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      Dietary flavonoid intake is associated with a lower risk of diabetic nephropathy in US adults: data from NHANES 2007–2008, 2009–2010, and 2017–2018

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          Abstract

          Few epidemiological studies have investigated the relationship between flavonoids and diabetic nephropathy (DN).

          Abstract

          Few epidemiological studies have investigated the relationship between flavonoids and diabetic nephropathy (DN). Therefore, we explored the association between dietary flavonoid intake and DN among 1949 US adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2008, 2009–2010, and 2017–2018. Weighted logistic regression models demonstrated that the total flavonoid intake in the second (OR: 0.642; 95% CI: 0.456–0.906), third (OR: 0.665; 95% CI: 0.447–0.988), and the highest (OR: 0.551; 95% CI: 0.382–0.796) quantiles ( versus the lowest) were associated with the decreased risk of DN. Restricted cubic spline (RCS) analyses showed that the total flavonoid intake had a negative linear association with DN ( p-value for non-linearity was 0.003). Weighted quantile sum (WQS) regression analyses revealed that flavan-3-ols, flavones, and anthocyanidins were the main contributors for the combined effects of six flavonoid subclasses. Our findings suggested that higher dietary flavonoid intake was associated with a decreased risk of DN, with the greatest influence coming from flavan-3-ols, flavones, and anthocyanidins.

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          Update on Diabetic Nephropathy: Core Curriculum 2018

          Kausik Umanath, Julia Lewis (2018)
          Diabetic kidney disease and diabetic nephropathy are the leading cause of end-stage kidney disease in the United States and most developed countries. Diabetes accounts for 30% to 50% of the incident cases of end-stage kidney disease in the United States. Although this represents a significant public health concern, it is important to note that only 30% to 40% of patients with diabetes develop diabetic nephropathy. Specific treatment of patients with diabetic nephropathy can be divided into 4 major arenas: cardiovascular risk reduction, glycemic control, blood pressure control, and inhibition of the renin-angiotensin system (RAS). Recommendations for therapy include targeting a hemoglobin A1c concentration < 7% and blood pressure < 140/90mmHg with therapy anchored around the use of a RAS-blocking agent. The single best evidence-based therapy for diabetic nephropathy is therapy with a RAS-blocking medication. This Core Curriculum outlines and discusses in detail the epidemiology, pathophysiology, diagnosis, and management of diabetic nephropathy.
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            Anti-inflammatory effects of flavonoids

            Soheila J Maleki, Jesús F Crespo, Beatriz Cabanillas (2019)
            Inflammation plays a key role in diseases such as diabetes, asthma, cardiovascular diseases and cancer. Diet can influence different stages of inflammation and can have an important impact on several inflammatory diseases. Increasing scientific evidence has shown that polyphenolic compounds, such as flavonoids, which are found in fruits, vegetables, legumes, or cocoa, can have anti-inflammatory properties. Recent studies have demonstrated that flavonoids can inhibit regulatory enzymes or transcription factors important for controlling mediators involved in inflammation. Flavonoids are also known as potent antioxidants with the potential to attenuate tissue damage or fibrosis. Consequently, numerous studies in vitro and in animal models have found that flavonoids have the potential to inhibit the onset and development of inflammatory diseases. In the present review, we focused in flavonoids, the most abundant polyphenols in the diet, to give an overview of the most recent scientific knowledge about their impact on different inflammatory diseases.
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              Inflammation and the pathogenesis of diabetic nephropathy.

              Jun Wada, Hirofumi Makino (2013)
              The most problematic issue in clinical nephrology is the relentless and progressive increase in patients with ESRD (end-stage renal disease) worldwide. The impact of diabetic nephropathy on the increasing population with CKD (chronic kidney disease) and ESRD is enormous. Three major pathways showing abnormality of intracellular metabolism have been identified in the development of diabetic nephropathy: (i) the activation of polyol and PKC (protein kinase C) pathways; (ii) the formation of advanced glycation end-products; and (iii) intraglomerular hypertension induced by glomerular hyperfiltration. Upstream of these three major pathways, hyperglycaemia is the major driving force of the progression to ESRD from diabetic nephropathy. Downstream of the three pathways, microinflammation and subsequent extracellular matrix expansion are common pathways for the progression of diabetic nephropathy. In recent years, many researchers have been convinced that the inflammation pathways play central roles in the progression of diabetic nephropathy, and the identification of new inflammatory molecules may link to the development of new therapeutic strategies. Various molecules related to the inflammation pathways in diabetic nephropathy include transcription factors, pro-inflammatory cytokines, chemokines, adhesion molecules, Toll-like receptors, adipokines and nuclear receptors, which are candidates for the new molecular targets for the treatment of diabetic nephropathy. Understanding of these molecular pathways of inflammation would translate into the development of anti-inflammation therapeutic strategies.
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                Author and article information

                Contributors
                Journal
                Journal ID (publisher-id): FFOUAI
                Title: Food & Function
                Abbreviated Title: Food Funct.
                Publisher: Royal Society of Chemistry (RSC)
                ISSN (Print): 2042-6496
                ISSN (Electronic): 2042-650X
                Publication date Created: May 11 2023
                Publication date (Electronic): 2023
                Volume: 14
                Issue: 9
                Pages: 4183-4190
                Affiliations
                [1 ]School of Public Health, Wuhan University, Wuhan 430071, China
                [2 ]Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, 430030, Wuhan, China
                [3 ]School of Nursing, Wuhan University, Wuhan 430071, China
                [4 ]Center for Chronic Disease Rehabilitation, School of Nursing, Wuhan University, Wuhan, China
                Article
                DOI: 10.1039/D3FO00242J
                PubMed ID: 37066968
                SO-VID: 7c5a776e-e15f-468e-ad68-06a75db1774e
                Copyright © © 2023
                License:

                http://rsc.li/journals-terms-of-use

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