Nakamura H, Yamazaki M, Chiba Y, Tamura N, Momotsu T, Ito S, Shibata A, Kamoi K, Yamaji T
First Department of Internal Medicine, Niigata University School of Medicine.
Tohoku J Exp Med. 1990 Nov;162(3):269-78. doi: 10.1620/tjem.162.269.
To evaluate the effects of acute protein loading on the glomerular filtration rate, albumin excretion rate and concentration of plasma amino acids, ten healthy volunteers and six type 2 diabetic patients with normoalbuminuria were studied before and after eating 0.7 g/kg body weight of tuna fish, boiled egg white, cheese or tofu (bean curd) on separate days. Furthermore, to study the possible role of glucagon, growth hormone, atrial natriuretic peptide and kallikrein in the responses of glomerular filtration rate to protein, these substances were measured before and after ingestion of tuna fish or egg white in six healthy volunteers. In healthy subjects, glomerular filtration rate increased significantly (p less than 0.01) from 98.1 +/- 4.2 ml/min during the baseline period to 129.9 +/- 6.6 ml/min after ingestion of tuna fish. No significant differences were seen between glomerular filtration rate before and after ingestion of egg white, cheese or bean curd. No significant differences were observed between the baseline albumin excretion rate and that after loading with any of the four kinds of protein. Plasma concentrations of alanine, glycine and arginine (amino acids known to induce glomerular hyperfiltration) increased to a greater degree after ingestion of tuna fish than after administration of the other meals. Diabetic subjects and healthy volunteers had similar responses. Plasma glucagon and growth hormone concentrations increased after ingestion of the tuna fish meal or egg white. Plasma atrial natriuretic peptide concentration and urinary kallikrein excretion were unaffected by ingestion of these two kinds of protein. These findings suggest that responses of glomerular filtration rate to acute protein loading may differ depending on the protein ingested, and that these responses may not be directly induced by glucagon, growth hormone, atrial natriuretic peptide or kallikrein.
为评估急性蛋白质负荷对肾小球滤过率、白蛋白排泄率及血浆氨基酸浓度的影响，我们对10名健康志愿者和6名正常白蛋白尿的2型糖尿病患者进行了研究，在不同日期让他们分别食用0.7 g/kg体重的金枪鱼、煮蛋清、奶酪或豆腐（豆腐），并在食用前后进行检测。此外，为研究胰高血糖素、生长激素、心房利钠肽和激肽释放酶在肾小球滤过率对蛋白质反应中的可能作用，我们对6名健康志愿者在摄入金枪鱼或蛋清前后检测了这些物质。在健康受试者中，肾小球滤过率在基线期为98.1±4.2 ml/min，摄入金枪鱼后显著增加（p<0.01）至129.9±6.6 ml/min。摄入蛋清、奶酪或豆腐前后的肾小球滤过率未见显著差异。四种蛋白质负荷前后的基线白蛋白排泄率也无显著差异。摄入金枪鱼后，丙氨酸、甘氨酸和精氨酸（已知可诱导肾小球超滤的氨基酸）的血浆浓度升高幅度大于其他餐食。糖尿病患者和健康志愿者的反应相似。摄入金枪鱼餐或蛋清后，血浆胰高血糖素和生长激素浓度升高。摄入这两种蛋白质后，血浆心房利钠肽浓度和尿激肽释放酶排泄未受影响。这些发现表明，肾小球滤过率对急性蛋白质负荷的反应可能因摄入的蛋白质不同而有所差异，且这些反应可能不是由胰高血糖素、生长激素、心房利钠肽或激肽释放酶直接诱导的。
