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DASH Diet, Reduced Rank Regression Dietary Patterns and Relations with Kidney Function in the CHRIS General Population Study

medrxiv(2024)

University of Verona

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Abstract
Objective: We assessed dietary patterns (DPs) using the pre-defined Dietary Approaches to Stop Hy-pertension (DASH) score and reduced rank regression (RRR) to evaluate their association with esti-mated glomerular filtration rate (eGFR) in a general population sample. Methods: We analysed cross-sectional data from 6,133 healthy adult participants of the Cooperative Health Research In South Tyrol (CHRIS) study. Using self-reported food frequency questionnaire data, we derived the DASH-score and two RRR-based sex-specific DP-scores based on nine cardio-renal-metabolic parameters. We fitted sex-stratified linear and non-linear models to assess associations with creatinine-based eGFR. Results: Males with higher intake of cereals, whole grains, sugar, fruits, and legumes, and lower intake of beer, and red and processed meat (MDP1), exhibited higher eGFR levels. Coherently, high adher-ence to the DASH-style diet was associated with higher eGFR. In females, the associations varied by menstrual status. Among those with ceased menstruation, a low intake of meat, spirits, refined grains, beer, and fish, and a high intake of whole grains and dairy products was associated with higher eGFR. In females still experiencing regular menstruation, a high intake of beef, nuts, beer, legumes, fish, and coffee, and low intake of refined grains, (FDP2) was associated with lower eGFR. No association was observed with the DASH score in females. Conclusion: Our findings confirm the DASH-style diet is associated with better kidney function in males, but not in females. By identifying sex-specific kidney function-oriented DPs, the RRR approach provides new insights into the diet-eGFR relation, highlighting in addition potential effect modification by menstrual status. ### Competing Interest Statement CP is consultant for Quotient Therapeutics. PMF received consultant fees and grants or other support from Allena Pharmaceuticals, Alnylam, Amgen, AstraZeneca, Bayer, Gilead, Novo Nordisk, Otsuka Pharmaceuticals, Rocchetta, Vifor Fresenius, and royalties as an author for UpToDate. All other authors declared no conflict of interest. ### Funding Statement The CHRIS Study was funded by the Autonomous Province of Bolzano-South Tyrol - Department of In-novation, Research, University and Museums and supported by the European Regional Development Fund (FESR1157). This work was funded through a Eurac Research Head Office funded the PhD schol-arship, established in collaboration with University of Verona. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics Committee of the Healthcare System of the Autonomous Province of Bolzano-South Tyrol approved the CHRIS baseline protocol on 19 April 2011 (21-2011). The study conforms to the Declara-tion of Helsinki, and with national and institutional legal and ethical requirements. All participants in-cluded in the analysis gave written informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data and samples can be requested for clearly defined research via the CHRIS Portal (CHRIS Portal - Eurac Research: https://chrisportal.eurac.edu/).
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要点】:本文通过预定义的DASH评分和降秩回归方法评估了饮食模式与估算肾小球滤过率(eGFR)的关系,发现DASH饮食与男性更好的肾功能相关,而在女性中这种关系不明显,且饮食模式与肾功能的关系受到月经状况的影响。

方法】:使用来自CHRIS研究的6133名健康成年参与者的横断面数据,通过自我报告的食物频率问卷数据得出DASH评分和基于九个心肺肾代谢参数的两个降秩回归方法得出的性别特异饮食模式评分。

实验】:通过拟合性别分层的线性和非线性模型评估饮食模式与基于肌酐的eGFR的关联,发现不同性别和月经状况下的饮食模式与eGFR有不同关联。