RESUMEN
A dietary diversity score (DDS) may be a useful strategy for monitoring risks associated with chronic diseases. Few studies have investigated the relationship between DDS and the progression to chronic kidney disease (CKD). A better understanding of the relationship between DDS and diabetic nephropathy (DN) may provide insight for monitoring the overall diet and clinical outcomes. This case-control study included 105 women with DN and 105 controls with age and diabetes duration-matched to evaluate the extent to which DDS is associated with DN. Dietary intake was assessed using the food frequency questionnaire (FFQ). DDS was calculated based on the method using five food groups: bread/grains, vegetables, fruits, meats, and dairies. Conditional logistic regression was performed to examine the association between DDS and odds of DN. Anthropometric measures and physical activity levels were evaluated using standard protocols. In a fully adjusted model [controlled for age, body mass index (BMI), energy intake, physical activity, diabetes duration, cardiovascular disease history, and drug usage], greater adherence (the third vs. the first tertile) to DDS [odds ratio (OR) = 0.13; 95% CI (0.05-0.35)], vegetables group [OR = 0.09; 95% CI (0.02-0.36)], and fruits group [OR = 0.05; 95% CI (0.01-0.20)] were significantly associated with lower odds of DN. However, we did not observe any significant relationship between other DDS components and the odds of DN. Our findings showed that higher DDS might be associated with reduced odds of DN. However, more prospective studies are warranted to confirm these findings.
RESUMEN
BACKGROUND: Several studies have investigated the association between dietary protein and the risk of diabetic nephropathy (DN); however, there is no agreement on the type of dietary protein sources that might increase the risk of DN. This study was conducted to investigate the associations between different protein sources and the odds of DN developing in Iranian women with existing type 2 diabetes. METHODS: In this case-control study, 105 women with DN and 105 controls, matched for age and diabetes duration, were selected from the Kowsar Diabetes Clinic in Semnan, Iran. Dietary intake was assessed using a validated and reliable food frequency questionnaire. Dietary protein patterns were estimated using the factor analysis method. Multivariate logistic regression was performed to examine the association between protein patterns and the odds of developing DN. RESULTS: Two patterns were identified: the Mediterranean-based Dietary Protein Sources (MDPS) pattern which is rich in low-fat dairy, fish, poultry, soy, and legumes, and the Western-based Dietary Protein Sources (WDPS) pattern, rich in red and processed meats, eggs, and high-fat dairy. After adjusting for several confounders, greater adherence (third vs. the first tertile) to the MDPS pattern was associated with lower odds of DN (OR = 0.03; 95 % CI: 0.00, 0.10). In contrast, a strong positive association was observed between adherence to the WDPS pattern and DN (OR = 2.81; 95 % CI: 1.09-7.21). CONCLUSIONS: Our results show that there is a potential association between the type of protein sources consumed and the odds of DN development in women with type 2 diabetes. Further studies are needed to confirm these findings.
