Retinol intake is associated with the risk of chronic kidney disease in individuals with type 2 diabetes mellitus: results from NHANES

Abstract

The aim of this study was to investigate the potential association between retinol intake and the risk of chronic kidney disease (CKD) in individuals with type 2 diabetes mellitus (T2DM). The study included individuals diagnosed with T2DM between 2009 and 2018 from the NHANES database. Demographic and laboratory test data were collected for these individuals, as well as information on CKD diagnosis. Logistic regression models were utilized to estimate the relationship between different retinol intakes and the risk of CKD in patients with T2DM. A total of 3988 patients were included in the study. The mean prevalence of CKD in the T2DM population in the United States from 2009 to 2018 was 36.98 (0.02)%. Multivariate logistic regression analysis revealed a 26% decrease in the incidence of CKD in individuals with higher retinol intake compared to those with lower retinol intake in T2DM (OR = 0.74; 95% CI 0.56-0.98). Furthermore, an increase in retinol intake per 1-standard deviation (SD) was associated with a 16% decreased risk of the incidence of CKD (OR = 0.84; 95% CI 0.72-0.97). Lower retinol intake is an independent risk factor for the onset of CKD in patients with T2DM, and augmenting moderate quantities of retinol confers potential nephroprotective advantages.

Figure 1

Flowchart of included individuals in this study.

Figure 2

Associations between retinol intake and the occurrence of CKD in individuals with T2DM. Model 1^a adjusted for baseline age, sex, race, BMI; Model 2^b adjusted for covariates in model 1 plus smoking (‘yes’ or ‘no’), alcohol use (‘yes’ or ‘no’), hypertension (‘yes’ or ‘no’). Model 3^c adjusted for covariates in model 2 plus anemia (‘yes’ or ‘no’), anti-diabetic drugs, HbA1c, serum albumin. OR, odds ratio; CI, Confidence interval; BMI, Body Mass Index; CKD, chronic kidney disease; T2DM, type 2 diabetes mellitus.

Figure 3

Subgroup analysis of the risk of the occurrence of CKD in individuals with T2DM. Adjust for age (< 65, ≥ 65), sex (‘Female’, ‘Male’), race, BMI, smoke (‘no’, ‘yes’), alcohol use (‘no’, ‘yes’). HR, hazard ratio; CI, confidence interval; BMI, Body Mass Index.