小球滤过率(eGFR)来确定CKD的发展。蛋白质摄入量在基线时通过使用简短型自我管理饮食史问卷进行测量。我们使用Cox比例风险回归模型，根据蛋白质摄入的能量百分比(%能量)计算了发生CKD的性别、年龄、社区和多变量调整的风险比(HR)。结果:在26422人年的随访中，300名参与者发展为CKD(137名男性和163名女性)。总蛋白质摄入量最高(≥16.9%能量)和最低(≤13.4%能量)四分位数的性别、年龄和社区调整HR(95%可信区间，CI)为0.66 (0.48-0.90)，p为趋势= 0.007。在进一步调整体重指数、吸烟状况、饮酒状况、舒张压、降压药使用、糖尿病、血清总胆固醇水平、降胆固醇药物使用、总能量摄入和基线eGFR后，多变量HR (95%CI)为0.72(0.52-0.99)，趋势p = 0.016。这种关联不因性别、年龄和基线eGFR而异。分别检测动物和植物蛋白摄入量时，各自的多变量hr (95% ci)分别为0.77(0.56 ~ 1.08)和1.24 (0.89 ~ 1.75)，p为趋势值= 0.270。结论:较高的蛋白质摄入量，特别是动物蛋白摄入量与较低的CKD风险相关。

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Total protein intake and subsequent risk of chronic kidney disease: the Circulatory Risk in Communities Study.

Background: Whether dietary protein intake worsens renal function in the general population has been discussed but not yet determined. We aimed to examine the longitudinal association between dietary protein intake and risk of incident chronic kidney disease (CKD).

Methods: We conducted a 12-year follow-up study with 3,277 Japanese adults (1,150 men and 2,127 women) aged 40-74 years, initially free from CKD, who participated in cardiovascular risk surveys from two Japanese communities under the Circulatory Risk in Communities Study. The development of CKD was defined by the estimated glomerular filtration rate (eGFR) during the follow-up period. Protein intake was measured at baseline by using the brief-type self-administered diet history questionnaire. We estimated sex-, age-, community- and multivariate-adjusted hazard ratios (HR) for incident CKD were calculated using the Cox proportional hazards regression models according to quartiles of percentage of energy (%energy) from protein intake.

Results: During 26,422 person-years of follow-up, 300 participants developed CKD (137 men and 163 women). The sex-, age-, and community-adjusted HR (95% confidence interval, CI) for the highest (≥16.9%energy) versus lowest (≤13.4%energy) quartiles of total protein intake was 0.66 (0.48-0.90), p for trend = 0.007. The multivariable HR (95%CI) was 0.72 (0.52-0.99), p for trend = 0.016 after further adjustment for body mass index, smoking status, alcohol drinking status, diastolic blood pressure, antihypertensive medication use, diabetes mellitus, serum total cholesterol levels, cholesterol-lowering medication use, total energy intake, and baseline eGFR. The association did not vary by sex, age, and baseline eGFR. When examining animal and vegetable protein intake separately, the respective multivariable HRs (95%CIs) were 0.77 (0.56-1.08), p for trend = 0.036, and 1.24 (0.89-1.75), p for trend = 0.270.

Conclusions: Higher protein intake, more specifically animal protein intake was associated with a lower risk of CKD.

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来源期刊

Environmental Health and Preventive Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -

CiteScore

7.90

自引率

2.10%

发文量

审稿时长

10 weeks

期刊介绍： The official journal of the Japanese Society for Hygiene, Environmental Health and Preventive Medicine (EHPM) brings a comprehensive approach to prevention and environmental health related to medical, biological, molecular biological, genetic, physical, psychosocial, chemical, and other environmental factors. Environmental Health and Preventive Medicine features definitive studies on human health sciences and provides comprehensive and unique information to a worldwide readership.