The Association Between Circadian Eating Behaviors and Diabetic Kidney Disease in Diabetes Mellitus Patients: A...

Recent studies have suggested that circadian eating behaviors play a significant role in metabolic diseases and their related complications. However, the impact of daily eating frequency (DEF) and nighttime fasting duration (NFD) on diabetic kidney disease remains poorly understood. This study aims to investigate the potential association between DEF and NFD with the development of diabetic kidney disease.

Data from the NHANES dataset (1999-2018) were collected to obtain information on diabetes and circadian eating behaviors. Using the recorded start and end times of each meal throughout the day, we calculated the NFD. And the frequency of eating episodes was used to evaluate DEF. Meanwhile, diabetic kidney disease was diagnosed in diabetic patients according to the criteria of impaired estimated glomerular filtration rate (<60 mL/min/1.73 m²) and/or the presence of albuminuria (urinary albumin to urinary creatinine ratio >30 mg/g). Weighted logistic regression models were used to assess the associations between DEF and NFD in relation to the diabetic kidney disease.

Our study encompassed a total of 7,336 adult participants. We found that the prevalence of diabetic kidney disease has a nonlinear relationship with DEF and NFD, plateauing at 3 meals per day and minimizing when NFD is between 10 and 11. Based on this result, the entire population was divided into 5 subgroups according to the quantiles of DEF and NFD. Compared to DEF at 3 times, participants with DEF fewer than 3 times had a higher diabetic kidney disease prevalence even after adjusting for covariates (odds ratio [OR] = 1.59, 95% confidence interval [CI]: 1.16-2.18). Furthermore, participants with an NFD exceeding 12 hours demonstrated a higher prevalence of diabetic kidney disease (12-13.5 hours OR = 1.30, 95% CI: 1.04,1.65); >14 h: OR = 1.45, 95% CI: 1.09, 1.91), compared to those with an NFD of 10 to 11 hours.

Our findings indicate that a DEF of fewer than 3 times per day and an NFD of more than 12 hours are associated with an increased prevalence of diabetic kidney disease. Modifying circadian eating patterns may hold potential for improving renal outcomes in individuals with diabetes.