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Asia Pac J Clin Nutr. 2018;27(2):366-374. doi: 10.6133/apjcn.042017.15.

Dietary patterns, dietary biomarkers, and kidney disease in patients with type 2 diabetes: a repeated-measure study in Taiwan.

Author information

1
School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
2
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
3
Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia.
4
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
5
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University and University Hospital, Kaohsiung, Taiwan.
6
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University and University Hospital, Kaohsiung, Taiwan.
7
Departmentof Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Email: mechhu@kmu.edu.tw.
8
Departmentof Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

BACKGROUND AND OBJECTIVES:

Western dietary patterns have been linked with kidney disease. This study investigated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker.

METHODS AND STUDY DESIGN:

We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three repeated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio >=30 mg/g and kidney dysfunction by estimated glomerular filtration rate <60 mL/min/1.73m2. Generalized estimating equation models were used to estimate ORs (95% CIs) of kidney disease adjusted for covariates. Erythrocyte fatty acids were only measured in blood samples collected in 2008.

RESULTS:

Three dietary patterns were identified: high fat-meat, traditional Chinese food-snack, and fish-vegetable. In the adjusted model, the high fat-meat and traditional Chinese food-snack diets were not associated with any kidney outcomes. The fishvegetable diet was inversely associated with kidney dysfunction (quartile 4 vs 1, OR: 0.75, 0.58-0.97), but not associated with albuminuria. A higher fish-vegetable diet factor score was associated with higher n-3 fatty acid levels.

CONCLUSION:

In patients with diabetes, we found greater adherence to a fish-vegetable diet to be associated with better kidney function and greater n-3 fatty acid profiles. The inclusion of repeated dietary assessments and dietary biomarker measurements in future diet-disease research, especially in patient populations, may provide more definitive risk evaluation.

PMID:
29384324
DOI:
10.6133/apjcn.042017.15
[Indexed for MEDLINE]
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