期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 113, 期 4, 页码 1023-1031出版社
ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqaa379
关键词
Mendelian randomization; diet; chronic kidney disease; macronutrient; protein; fat
资金
- Industrial Strategic Technology Development Program-Development of Bio-Core Technology - Ministry of Trade, Industry, Energy (Korea) [10077474]
- National Research Foundation of Korea [4199990714498] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
The study indicates that higher relative protein intake is associated with a lower risk of chronic kidney disease, while increased relative fat intake is causally linked to kidney function impairment. Therefore, a desirable macronutrient composition, including high relative protein intake and low relative fat intake, may reduce the risk of chronic kidney disease in the general population.
Background: The effects of specific macronutrients on kidney function independent of total calorie intake have rarely been studied, although the composition of macronutrient intake has been reported to affect health outcomes. Objectives: We aimed to investigate the effects of macronutrient intake ratios on the risk of chronic kidney disease (CKD) by Mendelian randomization (MR) analysis. Methods: The study was an observational cohort study mainly based on the UK Biobank and including MR analysis. First, we evaluated the relative baseline macronutrient composition-that is, the number of calories from each macronutrient divided by total calorie intake-of the diets of UK Biobank participants, and we used Cox regression to assess the incidence of end-stage kidney disease (ESKD) in 65,164 participants with normal kidney function [estimated glomerular filtration rate (eGFR) >= 60 mL/min/1.73 m(2)]. We implemented a genetic instrument for relative fat, protein, and carbohydrate intake developed by a previous genome-wide association study (GWAS) and performed MR analysis. Two-sample MR was performed with the summary statistics from independent CKDGen GWAS for kidney function traits (n = 567,460), including CKD (eGFR <60 mL/min/1.73 m(2)) and log-transformed eGFR. Results: The median relative macronutrient intake composition at baseline was 35% fats, 15% protein, and 50% carbohydrates. Higher relative protein intake in subjects with normal kidney function was significantly associated with a lower risk of incident ESKD (HR: 0.54; 95% CI: 0.30, 0.95) in the observational investigation. Two-sample MR indicated that increased relative fat intake causally increased the risk of kidney function impairment [CKD (OR: 1.94; 95% CI: 1.39, 2.71); log eGFR (beta: -0.036; 95% CI: -0.048, -0.024)] and that higher relative protein intake was causally linked to a lower CKD risk [CKD (OR: 0.50; 95% CI: 0.35, 0.72); log eGFR (beta: 0.044; 95% CI: 0.030, 0.058)]. Conclusions: A desirable macronutrient composition, including high relative protein intake and low relative fat intake, may causally reduce the risk of CKD in the general population.
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