Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Graduate School of Life and Environmental Sciences, Kyoto Prefectural University Kyoto, Kyoto, Japan.
Diabetes Metab Res Rev. 2019 Jul;35(5):e3150. doi: 10.1002/dmrr.3150. Epub 2019 Apr 3.
Diabetic kidney disease is an important problem in individuals with diabetes. The effect of dietary protein intake on the renal function of patients with diabetes is controversial. Here, we sought to clarify the association between dietary protein intake and changes in the urinary albumin excretion (UAE) or estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.
In this retrospective cohort study, we included 144 patients (70 men, mean ± standard deviation of age 64 ± 10 years, and median (interquartile range) of UAE 15.0 (7.0-38.9) mg/gCr) without an eGFR less than 30 mL/min/1.73 m and/or UAE greater than or equal to 300 mg/gCr. Changes in the UAE or eGFR were defined as (logarithms [UAE+1] or eGFR at follow-up minus logarithms [UAE+1] or eGFR at baseline examination)/follow-up duration (years). Habitual protein intake was estimated by a self-administered diet history questionnaire.
The median follow-up duration was 5 years. Protein intake (g/kg ideal body weight/day) was not associated with the change in the UAE (r = -0.130, p = 0.120) or change in the eGFR (r = -0.074, p = 0.381). Multiple linear regression analyses showed that after adjusting for covariates, the patients' protein intake was not associated with change in their UAE (standardized regression coefficient: 0.044, p = 0.732) or change in their eGFR (standardized regression coefficient: 0.250, p = 0.085).
Dietary protein intake does not influence changes in the UAE or eGFR among patients with type 2 diabetes without macroalbuminuria.
糖尿病肾病是糖尿病患者的一个重要问题。饮食蛋白质摄入量对糖尿病患者肾功能的影响存在争议。在这里,我们旨在阐明 2 型糖尿病患者的饮食蛋白质摄入量与尿白蛋白排泄率(UAE)或估算肾小球滤过率(eGFR)变化之间的关系。
在这项回顾性队列研究中,我们纳入了 144 名患者(70 名男性,年龄为 64 ± 10 岁,中位数(四分位距)的 UAE 为 15.0(7.0-38.9)mg/gCr),且 eGFR 不低于 30 mL/min/1.73 m2 和/或 UAE 不低于 300 mg/gCr。UAE 或 eGFR 的变化定义为(随访时的 UAE 或 eGFR 的对数[UAE+1]减去基线检查时的 UAE 或 eGFR 的对数[UAE+1])/随访时间(年)。习惯性蛋白质摄入量通过自我管理的饮食史问卷来估计。
中位随访时间为 5 年。蛋白质摄入量(g/kg 理想体重/天)与 UAE 的变化(r = -0.130,p = 0.120)或 eGFR 的变化(r = -0.074,p = 0.381)无关。多元线性回归分析表明,在调整协变量后,患者的蛋白质摄入量与 UAE 的变化(标准化回归系数:0.044,p = 0.732)或 eGFR 的变化(标准化回归系数:0.250,p = 0.085)无关。
在没有大量白蛋白尿的 2 型糖尿病患者中,饮食蛋白质摄入量不会影响 UAE 或 eGFR 的变化。