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在2型糖尿病患者中,较高的果糖摄入量与更多的蛋白尿相关。

A Higher Fructose Intake Is Associated with Greater Albuminuria in Subjects with Type 2 Diabetes Mellitus.

作者信息

Gómez-Sámano Miguel Ángel, Almeda-Valdes Paloma, Cuevas-Ramos Daniel, Navarro-Flores María Fernanda, Espinosa-Salazar Héctor Donaldo, Martínez-Saavedra Mayela, León-Domínguez Jefsi Argelia, Enríquez-Estrada Víctor Manuel, López-González Ana Laura, Sarmiento-Moreno Ana Laura, Rivera-González Lucero Alejandra, Juárez-León Óscar Alfredo, Pérez-González Bernardo, Ávila-Palacios Yessica, Sigala-Pedroza Lineth, Huerta-Ávila Eira, Vargas-Álvarez María Angelina, Sánchez-Jaimes Carlos, Cárdenas-Vera Mariana, Mehta Roopa, López-Flores A La Torre Manuel Alejandro, Manjarrez-Martínez Iliana, Brito-Córdova Griselda Xochitl, Zuarth-Vázquez Julia M, Vega-Beyhart Arturo, López-Carrasco Guadalupe, Johnson Richard J, Gómez-Pérez Francisco Javier

机构信息

Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, 14080 Mexico City, Mexico.

Division of Renal Diseases and Hypertension, University of Colorado, Denver 12631, Aurora, USA.

出版信息

Int J Nephrol. 2018 Oct 17;2018:5459439. doi: 10.1155/2018/5459439. eCollection 2018.

Abstract

The aim of this single center cross-sectional study was to investigate the association between fructose intake and albuminuria in subjects with type 2 diabetes mellitus (T2DM). This is a single center cross-sectional study. One hundred and forty-three subjects with T2DM were recruited from the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran. The median daily fructose intake was estimated with a prospective food registry during 3 days (2 week-days and one weekend day) and they were divided into low fructose intake (<25 g/day) and high fructose intake (≥ 25 g/day). Complete clinical and biochemical evaluations were performed, including anthropometric variables and a 24-hour urine collection for albuminuria determination. One hundred and thirty-six subjects were analyzed in this study. We found a positive significant association between daily fructose intake and albuminuria (= 0.178, p=0.038) in subjects with type 2 diabetes mellitus. Other variables significantly associated with albuminuria were body mass index (BMI) (= 0.170, p=0.048), mean arterial pressure (MAP) (= 0.280, p=0.001), glycated hemoglobin (A1c) (= 0.197, p=0.022), and triglycerides (= 0.219, p=0.010). After adjustment for confounding variables we found a significant and independent association between fructose intake and albuminuria (= 13.96, p=0.006). We found a statistically significant higher albuminuria (60.8 [12.8-228.5] versus 232.2 [27.2-1273.0] mg/day, p 0.002), glycated hemoglobin (8.6±1.61 versus 9.6±2.1 %), p= 0.003, and uric acid (6.27±1.8 versus 7.2±1.5 mg/dL), p=0.012, in the group of high fructose intake versus the group with low fructose intake, and a statistically significant lower creatinine clearance (76.5±30.98 mL/min versus 94.9±36.8, p=0.014) in the group with high fructose intake versus the group with low fructose intake. In summary we found that a higher fructose intake is associated with greater albuminuria in subjects with T2DM.

摘要

这项单中心横断面研究的目的是调查2型糖尿病(T2DM)患者果糖摄入量与蛋白尿之间的关联。这是一项单中心横断面研究。从萨尔瓦多·苏比拉án国家医学与营养研究所招募了143名T2DM患者。通过前瞻性食物登记册估计3天(2个工作日和1个周末日)的每日果糖摄入量中位数,并将他们分为低果糖摄入量(<25克/天)和高果糖摄入量(≥25克/天)两组。进行了全面的临床和生化评估,包括人体测量变量以及收集24小时尿液以测定蛋白尿。本研究分析了136名受试者。我们发现2型糖尿病患者的每日果糖摄入量与蛋白尿之间存在显著正相关(=0.178,p=0.038)。与蛋白尿显著相关的其他变量包括体重指数(BMI)(=0.170,p=0.048)、平均动脉压(MAP)(=0.280,p=0.001)、糖化血红蛋白(A1c)(=0.197,p=0.022)和甘油三酯(=0.219,p=0.010)。在对混杂变量进行调整后,我们发现果糖摄入量与蛋白尿之间存在显著且独立的关联(=13.96,p=0.006)。我们发现,高果糖摄入组的蛋白尿(60.8[12.8 - 228.5]对232.2[27.2 - 1273.0]毫克/天,p<0.002)、糖化血红蛋白(8.6±1.61对9.6±2.1%),p=0.003和尿酸(6.27±1.8对7.2±1.5毫克/分升),p=0.012在统计学上显著高于低果糖摄入组,而高果糖摄入组的肌酐清除率(76.5±30.98毫升/分钟对94.9±36.8),p=0.014在统计学上显著低于低果糖摄入组。总之,我们发现T2DM患者中较高的果糖摄入量与更多的蛋白尿相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6982/6207863/b373ff4ea85d/IJN2018-5459439.001.jpg

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