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低蛋白饮食对老年2型糖尿病患者抑郁症状及生活质量的长期影响。

Long term effects of low protein diet on depressive symptoms and quality of life in elderly Type 2 diabetic patients.

作者信息

Ciarambino Tiziana, Castellino Pietro, Paolisso Giuseppe, Coppola Ludovico, Ferrara Nicola, Signoriello Giuseppe, Giordano Mauro

机构信息

Department of Gerontology, Geriatrics adn Metabolic Disease, Second University of Naples, Naples.

出版信息

Clin Nephrol. 2012 Aug;78(2):122-8. doi: 10.5414/CN107279.

Abstract

OBJECTIVES

The long term effects of a low protein diet (LPD) on depressive symptoms and the quality of life in elderly Type 2 diabetic are unclear.

METHODS

38 elderly Type 2 diabetic patients with CRD (Stage 3 - 4) were enrolled in the study. After 4 weeks on a normal protein diet regimen (NPD) providing 1.0 g/kg per day, all participants were assigned for 30 months, randomly, to a LPD (0.7 g/kg per day), either 7 days a week (LPD 7/7) or 6 days a week (LPD 6/7). Mini mental state examination (MMSE), activities daily living (ADL), cumulative illness severity (CIRS-IS), geriatric depression scale (GDS-15) and short-form healthy survey (SF- 36) were evaluated every 3 months.

RESULTS

Before the LPD regimen creatinine clearance (CrCl), MMSE, ADL, CIRS-IS, GDS-15 and SF-36 were similar in both LPD 7/7 and LPD 6/7 groups. After 30 months, the mean GDS- 15 increased significantly more in LPD 7/7 group than in LPD 6/7 group (p < 0.05). Both mean SF-36 MCS and SF-36 PCS were decreased significantly more in LPD 7/7 group than in LPD 6/7 group (p < 0.05). After 30 months, the decline in CrCl observed was similar in LPD 7/7 and LPD 6/7 groups (2.77 ± 0.3 and 2.84 ± 0.3 ml/min/year, respectively).

CONCLUSION

In elderly Type 2 diabetic patients, long term effects of LPD 6/7 regimen in comparison to LPD 7/7 are associated with a similar decline in CrCl, but with decreased depressive symptoms and a better quality of life.

摘要

目的

低蛋白饮食(LPD)对老年2型糖尿病患者抑郁症状和生活质量的长期影响尚不清楚。

方法

38例患有慢性肾脏病(3 - 4期)的老年2型糖尿病患者被纳入研究。在接受每天每千克体重1.0克蛋白质的正常蛋白质饮食方案(NPD)4周后,所有参与者被随机分配接受30个月的LPD(每天每千克体重0.7克),一周7天(LPD 7/7)或一周6天(LPD 6/7)。每3个月评估简易精神状态检查(MMSE)、日常生活活动能力(ADL)、累积疾病严重程度(CIRS - IS)、老年抑郁量表(GDS - 15)和简短健康调查(SF - 36)。

结果

在LPD方案实施前,LPD 7/7组和LPD 6/7组的肌酐清除率(CrCl)、MMSE、ADL、CIRS - IS、GDS - 15和SF - 36相似。30个月后,LPD 7/7组的平均GDS - 15升高幅度显著大于LPD 6/7组(p < 0.05)。LPD 7/7组的平均SF - 36 MCS和SF - 36 PCS下降幅度也显著大于LPD 6/7组(p < 0.05)。30个月后,LPD 7/7组和LPD 6/7组观察到的CrCl下降情况相似(分别为2.77±0.3和2.84±0.3毫升/分钟/年)。

结论

在老年2型糖尿病患者中,与LPD 7/7方案相比,LPD 6/7方案的长期影响是CrCl下降幅度相似,但抑郁症状减轻,生活质量更好。

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