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