Dietary factors and the risk of incident kidney stones in younger women - Nurses' health study II
Dietary factors and the risk of incident kidney stones in younger women - Nurses' health study II
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DOI：
10.1001/archinte.164.8.885
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发表时间：
2004-04-26
影响因子：
--
通讯作者：
Stampfer, MJ
中科院分区：
文献类型：
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作者：
Curhan, GC;Willett, WC;Stampfer, MJ
背景资料：在老年女性和男性中，更多地摄入膳食钙，钾和总液体可降低肾结石形成的风险，而补充钙，钠，动物蛋白和蔗糖可能会增加风险。最近，植酸盐已被认为在结石形成中发挥作用。据我们所知，没有前瞻性资料的作用，饮食因素和风险的肾结石形成是在年轻women.Methods：我们前瞻性研究，在8年的时间内，饮食因素之间的关联和风险的事件症状肾结石96245名女性参与者在护士健康研究11;参与者年龄介乎二十七至四十四岁，并无肾结石病史。1991年和1995年，自我管理的食物频率问卷被用来评估饮食。主要结局指标为偶发症状性肾结石。考克斯比例风险回归模型被用来调整同时为各种风险factors.Results：我们记录了1223事件症状性肾结石在685973人年的后续行动。在调整相关风险因素后，较高的膳食钙摄入量与肾结石风险降低相关（趋势P= 0.007）。膳食钙摄入量最高五分位数的妇女与膳食钙摄入量最低五分位数的妇女相比，多变量相对风险为0.73（95%置信区间，0.59-0.90）。补充钙的摄入与结石形成的风险无关。植酸盐摄入量与结石形成风险降低有关。与植酸摄入量最低的五分之一妇女相比，摄入量最高的五分之一妇女的相对危险度为0.63（95%置信区间为0.51-0.78）。其他饮食因素显示，与摄入量最低的五分之一妇女相比，摄入量最高的五分之一妇女的相对风险（95%置信区间）如下：动物蛋白，0.84（0.68-1.04）;液体，0.68（0.56-0.83）;蔗糖，1.31（1.07-1.60）。钠，钾，镁的摄入量与其他饮食factors.Conclusions调整后的风险没有独立相关性：较高的膳食钙摄入量降低了年轻女性肾结石形成的风险，但补充钙与风险无关。这项研究还表明，一些饮食风险因素可能因年龄和性别而异。最后，膳食植酸盐可能是一种新的，重要的，安全的预防结石的选择。
Background: In older women and men, greater intakes of dietary calcium, potassium, and total fluid reduce the risk of kidney stone formation, while supplemental calcium, sodium, animal protein, and sucrose may increase the risk. Recently, phytate has been suggested to play a role in stone formation. To our knowledge, no prospective information on the role of dietary factors and risk of kidney stone formation is available in younger women.Methods: We prospectively examined, during an 8-year period, the association between dietary factors and the risk of incident symptomatic kidney stones among 96 245 female participants in the Nurses' Health Study 11; the participants were aged 27 to 44 years and had no history of kidney stones. Self-administered food frequency questionnaires were used to assess diet in 1991 and 1995. The main outcome measure was an incident symptomatic kidney stone. Cox proportional hazards regression models were used to adjust simultaneously for various risk factors.Results: We documented 1223 incident symptomatic kidney stones during 685973 person-years of follow-up. After adjusting for relevant risk factors, a higher dietary calcium intake was associated with a reduced risk of kidney stones (P=.007 for trend). The multivariate relative risk among women in the highest quintile of intake of dietary calcium compared with women in the lowest quintile was 0.73 (95% confidence interval, 0.59-0.90). Supplemental calcium intake was not associated with risk of stone formation. Phytate intake was associated with a reduced risk of stone formation. Compared with women in the lowest quintile of phytate intake, the relative risk for those in the highest quintile was 0.63 (95% confidence interval, 0.51-0.78). Other dietary factors showed the following relative risks (95% confidence intervals) among women in the highest quintile of intake compared with those in the lowest quintile: animal protein, 0.84 (0.68-1.04); fluid, 0.68 (0.56-0.83); and sucrose, 1.31 (1.07-1.60). The intakes of sodium, potassium, and magnesium were not independently associated with risk after adjusting for other dietary factors.Conclusions: A higher intake of dietary calcium decreases the risk of kidney stone formation in younger women, but supplemental calcium is not associated with risk. This study also suggests that some dietary risk factors may differ by age and sex. Finally, dietary phytate may be a new, important, and safe addition to our options for stone prevention.