Healthy adult vegetarians have better renal function than matched omnivores: a cross-sectional study in China

Xu, Kaijie; Cui, Xueying; Wang, Bian; Tang, Qingya; Cai, Jun; Shen, Xiaoping

doi:10.1186/s12882-020-01918-2

Cited by 11 publications

(5 citation statements)

References 42 publications

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“…There has been limited evidence on comparisons of renal biomarkers between vegetarians and nonvegetarians, although several small studies have reported lower serum ( 51 ) or urinary creatinine ( 52 ) or lower blood urea nitrogen (a correlate of serum urea) ( 51 ) in vegetarians or vegans, for which large differences were found in our study. Similar to current findings, previous analyses in the UK EPIC-Oxford cohort have found that compared with meat eaters, fish eaters and vegetarians had lower concentrations of serum uric acid (also known as urate), whereas vegans had the highest concentrations ( 53 ), possibly due to their exclusion of dairy products and subsequently reduced excretion of uric acid ( 54 ).…”

Section: Discussioncontrasting

confidence: 59%

Biomarker Concentrations in White and British Indian Vegetarians and Nonvegetarians in the UK Biobank

Tong

Pérez-Cornago

Bradbury

et al. 2021

The Journal of Nutrition

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Background Prospective studies have shown differences in some disease risks between vegetarians and nonvegetarians, but the potential biological pathways are not well understood. Objectives We aimed to assess differences in concentrations of biomarkers related to disease pathways in people with varying degrees of animal foods exclusion. Methods The UK Biobank recruited 500,000 participants aged 40–69 y (54.4% women) throughout the United Kingdom in 2006–2010. Blood and urine were collected at recruitment and assayed for more than 30 biomarkers related to cardiovascular diseases, bone and joint health, cancer, diabetes, renal disease, and liver health. In cross-sectional analyses, we estimated adjusted geometric means of these biomarkers by 6 diet groups (regular meat eaters, low meat eaters, poultry eaters, fish eaters, vegetarians, vegans) in 466,058 white British participants and 2 diet groups (meat eaters, vegetarians) in 5535 British Indian participants. Results We observed differences in the concentrations of most biomarkers, with many biomarkers showing a gradient effect from meat eaters to vegetarians/vegans. Of the largest differences, compared with white British regular meat eaters, white British vegans had lower C-reactive protein [adjusted geometric mean (95% CI): 1.13 (1.03, 1.25) compared with 1.43 (1.42, 1.43) mg/L], lower low-density lipoprotein cholesterol [3.13 (3.07, 3.20) compared with 3.65 (3.65, 3.65) mmol/L], lower vitamin D [34.4 (33.1, 35.9) compared with 44.5 (44.4, 44.5) nmol/L], lower serum urea [4.21 (4.11, 4.30) compared with 5.36 (5.36, 5.37) mmol/L], lower urinary creatinine [5440 (5120, 5770) compared with 7280 (7260, 7300) μmol/L], and lower γ-glutamyltransferase [23.5 (22.2, 24.8) compared with 29.6 (29.6, 29.7) U/L]. Patterns were mostly similar in British Indians, and results were consistent between women and men. Conclusions The observed differences in biomarker concentrations, including lower C-reactive protein, lower LDL cholesterol, lower vitamin D, lower creatinine, and lower γ-glutamyltransferase, in vegetarians and vegans may relate to differences in future disease risk.

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Section: Discussioncontrasting

confidence: 59%

Biomarker Concentrations in White and British Indian Vegetarians and Nonvegetarians in the UK Biobank

Tong

Pérez-Cornago

Bradbury

et al. 2021

The Journal of Nutrition

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“…A study in Thailand revealed a significantly lower level of BUN, BUN/creatinine ratio and a lower urinary protein excretion rate in vegans compared to nonvegans, 21 while a recent cross‐sectional study in China reported that vegetarians had better kidney function parameters than nonvegetarians, also after adjustment for possible confounding factors. 22 In another cross‐sectional study on 55,113 participants from Taiwan, VD was significantly associated with lower prevalence of CKD, 23 and similar findings were reported in two prospective cohort studies after 6.1 years 24 and 24 years 25 of follow‐up.…”

Section: Discussionsupporting

confidence: 58%

Effects of vegetarian versus Mediterranean diet on kidney function: Findings from the CARDIVEG study

