1型糖尿病儿童和青少年的膳食蛋白质摄入量与提示早期糖尿病肾病的指标之间是否存在关联？

Does dietary protein intake correlate with markers suggestive of early diabetic nephropathy in children and adolescents with Type 1 diabetes mellitus?

作者信息

O'Hayon B E, Cummings E A, Daneman D, Ossip M G, Lawson M L, Sochett E B

机构信息

Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.

出版信息

Diabet Med. 2000 Oct;17(10):708-12. doi: 10.1046/j.1464-5491.2000.00366.x.

DOI:10.1046/j.1464-5491.2000.00366.x

PMID:11110503

Abstract

AIMS

To examine the relationship between dietary protein intake and possible early markers of diabetic nephropathy (creatinine clearance (CrCI), kidney volume and albumin excretion rate (AER)).

METHODS

One hundred and forty-five subjects with diabetes for 5-10 years, divided into three pubertal groups, participated. Kidney volume was measured by ultrasound, and serum creatinine and HbA1c were assayed. Two or three 24-h urine collections were obtained for albumin, creatinine and urea excretion rates. Dietary protein intake was estimated from urinary urea nitrogen excretion rate. Glomerular filtration rate was estimated by creatinine clearance.

RESULTS

Mean protein intake was 1.22 +/- 0.48 g x kg(-1) x day(-1) Protein intake was significantly higher in males than females (P < 0.0001) and highest in prepubertal compared to mid-pubertal and post-pubertal subjects (P < 0.001). In multiple regression analysis, protein intake was positively associated with CrCl (P < 0.0001), and male sex (P < 0.0001) and negatively associated with body surface area (P = 0.0013) and age (P = 0.01). Kidney volume and AER were not related to dietary protein intake.

CONCLUSIONS

This cross-sectional study failed to show a significant relationship between dietary protein intake and markers of early nephropathy, other than CrCl. However, a longitudinal, prospective study is required to definitively assess the role of protein intake in the evolution of diabetic nephropathy.

摘要

目的

研究膳食蛋白质摄入量与糖尿病肾病早期可能标志物（肌酐清除率（CrCI）、肾脏体积和白蛋白排泄率（AER））之间的关系。

方法

145名患糖尿病5至10年的受试者参与研究，他们被分为三个青春期组。通过超声测量肾脏体积，检测血清肌酐和糖化血红蛋白（HbA1c）。收集两到三次24小时尿液，测定白蛋白、肌酐和尿素排泄率。根据尿尿素氮排泄率估算膳食蛋白质摄入量。通过肌酐清除率估算肾小球滤过率。

结果

平均蛋白质摄入量为1.22±0.48 g×kg⁻¹×d⁻¹。男性的蛋白质摄入量显著高于女性（P<0.0001），且青春期前受试者的蛋白质摄入量高于青春期中期和青春期后期受试者（P<0.001）。在多元回归分析中，蛋白质摄入量与肌酐清除率（P<0.0001）、男性性别（P<0.0001）呈正相关，与体表面积（P = 0.0013）和年龄（P = 0.01）呈负相关。肾脏体积和白蛋白排泄率与膳食蛋白质摄入量无关。