Background

Whether diabetes and genetic susceptibility of kidney diseases modifies the relationship between ultra-processed foods (UPF) consumption and incident chronic kidney disease (CKD) remains uncertain. We aimed to investigate the association between UPF consumption and new-onset CKD in participants with and without diabetes, and explore whether genetic risks of kidney diseases may modify the association.

Methods

153,985 participants who were free of CKD at baseline and provided 24-h dietary recalls in the UK Biobank were included. UPF was defined according to the NOVA classification. The energy contribution of UPF was calculated by dividing the energy intake of UPF by the total energy intake. The study outcome was new-onset CKD, ascertained by self-report data and data linkage with primary care, hospital admissions, and death registry records.

Results

During a median follow-up of 12.1 years, 4,058 participants developed new-onset CKD. There was a significant positive association between UPF consumption and new-onset CKD in total participants (per 10% increment, adjusted hazard ratio (HR) 1.04; 95% confidence interval (CI) [1.01;1.06]. The positive association between UPF consumption and risk of new-onset CKD was significantly stronger in participants with diabetes (per 10% increment, adjusted HR 1.11 [1.05;1.17]) than in those without diabetes (per 10% increment, adjusted HR 1.03 [1.00;1.05]; P-interaction = 0.005). Genetic risks of kidney diseases did not significantly modify the positive association in those with or without diabetes (all P-interactions > 0.05).

Conclusion

There was a significantly stronger positive association between UPF consumption and new-onset CKD in participants with diabetes compared with those without diabetes.

中文翻译：

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患有或不患有糖尿病的参与者中超加工食品消费与新发慢性肾脏病的关系

背景

糖尿病和肾脏疾病的遗传易感性是否会改变超加工食品 (UPF) 消费与慢性肾脏病 (CKD) 之间的关系仍不确定。我们的目的是调查患有或不患有糖尿病的参与者中 UPF 摄入量与新发 CKD 之间的关联，并探讨肾脏疾病的遗传风险是否可能改变这种关联。

方法

纳入的 153,985 名参与者在基线时没有 CKD，并在英国生物库中提供了 24 小时饮食回忆。UPF是根据NOVA分类定义的。UPF的能量贡献是通过将UPF的能量摄入量除以总能量摄入量来计算的。研究结果是新发 CKD，通过自我报告数据以及与初级保健、入院和死亡登记记录的数据关联来确定。

结果

在中位随访 12.1 年期间，4,058 名参与者出现了新发 CKD。在所有参与者中，UPF 摄入量与新发 CKD 之间存在显着正相关（每增加 10%，调整后风险比 (HR) 1.04；95% 置信区间 (CI) [1.01;1.06]。UPF 摄入量与新发 CKD 之间呈显着正相关。患有糖尿病的参与者（每增加 10%，调整后的 HR 1.11 [1.05;1.17]）新发 CKD 的风险显着高于非糖尿病参与者（每增加 10%，调整后的 HR 1.03 [1.00;1.05]；P -交互作用= 0.005）。肾脏疾病的遗传风险并没有显着改变患有或不患有糖尿病的人的正相关性（所有P交互作用> 0.05）。

结论

与非糖尿病患者相比，糖尿病患者 UPF 摄入量与新发 CKD 之间存在显着更强的正相关性。