Department of Nephrology and Renal Functional Explorations, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
CarMeN: Cardiovasculaire, Métabolisme, Diabétologie & Nutrition-INSERM U1060/Lyon 1 University/Institut National de la Recherche Agronomique, Paris, France.
Diabetes Care. 2018 Jun;41(6):1292-1294. doi: 10.2337/dc18-0131. Epub 2018 Apr 2.
Chronic kidney disease is associated with higher morbidity and mortality in patients with diabetes. A low-protein diet is recommended to slow diabetic nephropathy progression because each protein load leads to renal hemodynamic variations. The aim of our study was to evaluate whether the advanced glycation end products (AGE) content of a protein load is responsible for the protein-induced renal hemodynamic variations in humans.
Ten healthy subjects were assigned to a high-protein (1 g/kg) low-AGE (3,000 kU AGE) versus high-AGE (30,000 kU AGE) meal. Renal perfusion, oxygen consumption, and oxygen content were measured before and 120 min after each meal.
Renal perfusion (3.2 ± 0.5 vs. 3.8 ± 0.4 mL/min/g; = 0.0002) and oxygen consumption (0.3 ± 0.04 vs. 0.4 ± 0.08 min; = 0.005) increased significantly after the high-AGE meal compared with the low-AGE meal.
Our results suggest that the AGE content of a protein load is responsible for renal hemodynamic modifications. Therefore, prevention of diabetic nephropathy progression could aim predominantly at reducing food AGE content.
慢性肾病会增加糖尿病患者的发病率和死亡率。推荐低蛋白饮食以减缓糖尿病肾病的进展，因为每次摄入蛋白质都会导致肾脏血流动力学发生变化。本研究旨在评估蛋白质负荷的晚期糖基化终产物（AGE）含量是否是引起人类蛋白质诱导的肾脏血流动力学变化的原因。
10 名健康受试者被分配到高蛋白（1 g/kg）低 AGE（3000 kU AGE）与高 AGE（30000 kU AGE）餐组。在每餐前后 120 分钟测量肾脏灌注、耗氧量和氧含量。
与低 AGE 餐相比，高 AGE 餐后肾脏灌注（3.2 ± 0.5 对 3.8 ± 0.4 mL/min/g； = 0.0002）和耗氧量（0.3 ± 0.04 对 0.4 ± 0.08 min； = 0.005）明显增加。
我们的结果表明，蛋白质负荷的 AGE 含量是引起肾脏血流动力学改变的原因。因此，预防糖尿病肾病进展的主要目标可能是降低食物 AGE 含量。
