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Diabetes Care ; 41(8): 1615-1622, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29903846

RESUMEN

OBJECTIVE: We assessed the association between diet quality and microalbuminuria in youth-onset type 1 diabetes using three indices: a modified Mediterranean diet score for children and adolescents (mKIDMED), the Dietary Approaches to Stop Hypertension (DASH), and the Healthy Eating Index-2010 (HEI). RESEARCH DESIGN AND METHODS: Youth and young adults from the SEARCH (SEARCH for Diabetes in Youth) Nutrition Ancillary Study (SNAS) diagnosed with type 1 diabetes in 2002-2008, who had repeated dietary assessments at baseline and follow-up visits and urine albumin-to-creatinine ratio (UACR) measured at the outcome visit (2012-2015) (n = 461), were selected for study. Regression models estimated the association between each longitudinally assessed diet score and UACR and microalbuminuria (UACR ≥30 µg/mg). RESULTS: The cohort was 43% female, and at follow-up, mean age was 20 years, disease duration was 108 months, and 7% had microalbuminuria. Adherence to a higher-quality diet was low for the mKIDMED (mean 3.7 of a possible range of -3 to 12) and the DASH (mean 42 of 80) and better, for the HEI (mean 56.3 of 100). A borderline inverse association was observed between the HEI score and microalbuminuria after adjustment for caloric and protein intake and demographic and disease factors (odds ratio [OR]HEI 0.83, P = 0.07), which lost significance with further adjustment for HbA1c and systolic blood pressure (ORHEI 0.86, P = 0.19). Results were similar for continuous UACR. No significant associations were observed for diet quality characterized by the mKIDMED or DASH indices. CONCLUSIONS: Greater adherence to the HEI may be beneficial for kidney health in youth and young adults with type 1 diabetes. Low adherence to the mKIDMED and DASH diets may explain the lack of association with microalbuminuria.


Asunto(s)
Albuminuria/epidemiología , Diabetes Mellitus Tipo 1/epidemiología , Nefropatías Diabéticas/epidemiología , Dieta , Conducta Alimentaria/fisiología , Adolescente , Adulto , Albuminuria/complicaciones , Niño , Estudios de Cohortes , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/dietoterapia , Nefropatías Diabéticas/etiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Encuestas Nutricionales , Estado Nutricional , Factores de Tiempo , Estados Unidos/epidemiología , Adulto Joven
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