| Title: | Causal effects of relative fat, protein, and carbohydrate intake on chronic kidney disease: a Mendelian randomization study |
| Journal: | American Journal of Clinical Nutrition |
| Published: | 1 Apr 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/33564816/ |
| DOI: | https://doi.org/10.1093/ajcn/nqaa379 |
| URL: | https://academic.oup.com/ajcn/article-pdf/113/4/1023/36912109/nqaa379.pdf |
| Citations: | 15 (7 in last 2 years) as of 8 Aug 2024 |
Publication 4447
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Abstract
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.</p>
OBJECTIVES: We aimed to investigate the effects of macronutrient intake ratios on the risk of chronic kidney disease (CKD) by Mendelian randomization (MR) analysis.</p>
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 m2]. 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 m2) and log-transformed eGFR.</p>
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 (β: -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 (β: 0.044; 95% CI: 0.030, 0.058)].</p>
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.</p>
11 Keywords
- Cohort Studies
- Dietary Carbohydrates
- Dietary Fats
- Dietary Proteins
- Female
- Genetic Predisposition to Disease
- Humans
- Male
- Middle Aged
- Renal Insufficiency, Chronic
- United Kingdom
14 Authors
- Sehoon Park
- Soojin Lee
- Yaerim Kim
- Yeonhee Lee
- Min Woo Kang
- Kwangsoo Kim
- Yong Chul Kim
- Seung Seok Han
- Hajeong Lee
- Jung Pyo Lee
- Kwon Wook Joo
- Chun Soo Lim
- Yon Su Kim
- Dong Ki Kim
Enabling scientific discoveries that improve human health