Study explores link between dietary iron intake and diabetic kidney disease in individuals with diabetes

The researchers found a lower risk of diabetic kidney disease with ≥ 12.59 mg of dietary iron, especially in males, younger, have better blood sugar control, heavier weight, and ex-smokers.

Diabetic kidney disease, a common complication of diabetes, poses a significant health burden globally. Despite advancements in diabetes management, the precise mechanisms underlying DKD development remain incompletely understood. Emerging evidence suggests that dietary factors, including iron intake, may play a role in the pathogenesis of DKD.

Against the above background, Yaoming Xue, Southern Medical University, Guangzhou, China, and colleagues aimed to determine the correlation between dietary iron intake and diabetic kidney disease among diabetic adults by conducting a cross-sectional study.

The study enrolled 8118 participants with diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. 24-hour recall interviews were used to obtain dietary iron intake. Diabetic kidney disease was defined as albumin creatinine ratio (ACR) ≥ 30 mg/g or eGFR < 60 mL/min per 1.73 m2.

Three weighted logistic regression models were utilized to investigate the odd ratio (OR) for DKD. Stratified analyses were performed by age, gender, BMI, HbA1c, hypertension status, HbA1c, smoking status, and diabetes types.

The researchers reported the following findings:

· 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; OR = 0.79).

· In stratified analyses, higher iron intake was negatively related to diabetic kidney disease, especially among those who were male, < 60 years old, those with HbA1c < 7.0%, those with hypertension, and those who were ex-smokers. The result remained robust in sensitivity analyses.

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

In conclusion, the study elucidates the association between dietary iron intake and DKD risk among individuals with diabetes. By highlighting the potential impact of dietary factors on kidney health, the findings underscore the importance of holistic approaches to diabetes management that encompass both pharmacological and lifestyle interventions.

Reference:

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