Table_5_Lower body mass index potentiates the association between skipping breakfast and prevalence of proteinuria.pdf

BackgroundProteinuria is an important predictor of cardiovascular disease and mortality. Several studies reported the association between skipping breakfast and the prevalence of proteinuria. Furthermore, skipping breakfast was associated with an increased risk of obesity. Although proteinuria is highly prevalent in obese individuals, the association between the prevalence of proteinuria and low body mass index (BMI) was reported in a previous cross-sectional study in asymptomatic individuals without known kidney diseases. The aim of this cross-sectional study was to assess the clinical impact of BMI on the association between skipping breakfast and the prevalence of proteinuria in normal renal function subjects.
MethodsThe present study included 26,888 subjects (15,875 males and 11,013 females) with an estimated glomerular filtration rate ≥60 ml/min/1.73 m2 and no history of kidney disease who underwent a health checkup in Sumitomo Hospital. The association between skipping breakfast and the prevalence of proteinuria (defined as dipstick proteinuria of ≥1+) was assessed using logistic regression models adjusted for clinically relevant factors.
ResultsSkipping breakfast was reported in 3,306 males (20.8%) and 1,514 females (13.8%). Multivariable adjusted logistic regression models showed that skipping breakfast was significantly associated with the prevalence of proteinuria above 1+. This association was evident in lower BMI subjects, even after adjusting for clinically relevant factors (adjusted odds ratios of males and females were 1.67 [1.17–2.38] and 1.92 [1.31–2.82], respectively), whereas this association was not evident in higher BMI subjects.
ConclusionLower BMI subjects with proteinuria might need to be careful about skipping breakfast.

背景：蛋白尿(Proteinuria)是心血管疾病与死亡的重要预测因子。多项研究已报道了不吃早餐与蛋白尿患病率之间的关联。此外，不吃早餐与肥胖风险升高存在相关性。尽管肥胖个体的蛋白尿患病率极高，但此前一项针对无已知肾脏疾病的无症状人群的横断面研究显示，蛋白尿患病率与低体质量指数(BMI)存在关联。本项横断面研究旨在评估体质量指数对肾功能正常人群中，不吃早餐与蛋白尿患病率之间关联的临床影响。
方法：本研究纳入了26888名研究对象（男性15875名，女性11013名），这些对象均在住友医院接受健康检查，估算肾小球滤过率(estimated glomerular filtration rate)≥60 ml/min/1.73㎡，且无肾脏疾病病史。本研究采用针对临床相关混杂因素校正的logistic回归(logistic regression)模型，分析不吃早餐与蛋白尿（定义为尿试纸检测蛋白尿≥1+）患病率之间的关联。
结果：研究显示，3306名男性（占比20.8%）与1514名女性（占比13.8%）存在不吃早餐的情况。经多因素校正的logistic回归模型结果表明，不吃早餐与蛋白尿≥1+的患病率显著相关。该关联在低体质量指数人群中依然显著，即使在校正临床相关混杂因素后仍成立（男性与女性的校正比值比分别为1.67[1.17~2.38]和1.92[1.31~2.82]）；而在高体质量指数人群中，上述关联并不显著。
结论：伴蛋白尿的低体质量指数人群需谨慎避免不吃早餐。