低蛋白饮食联合酮酸可通过抑制 KKAy 小鼠模型的氧化应激延缓糖尿病肾病的进展。

Low-protein diet supplemented with ketoacids delays the progression of diabetic nephropathy by inhibiting oxidative stress in the KKAy mice model.

机构信息

Department of Nephrology,Shanghai Changzheng Hospital,Kidney Institute,Second Military Medical University,Shanghai,200003, People's Republic of China.

出版信息

Br J Nutr. 2018 Jan;119(1):22-29. doi: 10.1017/S0007114517003208. Epub 2017 Dec 6.

Abstract

Diabetic nephropathy (DN) is a major cause of chronic kidney disease. We aimed to investigate the effect of the low-protein diets (LPD) supplemented with ketoacids (LPD+KA) in KKAy mice, an early type 2 DN model. KKAy mice were treated with normal protein diet (NPD), LPD or LPD+KA from 12 to 24 weeks of age. A period of 12-week treatment with LPD significantly reduced albuminuria as compared with that observed after NPD treatment. Treatment with LPD+KA further reduced albuminuria as compared with that observed with LPD treatment alone. Moreover, LPD treatment reduced mesangial expansion, thickness of glomerular basement membrane and the severity of the podocyte foot process effacement in KKAy mice; these effects were more pronounced in KKAy mice treated with LPD+KA. Both LPD and LPD+KA treatments slightly reduced total body weight, but had no significant effect on kidney weight and blood glucose concentrations when compared with NPD-treated KKAy mice. LPD treatment slightly attenuated oxidative stress in kidneys as compared with that observed in NPD-treated KKAy mice; however, LPD+KA treatment remarkably ameliorated oxidative stress in diabetic kidneys as shown by decreased malondialdehyde concentrations, protein carbonylation, nitrotyrosine expression and increased superoxide dismutase expression. Nutritional therapy using LPD+KA confers additional renal benefits as compared with those of LPD treatment alone in early type 2 DN through inhibition of oxidative stress.

摘要

糖尿病肾病(DN)是慢性肾脏病的主要病因。我们旨在研究补充酮酸的低蛋白饮食(LPD+KA)对 KKAy 小鼠(一种早期 2 型糖尿病肾病模型)的影响。从 12 至 24 周龄起,KKAy 小鼠分别接受正常蛋白饮食(NPD)、LPD 或 LPD+KA 治疗。与 NPD 治疗相比,LPD 治疗 12 周可显著减少蛋白尿。与 LPD 治疗相比,LPD+KA 治疗进一步减少蛋白尿。此外,LPD 治疗可减少 KKAy 小鼠系膜扩张、肾小球基底膜厚度和足细胞足突消失的严重程度;LPD+KA 治疗的效果更为明显。LPD 和 LPD+KA 治疗均使总体体重略有减轻,但与 NPD 治疗的 KKAy 小鼠相比,对肾重和血糖浓度无显著影响。与 NPD 治疗的 KKAy 小鼠相比,LPD 治疗可略微减轻肾脏的氧化应激;然而,LPD+KA 治疗可通过降低丙二醛浓度、蛋白羰基化、硝基酪氨酸表达和增加超氧化物歧化酶表达,显著改善糖尿病肾脏的氧化应激。与 LPD 治疗相比,LPD+KA 的营养治疗在早期 2 型糖尿病肾病中通过抑制氧化应激,可带来额外的肾脏益处。

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