Original Investigations: Pathogenesis and Treatment of Kidney Disease and HypertensionAssociation of dietary protein intake and microalbuminuria in healthy adults: Third National Health and Nutrition Examination Survey*,**,*
Section snippets
Study population and design
This study includes participants from the Third National Health and Nutrition Examination Survey (NHANES III). The NHANES III is a stratified multistage probability sample of the civilian noninstitutionalized US population that was conducted by the National Center for Health Statistics from 1988 to 1994. Survey participants are non-Hispanic whites, blacks, and Mexican Americans aged 2 months and older, with oversampling of participants who were young, elderly, black, or Mexican American to
Results
The distribution of demographic characteristics, dietary components, and comorbidities by quintiles of DPI is listed in Table 1.
Empty Cell Quintiles of Protein (% of energy) Covariates 1 (low) (<11.7) 2 (11.7-<14.0) 3 (14.0-<16.2) 4 (16.2-<19.0) 5 (high) (≥19.0) Age (y) 39.3 ± 0.5 41.6 ± 0.5 42.5 ± 0.5 43.8 ± 0.5 44.7 ± 0.7 Sex (% women) 52.5 49.3 48.7 49.1 49.6 Race (%) White 79.2 78.8 76.6 76.0 71.6 Black 11.1 9.6 10.0 10.1 10.7 Mexican
Discussion
In this study, we describe the association between DPI and MA and mean urinary ACR in adults with normal renal function and no clinical proteinuria. We observed that DPI was not associated with MA or ACR in healthy persons or those with isolated hypertension or diabetes. However, in persons with both conditions, high DPI was associated with an increased prevalence of MA in both adjusted and unadjusted models. Although we cannot comment on causality because of the cross-sectional design, these
Acknowledgements
The authors thank Dr Christopher Gardner for insightful discussions.
References (30)
- et al.
Microalbuminuria in the US population: Third National Health and Nutrition Examination Survey
Am J Kidney Dis
(2002) - et al.
Serum homocysteine level and protein intake are related to risk of microalbuminuria: The Hoorn Study
Kidney Int
(1998) - et al.
A solid phase fluorescent immunoassay for the measurement of human urinary albumin
Kidney Int
(1984) - et al.
Usefulness of microalbuminuria in predicting cardiovascular mortality in treated hypertensive men with and without diabetes mellitus
Risk Factor Intervention Study Group
Am J Cardiol
(1997) - et al.
Urinary albumin excretion—A predictor of risk of cardiovascular disease. A prospective 10-year follow-up of middle-aged nondiabetic normal and hypertensive men
Am J Hypertens
(1996) - et al.
The hyperfiltration theory: A paradigm shift in nephrology
Kidney Int
(1996) Dietary therapy in uremia: The impact on nutrition and progressive renal failure
Kidney Int Suppl
(2000)- et al.
Microalbuminuria is positively associated with usual dietary saturated fat intake and negatively associated with usual dietary protein intake in people with insulin-dependent diabetes mellitus
Am J Clin Nutr
(1998) - et al.
Elevated blood pressure among US adults with diabetes, 1988-1994
Am J Prev Med
(2002) - et al.
Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals
JAMA
(2001)
Microalbuminuria and cardiovascular risk
Q J Med
Arterial hypertension, microalbuminuria, and risk of ischemic heart disease
Hypertension
The effect of dietary protein restriction on the progression of diabetic and nondiabetic renal diseases: A meta-analysis
Ann Intern Med
Protein intake and urinary albumin excretion rates in the EURODIAB IDDM Complications Study
Diabetologia
Dietary protein and weight reduction: A statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association
Circulation
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Supported in part by National Research Service Award (NRSA) no. 5 T32 HL 07034 (M.R.C.) to the Stanford Center for Research in Disease Prevention and Individual NRSA no. F32 HL 10338-01 (L.P.) from the National Heart, Lung, and Blood Institute.
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Address correspondence to Mercedes R. Carnethon, PhD, Department of Preventive Medicine, The Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Ste 1102, Chicago, IL 60611. E-mail: [email protected]
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