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Association of dietary iron intake with diabetic kidney disease among individuals with diabetes

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Abstract

Purpose

The current study investigated the correlation between dietary iron intake and diabetic kidney disease among diabetic adults.

Methods

This cross-sectional study enrolled 8118 participants who suffered from diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Dietary iron intake was obtained from 24 h recall interviews, and diabetic kidney disease was defined as eGFR < 60 mL/min per 1.73 m2 or albumin creatinine ratio (ACR) ≥ 30 mg/g. Three weighted logistic regression models were utilized to investigate odd ratio (OR) and 95% CIs for diabetic kidney disease. Stratified analyses were performed by gender, age, BMI, HbA1c, hypertension status, and smoking status, and diabetes types.

Results

Among 8118 participants (51.6% male, mean age 61.3 years), 40.7% of participants suffered from diabetic kidney disease. With the adjustment of potential covariates, we found that ≥ 12.59 mg of dietary iron was related to a lower risk of diabetic kidney disease (OR = 0.78, 95% CI: 0.63 to 0.96; OR = 0.79, 95% CI: 0.63 to 0.98). In stratified analyses, higher iron intake was negatively related to diabetic kidney disease, especially among those who were male, < 60 years, those with hypertension, those with HbA1c < 7.0%, and those who were ex-smokers. The result remained robust in sensitivity analyses.

Conclusion

We found that ≥ 12.59 mg of dietary iron is associated with a lower risk of diabetic kidney disease, especially in those who were male, younger, heavier weight, have better blood sugar control, and those who were ex-smokers.

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Funding

This work was supported by research grants from the National Natural Science Foundation of China (Z.Z., 82270862, 81700730), (Y.J., 82370818, 82000785); the Guangzhou Science and Technology Project (Y.J.,2024A04J5098); and the National Undergraduate Training Program for Innovation and Entrepreneurship, Southern Medical University (Z.Z., 202312121031, Y.J., S202312121167).

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Authors and Affiliations

  1. Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Yichuan Wu, Manlu Xiao, Jiaqi Chen, Yuan Tao, Aomiao Chen, Huanjia Lin, Ying Xu, Linna Li, Hongxia Jia, Yaoming Xue, Yijie Jia & Zongji Zheng

  2. De Feng Academy, Southern Medical University, Guangzhou, China

    Yichuan Wu, Yuan Tao, Aomiao Chen, Huanjia Lin, Ying Xu, Yijie Jia & Zongji Zheng

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  1. Yichuan Wu
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Contributions

Y.W., Z.Z., Y.J., and Y.X. designed this study, Y.W., M.X., and J.C. performed the data extraction and statistical analysis. Y.T., H.L., L.L., Y.X., A.C., and H.J. validated the statistical analysis. Y.W. wrote the original draft of the manuscript, which was revised by Z.Z. Y.J. and Y.X. All authors made great contributions to the manuscript and approved it for submission. Z.Z. and Y.J. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Yaoming Xue, Yijie Jia or Zongji Zheng.

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Wu, Y., Xiao, M., Chen, J. et al. Association of dietary iron intake with diabetic kidney disease among individuals with diabetes. Endocrine (2024). https://doi.org/10.1007/s12020-024-03819-y

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