Ciarambino Tiziana, Castellino Pietro, Paolisso Giuseppe, Coppola Ludovico, Ferrara Nicola, Signoriello Giuseppe, Giordano Mauro
Department of Gerontology, Geriatrics adn Metabolic Disease, Second University of Naples, Naples.
Clin Nephrol. 2012 Aug;78(2):122-8. doi: 10.5414/CN107279.
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.
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.
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).
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.
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。
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)。
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)。
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。