Dinu

Colombini

Pagliai

et al. 2021

Eur J Clin Investigation

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Background:The aim of the present study was to assess the effects of a lacto-ovovegetarian diet (VD), compared to a Mediterranean diet (MD), on kidney function in a group of subjects with medium-to-low cardiovascular risk profile. Methods: We analysed 107 subjects (82 women, 25 men; median age 52) who followed a VD (n = 54) and a MD (n = 53) for 3 months in the CARDIVEG study, a randomized, open, crossover trial that compared the effects of these 2 diets on cardiovascular disease risk. Results: The effect of the two diets on kidney function markers was evaluated by conducting a general linear model for repeated measurements adjusted for possible confounding factors such as age, sex, physical activity, alcohol, smoking, hypertension, LDL cholesterol, glucose and body weight change. A significant reduction in creatinine (−5.3%; P < .001), urea nitrogen levels (−9%; P = .001), blood urea nitrogen (BUN) (−8.7%; P = .001) and BUN/creatinine ratio (−5.8%; P < .001), and an increase in estimated glomerular filtration rate (eGFR) (+3.5%; P = .001) was observed during the VD period. On the contrary, no significant changes were noted in the MD group. Variations obtained in the two dietary interventions were significantly different (P < .0001) for creatinine levels, BUN/creatinine and eGFR, for which opposite trends were observed in the VD and MD groups. Conclusions: In a selected group of subjects with medium-to-low cardiovascular risk profile, a 3 month VD period determined significant improvements in kidney function markers. Further trials are needed to confirm these results.

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“…There is evidence to suggest that dietary factors, particularly protein and the amino acid leucine, play a critical role in promoting muscle protein synthesis and preserving muscle mass [42,43]. Vegetarians have considerably lower serum creatinine concentrations than omnivores in numerous big cross-sectional investigations [44,45]. Interestingly, an animal study revealed that insufficient nutrition during the first half of pregnancy is associated with later metabolic abnormalities and favors a diabetogenic condition in the pregnant mother [46].…”

Section: Discussionmentioning

confidence: 99%

Low Serum Creatinine Levels in Early Pregnancy Are Associated with a Higher Incidence of Postpartum Abnormal Glucose Metabolism among Women with Gestational Diabetes Mellitus: A Retrospective Cohort Study

Chen

Zeng

et al. 2023

Nutrients

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The predictive factors for the progression from gestational diabetes mellitus (GDM) to type 2 diabetes remain incompletely elucidated. Our objective was to investigate the link between serum creatinine, a proxy for skeletal muscle mass, and the development of postpartum abnormal glucose metabolism (AGM). Methods: A retrospective review of the medical records of 501 women with GDM was conducted, all of whom underwent a 75 g oral glucose tolerance test (OGTT) between 4 and 12 weeks postpartum. Women were grouped based on quartiles of serum creatinine at the first antenatal visit to estimate the association between serum creatinine and postpartum AGM incidence. Results: Compared with the highest quartile of creatinine, lower quartiles were substantially linked to an increased incidence of postpartum AGM (adjusted odds ratios 3.37 [95% CI 1.77–6.42], 2.42 [95% CI 1.29–4.51] and 2.27 [95% CI 1.23–4.18], respectively). The generalized additive model suggested a linear relationship between serum creatinine levels and the risk of postpartum AGM below 68 µmol/L of serum creatinine levels. A decrease of 2 μmol/L in serum creatinine levels was found to be associated with a 10% increase in the odds of developing postpartum AGM. Linear regression revealed that a low serum creatinine level was linked to a higher postpartum 2-h glucose level and a decreased insulinogenic index (p = 0.007 and p = 0.027, respectively). Conclusions: An association was observed between lower serum creatinine levels in early pregnancy and an increased risk of postpartum AGM and poorer β-cell function in women with a recent history of GDM. Further research is needed to understand the mechanisms underlying our findings, as well as the role of skeletal muscle mass or nutritional status in early pregnancy on later glucose metabolism.

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Healthy adult vegetarians have better renal function than matched omnivores: a cross-sectional study in China

Cited by 11 publications

References 42 publications

Biomarker Concentrations in White and British Indian Vegetarians and Nonvegetarians in the UK Biobank

Biomarker Concentrations in White and British Indian Vegetarians and Nonvegetarians in the UK Biobank

Effects of vegetarian versus Mediterranean diet on kidney function: Findings from the CARDIVEG study

Low Serum Creatinine Levels in Early Pregnancy Are Associated with a Higher Incidence of Postpartum Abnormal Glucose Metabolism among Women with Gestational Diabetes Mellitus: A Retrospective Cohort Study

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