Plasma Metabolomics of Dietary Intake of Protein-Rich Foods and Kidney Disease Progression in Children

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition Pub Date : 2024-03-01 DOI:10.1053/j.jrn.2023.10.007

Xuyuehe Ren MHS , Jingsha Chen MS , Alison G. Abraham PhD , Yunwen Xu PhD, MHS , Aisha Siewe PhD , Bradley A. Warady MD , Paul L. Kimmel MD , Ramachandran S. Vasan MD , Eugene P. Rhee MD , Susan L. Furth MD, PhD , Josef Coresh MD, PhD , Michelle Denburg MD, MSCE , Casey M. Rebholz PhD, MS, MNSP, MPH , Chronic Kidney Disease Biomarkers Consortium

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引用次数: 0

Abstract

Objective

Evidence regarding the efficacy of a low-protein diet for patients with CKD is inconsistent and recommending a low-protein diet for pediatric patients is controversial. There is also a lack of objective biomarkers of dietary intake. The purpose of this study was to identify plasma metabolites associated with dietary intake of protein and to assess whether protein-related metabolites are associated with CKD progression.

Methods

Nontargeted metabolomics was conducted in plasma samples from 484 Chronic Kidney Disease in Children (CKiD) participants. Multivariable linear regression estimated the cross-sectional association between 949 known, nondrug metabolites and dietary intake of total protein, animal protein, plant protein, chicken, dairy, nuts and beans, red and processed meat, fish, and eggs, adjusting for demographic, clinical, and dietary covariates. Cox proportional hazards models assessed the prospective association between protein-related metabolites and CKD progression defined as the initiation of kidney replacement therapy or 50% eGFR reduction, adjusting for demographic and clinical covariates.

Results

One hundred and twenty-seven (26%) children experienced CKD progression during 5 years of follow-up. Sixty metabolites were significantly associated with dietary protein intake. Among the 60 metabolites, 10 metabolites were significantly associated with CKD progression (animal protein: n = 1, dairy: n = 7, red and processed meat: n = 2, nuts and beans: n = 1), including one amino acid, one cofactor and vitamin, 4 lipids, 2 nucleotides, one peptide, and one xenobiotic. 1-(1-enyl-palmitoyl)-2-oleoyl-glycerophosphoethanolamine (GPE, P-16:0/18:1) was positively associated with dietary intake of red and processed meat, and a doubling of its abundance was associated with 88% higher risk of CKD progression. 3-ureidopropionate was inversely associated with dietary intake of red and processed meat, and a doubling of its abundance was associated with 48% lower risk of CKD progression.

Conclusions

Untargeted plasma metabolomic profiling revealed metabolites associated with dietary intake of protein and CKD progression in a pediatric population.

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富含蛋白质食物的膳食摄入与儿童肾脏疾病进展的血浆代谢组学。

目的：关于低蛋白饮食对CKD患者的疗效，有不一致的证据，建议儿童患者使用低蛋白饮食是有争议的。饮食摄入也缺乏客观的生物标志物。本研究的目的是确定与蛋白质饮食摄入相关的血浆代谢产物，并评估蛋白质相关代谢产物是否与CKD进展相关。方法：对484名儿童慢性肾脏病（CKiD）参与者的血浆样本进行非靶向代谢组学研究。多变量线性回归估计了949种已知的非药物代谢产物与总蛋白、动物蛋白、植物蛋白、鸡肉、乳制品、坚果和豆类、红肉和加工肉、鱼和蛋的饮食摄入量之间的横断面关联，并对人口统计学、临床和饮食协变量进行了调整。Cox比例风险模型评估了蛋白质相关代谢产物与CKD进展之间的前瞻性关联，CKD进展定义为开始肾脏替代治疗或eGFR降低50%，并对人口统计学和临床协变量进行了调整。结果：127名（26%）儿童在5年的随访中出现CKD进展。60种代谢产物与膳食蛋白质摄入显著相关。在60种代谢产物中，有10种代谢产物与CKD进展显著相关（动物蛋白：n=1，乳制品：n=7，红肉和加工肉：n=2，坚果和豆类：n=1），包括一种氨基酸、一种辅因子和维生素、四种脂质、两种核苷酸、一种肽和一种异生素。1-（1-苯基对乙酰氨基）-2-油酰基-甘油磷酸乙醇胺（GPE，P-16:0/18:1）与红肉和加工肉的饮食摄入呈正相关，其丰度增加一倍与CKD进展风险增加88%相关。3-脲基丙酸酯与红肉和加工肉的饮食摄入呈负相关，其丰度增加一倍可降低48%的CKD进展风险。结论：未靶向血浆代谢组学分析揭示了儿童人群中与蛋白质饮食摄入和CKD进展相关的代谢产物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Renal Nutrition 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

12.50%

发文量

146

审稿时长

6.7 weeks

期刊介绍： The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.