Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2024; 15(3): 475-487
Published online Mar 15, 2024. doi: 10.4239/wjd.v15.i3.475
Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes: A cross-sectional study
Xin-Hua Jia, Sheng-Yan Wang, Ai-Qin Sun
Xin-Hua Jia, Sheng-Yan Wang, Department of Critical Care Medicine, Dezhou People’s Hospital, Dezhou 253000, Shandong Province, China
Ai-Qin Sun, Emergency Intensive Care Unit, Dezhou People’s Hospital, Dezhou 253000, Shandong Province, China
Author contributions: Jia XH made significant contributions to research design, data collection, analysis, manuscript writing, and revision; Wang SY contributed to research design and data collection; Sun AQ played a pivotal role in data analysis; all authors have read and approve the final manuscript.
Institutional review board statement: Ethical review and approval were waived for this study because no additional institutional review board approval was required for the secondary analysis.
Informed consent statement: The data for this study were sourced from the National Center for Health Statistics (NCHS) database. The National Health and Nutrition Examination Survey received authorization from the Ethics Review Committee of the NCHS, and all participants duly completed written informed consent forms prior to their engagement.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Publicly accessible datasets pertinent to this study are accessible online. The nomenclature of the repository/repositories can be found at the following web address: http://www.cdc.gov/nchs/nhanes.htm.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Hua Jia, Doctor, Attending Doctor, Department of Critical Care Medicine, Dezhou People’s Hospital, No. 1166 Dongfanghong West Road, Dezhou 253000, Shandong Province, China. jxinhua2023@163.com
Received: December 15, 2023
Peer-review started: December 15, 2023
First decision: December 23, 2023
Revised: January 5, 2024
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 15, 2024
ARTICLE HIGHLIGHTS
Research background

This study focused on the relationship between dietary fiber (DF) intake and diabetic kidney disease (DKD) in individuals with type 2 diabetes (T2D). The prevalence of T2D is increasing globally. The protective effect of DF against T2D is acknowledged, but its specific impact on DKD remains unclear. DKD poses a substantial health burden, underscoring the importance of investigating modifiable factors such as DF intake for potential preventive strategies.

Research motivation

The main topics driving this research included understanding the potential protective role of DF against DKD, a complication frequently associated with T2D. Key problems to be addressed include the lack of conclusive evidence on the DF-DKD relationship and the need for targeted interventions to mitigate DKD risk in T2D patients. Solving these problems is crucial for future research on diabetes management and the prevention of kidney disease.

Research objectives

The primary objective of this study was to investigate the association between DF intake and the prevalence of DKD in T2D individuals. Realizing these objectives contributes to filling gaps in the current knowledge regarding the role of DF in DKD prevention, providing insights for future research to refine dietary recommendations for individuals with T2D.

Research methods

This study employed a cross-sectional design utilizing National Health and Nutrition Examination Survey data collected between 2005 and 2018. DF intake was assessed through 24-h dietary recall interviews, and DKD diagnosis was based on predefined criteria, including albuminuria and impaired glomerular filtration rate. This study employed various statistical methods including multiple regression models, restricted cubic splines, stratified analysis with interactions, and sensitivity analysis.

Research results

Of the 6032 participants, 38.4% presented with DKD. The study reveals a significant association between higher DF intake and reduced odds of DKD, particularly in the highest intake tier (T3: ≥ 10.1 g/1000 kcal/day).

Research conclusions

This study proposes that an increased DF intake is associated with a reduced incidence of DKD in adults with T2D. These findings contribute to the field by suggesting potentially modifiable factors for DKD prevention of T2D in individuals.

Research perspectives

Future research should delve deeper into the mechanisms underlying this observed association and explore the feasibility of dietary interventions to prevent or manage DKD in T2D patients. Additionally, longitudinal studies are warranted to establish causality and inform evidence-based dietary guidelines for individuals with T2D at risk of DKD.