{"title":"Higher dietary insulinemic potential is associated with kidney stones: a nationally representative cross-sectional study.","authors":"Bao Zhang, Mengsha Tang, Xiude Li","doi":"10.1186/s12937-025-01163-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Insulin response may significantly contribute to the formation of kidney stones. Diets can modulate the insulin response and we hypothesize that high insulinemic potential diets may increase the kidney stones risk.</p><p><strong>Methods: </strong>Data were from the US National Health and Nutrition Examination Survey. Diets were assessed by 24-hour dietary recall. Two empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH) were used to reflect the dietary insulinemic potential. Diagnosis of kidney stones was based on self-report. Logistic regression was employed to calculate ORs and 95% CIs while adjusting for variables identified through a directed acyclic graph (DAG).</p><p><strong>Results: </strong>Higher EDIR [OR<sub>Tertile 3 vs. Tertile 1</sub> = 1.31 (95% CI: 1.13-1.53); OR<sub>Per-standard deviation increase</sub>= 1.11 (95% CI: 1.05-1.18); p<sub>trend</sub> = 0.001] and EDIH [OR<sub>Tertile 3 vs. Tertile 1</sub> = 1.26 (95% CI: 1.08-1.47); OR<sub>Per-standard deviation increase</sub>= 1.10 (95% CI: 1.04-1.16); p<sub>trend</sub> = 0.001] scores were both positively associated with kidney stones. The conclusion remains unchanged in the sensitivity analysis after adjusting for potential mediating factors that were identified from the DAG, including BMI, hypertension, and diabetes. Subgroup analysis showed that results in most subgroups were consistent with the main analysis.</p><p><strong>Conclusions: </strong>This study indicates that the insulinemic potential of diet may partly underlie the influence of dietary patterns on kidney stones, emphasizing the importance of avoiding dietary patterns with insulinemic potential.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"24 1","pages":"93"},"PeriodicalIF":3.8000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175452/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12937-025-01163-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Insulin response may significantly contribute to the formation of kidney stones. Diets can modulate the insulin response and we hypothesize that high insulinemic potential diets may increase the kidney stones risk.
Methods: Data were from the US National Health and Nutrition Examination Survey. Diets were assessed by 24-hour dietary recall. Two empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH) were used to reflect the dietary insulinemic potential. Diagnosis of kidney stones was based on self-report. Logistic regression was employed to calculate ORs and 95% CIs while adjusting for variables identified through a directed acyclic graph (DAG).
Results: Higher EDIR [ORTertile 3 vs. Tertile 1 = 1.31 (95% CI: 1.13-1.53); ORPer-standard deviation increase= 1.11 (95% CI: 1.05-1.18); ptrend = 0.001] and EDIH [ORTertile 3 vs. Tertile 1 = 1.26 (95% CI: 1.08-1.47); ORPer-standard deviation increase= 1.10 (95% CI: 1.04-1.16); ptrend = 0.001] scores were both positively associated with kidney stones. The conclusion remains unchanged in the sensitivity analysis after adjusting for potential mediating factors that were identified from the DAG, including BMI, hypertension, and diabetes. Subgroup analysis showed that results in most subgroups were consistent with the main analysis.
Conclusions: This study indicates that the insulinemic potential of diet may partly underlie the influence of dietary patterns on kidney stones, emphasizing the importance of avoiding dietary patterns with insulinemic potential.
期刊介绍:
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.