Gin H, Aparicio M, Potaux L, de Precigout V, Bouchet J L, Aubertin J
Clinique Médicale et des maladies infectieuses, Hopital Pellegrin, Bordeaux, France.
Metabolism. 1987 Nov;36(11):1080-5. doi: 10.1016/0026-0495(87)90029-1.
Ten patients with advanced renal failure (glomerular filtration rate 25 mL/min) were treated with a low phosphorus and low protein diet supplemented with ketoacid analogues. Before starting the diet and four months afterwards, a 50 g oral glucose tolerance test with a three step euglycemic insulin clamp was carried out. A dose-response curve of total body insulin sensitivity was plotted. By the fourth month, glucose tolerance had improved with significantly lower T0, T30, and T60 insulin levels. These results are attributed to the improvement in insulin action as demonstrated by the clamp technique. The dose-response curve had a distinctly higher plateau after dietary treatment, and the tissue sensitivity index to insulin (M/l ratio) was significantly improved. It is suggested that treatment of uremic patients with a low protein diet may reduce levels of a putative insulin inhibitor.
十名晚期肾衰竭患者（肾小球滤过率为25毫升/分钟）接受了低磷低蛋白饮食，并补充了酮酸类似物。在开始饮食前及四个月后，进行了一项50克口服葡萄糖耐量试验，并采用三步正常血糖胰岛素钳夹技术。绘制了全身胰岛素敏感性的剂量反应曲线。到第四个月时，葡萄糖耐量有所改善，T0、T30和T60胰岛素水平显著降低。这些结果归因于钳夹技术所显示的胰岛素作用的改善。饮食治疗后，剂量反应曲线有明显更高的平台期，组织对胰岛素的敏感性指数（M/I比值）显著改善。提示用低蛋白饮食治疗尿毒症患者可能会降低一种假定的胰岛素抑制剂的水平。
