Biomarker-based studies on the relevance of habitual phosphorus intake and dietary acid load during growth for endocrine and nephrological outcomes in adulthood

基于生物标志物的研究，研究生长过程中习惯性磷摄入量和膳食酸负荷与成年期内分泌和肾病结果的相关性

• 批准号: 464648434
• 负责人: Professor Dr. Thomas Remer
• 金额: --
• 依托单位: Abteilung für Allgemeine Pädiatrie und Neonatologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/464648434?language=en
• 关键词: Biomarker; based; studies; relevance; habitual

Whether a habitual high phosphorus(P)-intake may result in long-term adverse health outcomes is not yet clarified. Up do now, no population data are available on prospectively examined renal phosphate excretion rates determined in repeatedly – over years – collected 24-h urine samples for the non-invasive assessment of dietary P-intake. Studies are also lacking that examine possible long-term consequences of higher versus lower potential renal acid load (PRAL) for kidney health-relevant outcomes in young adulthood.In the current project, at first, a detailed long-term trend analysis of P intake in healthy children and adolescents in Germany between 1990 and 2019 shall be performed. This analysis will be based on measurements of phosphorus excretion in more than 7000 24-h urine samples collected from 3-17 years old participants of the DONALD study (Dortmund, Germany) during the above period.Potential long-term consequences of a high P-intake during childhood and adolescence will then be examined for different kidney health-relevant outcomes in adulthood. Particularly, specific nephrologic, and endocrine metabolic outcomes, will be analyzed with the aim to assess the prospective importance of higher vs. lower dietary P intake in children and youth. Kidney function in adult DONALD participants will be examined by measuring urinary albumin excretion, glomerular filtration rate, creatinine clearance, renal acid excretion capacity, and circulating uromodulin. The phosphate-regulating hormones parathyroid hormone, fibroblast growth factor 23, and a-Klotho will be additionally determined as well as sympathoadrenergic activity via catecholamine metabolite measurements.Relevant confounding through early life factors, socioeconomic status, anthropometric characteristics, metabolic markers, as well as further potential influencing factors will be allowed for. Additionally, it shall be examined whether at least parts of the observed relationships between P-intake and outcomes could be also explained by a habitual, rather high dietary acid load, quantified – biomarker-based – via PRAL measurements in repeatedly collected 24-h urine samples. Accordingly, preliminary information may be in addition obtained on whether kidney health benefits reported for mainly plant-based, at least partly alkalizing diets like the mediterranean or the DASH diet may be contributorily caused by a habitually reduced dietary acid load.

习惯性的高磷(P)摄入是否会导致长期的不良健康后果尚不清楚。到目前为止，还没有前瞻性检查的肾脏磷酸盐排泄率的人群数据，这些数据是在多年来反复收集24小时尿样以非侵入性评估饮食磷摄入量的。还缺乏研究来检验较高和较低潜在肾酸负荷(PRAL)对青壮年肾脏健康相关结局的可能长期后果。在当前的项目中，首先将对1990年至2019年期间德国健康儿童和青少年中的磷摄入量进行详细的长期趋势分析。这项分析将基于对唐纳德研究(德国多特蒙德)3-17岁参与者在上述期间收集的7000多个24小时尿样的磷排泄的测量。然后将检查儿童和青少年时期高磷摄入量的潜在长期后果，以确定成年后与肾脏健康相关的不同结果。特别是，将分析特定的肾病和内分泌代谢结果，目的是评估儿童和青年饮食中高磷摄入量与低磷摄入量的预期重要性。成年唐纳德参与者的肾功能将通过测量尿白蛋白排泄量、肾小球滤过率、肌酐清除量、肾酸排泄量和循环尿调素来检查。此外，还将通过儿茶酚胺代谢物测定甲状旁腺激素、成纤维细胞生长因子23和α-Klotho等磷酸盐调节激素以及交感肾上腺素活性。相关混淆将通过早期生活因素、社会经济状况、人体测量特征、代谢标志物以及进一步的潜在影响因素进行考虑。此外，应检查是否至少部分观察到的磷摄入量和结果之间的关系也可以通过重复收集的24小时尿样的PRAL测量来解释习惯性的、相当高的饮食酸负荷、基于量化生物标志物的测量。因此，可以另外获得关于主要以植物为主、至少部分碱化的饮食(如地中海饮食或DASH饮食)所报告的肾脏健康益处是否可能是习惯性地减少饮食酸性负荷所致的初步信息。