Urivetzky M, Motola J, Braverman S, Smith A D
J Urol. 1987 Apr;137(4):690-2. doi: 10.1016/s0022-5347(17)44176-0.
A total of 12 patients with absorptive hypercalciuria type II and 11 normal controls participated in a study to evaluate the effects of dietary protein levels on urinary calcium and oxalate excretion before and after a 1 gm. dose of oxalate. Two test periods were used during which calcium (less than 400 mg. per day) and oxalate were restricted. The first test was done under conditions of low dietary protein (12 per cent total caloric intake, 60 gm.) and the second test was done at a high protein level (25 per cent, 125 gm. protein). Twelve-hour urine specimens were obtained after dinner on day 3 of each diet (low and high protein) and again on day 4 when 1 gm. oxalate (spinach) was added to the dinner meal. The specimens were analyzed for calcium, oxalate and relative calcium oxalate saturation (concentration product ratio). There were no significant differences between the controls and subjects with absorptive hypercalciuria type II in oxalate excretion before the oxalate load on the low protein (controls 31.4 +/- 4.2 standard error, expressed as mmol. oxalate per mol. creatinine, and absorptive hypercalciuria type II 23.1 +/- 3.1) and high protein (controls 30.4 +/- 4.2 and absorptive hypercalciuria type II 28.8 +/- 5.9) diets. After the oxalate bolus the positive changes in oxalate excretion were 11.8 +/- 4.8 (low protein) and 17.8 +/- 4.7 (high protein) for controls, and 11.4 +/- 4.4 (low protein) and 31.8 +/- 5.2 (high protein) for patients with absorptive hypercalciuria type II. Thus, the increases in post-load urinary oxalate levels observed for controls and patients were greater on the high protein than on the low protein diets. After the oxalate load the increases in urinary oxalate and calcium oxalate supersaturation were significantly greater for patients with absorptive hypercalciuria type II than for control subjects for the high protein but not the low protein diets (p less than 0.05).
共有12名II型吸收性高钙尿症患者和11名正常对照者参与了一项研究，以评估膳食蛋白质水平对1克草酸盐前后尿钙和草酸排泄的影响。研究采用了两个测试期，在此期间限制钙（每天少于400毫克）和草酸盐的摄入。第一次测试在低膳食蛋白质（占总热量摄入的12%，60克）的条件下进行，第二次测试在高蛋白质水平（25%，125克蛋白质）下进行。在每种饮食（低蛋白和高蛋白）的第3天晚餐后以及第4天晚餐中添加1克草酸盐（菠菜）后，收集12小时的尿液样本。对样本进行钙、草酸盐和相对草酸钙饱和度（浓度乘积比）分析。在低蛋白（对照组31.4±4.2标准误，以每摩尔肌酐中草酸盐的毫摩尔数表示，II型吸收性高钙尿症患者为23.1±3.1）和高蛋白（对照组30.4±4.2，II型吸收性高钙尿症患者为28.8±5.9）饮食下，草酸盐负荷前，对照组和II型吸收性高钙尿症患者的草酸盐排泄无显著差异。草酸盐推注后，对照组草酸盐排泄的正向变化在低蛋白时为11.8±4.8，高蛋白时为17.8±4.7；II型吸收性高钙尿症患者在低蛋白时为11.4±4.4，高蛋白时为31.8±5.2。因此，对照组和患者在高蛋白饮食时负荷后尿草酸盐水平的升高幅度大于低蛋白饮食。草酸盐负荷后，II型吸收性高钙尿症患者尿草酸盐和草酸钙过饱和度的增加在高蛋白饮食时显著高于对照组，但在低蛋白饮食时并非如此（p<0.05）。
