Dietary habits, poverty, and chronic kidney disease in an urban population.
Dietary habits, poverty, and chronic kidney disease in an urban population.
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DOI：
10.1053/j.jrn.2014.07.008
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Powe NR
中科院分区：
文献类型：
--
作者：
Crews DC;Kuczmarski MF;Miller ER 3rd;Zonderman AB;Evans MK;Powe NR
在美国及全球范围内，贫困与慢性肾脏病（CKD）相关。不良的饮食习惯可能导致这种差异。
横断面研究。
2058名居住在马里兰州巴尔的摩市的30 - 64岁社区成年人。
对终止高血压膳食疗法（DASH）饮食的依从性。DASH评分基于9种目标营养素（总脂肪、饱和脂肪、蛋白质、纤维、胆固醇、钙、镁、钠和钾）；依从性定义为在满分9分的情况下得分≥4.5。贫困（自我报告家庭收入<2004年卫生与公众服务部指导标准的125%）和非贫困（≥指导标准的125%）。
CKD定义为估计肾小球滤过率<60 mL/min/1.73m²（CKD - EPI）。采用多变量逻辑回归计算按贫困状况分层的DASH评分三分位数与CKD关系的调整优势比（AOR）。
在2058名参与者中（平均年龄48岁；57%为黑人；44%为男性；42%为贫困人群），DASH评分中位数较低，为1.5（四分位间距，1 - 2.5）。只有5.4%的人依从该饮食法。在DASH评分较低的三分位数人群中，贫困、男性、黑种人以及吸烟更为普遍，而在DASH评分最高的三分位数人群中，高等教育和定期医疗保健更为普遍（所有P<0.05）。与非贫困组相比，贫困组的纤维、钙、镁和钾摄入量较低，胆固醇较高（所有P<0.05），钠摄入量无差异。贫困组共有5.6%、非贫困组有3.8%患有CKD（P = 0.05）。在贫困人群中，DASH评分最低的三分位数（与最高的相比）与更多的CKD相关[AOR 3.15，95%置信区间（CI）1.51 - 6.56]，但在非贫困人群中并非如此（AOR 0.73，95%CI 0.37 - 1.43）。交互作用P值为0.001。
在城市贫困人口中，不良的饮食习惯与CKD密切相关，可能是旨在减少CKD差异的干预措施的一个目标。
Poverty is associated with chronic kidney disease (CKD) in the US and worldwide. Poor dietary habits may contribute to this disparity. Cross-sectional study. 2,058 community-dwelling adults aged 30-64 years residing in Baltimore City, Maryland. Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet. DASH scoring based on 9 target nutrients (total fat, saturated fat, protein, fiber, cholesterol, calcium, magnesium, sodium, and potassium); adherence defined as score ≥4.5 out of maximum possible score of 9. Poverty (self-reported household income <125% of 2004 Department of Health and Human Services guideline) and non-poverty (≥125% of guideline). CKD defined as estimated glomerular filtration rate <60mL/min/1.73m2 (CKD-EPI). Multivariable logistic regression used to calculate adjusted odds ratios (AORs) for relation of DASH score tertile and CKD, stratified by poverty status. Among 2,058 participants (mean age 48 years; 57% black; 44% male; 42% with poverty), median DASH score was low, 1.5 (IQR, 1-2.5). Only 5.4% were adherent. Poverty, male sex, black race, and smoking were more prevalent among the lower DASH score tertiles, while higher education and regular health care were more prevalent among the highest DASH score tertile (P<0.05 for all). Fiber, calcium, magnesium and potassium intake were lower, and cholesterol higher, among the poverty as compared to non-poverty group (P<0.05 for all), with no difference in sodium intake. A total of 5.6% of the poverty and 3.8% of the non-poverty group had CKD (P=0.05). The lowest DASH tertile (compared to the highest) was associated with more CKD among the poverty [AOR 3.15, 95% Confidence Interval (CI) 1.51-6.56], but not among the non-poverty group (AOR 0.73, 95% CI 0.37-1.43). P interaction 0.001. Poor dietary habits are strongly associated with CKD among the urban poor and may represent a target for interventions aimed at reducing disparities in CKD.
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DOI：
10.1053/j.ajkd.2012.05.010
发表时间：
2012-11
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Crews DC;McClellan WM;Shoham DA;Gao L;Warnock DG;Judd S;Muntner P;Miller ER;Powe NR
通讯作者：
Powe NR
影响因子：
4.2
作者：
Blanton, Cynthia A.;Moshfegh, Alanna J.;Kretsch, Mary J.
通讯作者：
Kretsch, Mary J.
影响因子：
--
作者：
Mellen, Philip B.;Gao, Sue K.;Goff, David C.
通讯作者：
Goff, David C.
影响因子：
2.6
作者：
Fukui, M.;Tanaka, M.;Nakamura, N.
通讯作者：
Nakamura, N.
影响因子：
3.6
作者：
Gannon, Richard H. T.;Millward, D. Joe;Lanham-New, Susan A.
通讯作者：
Lanham-New, Susan A.