Koppeschaar H P, Meinders A E, Schwarz F
Metabolism. 1985 Nov;34(11):1066-72. doi: 10.1016/0026-0495(85)90081-2.
The renal concentrating ability (RCA) was studied in 30 obese subjects before and after modified fasting (MF) and T3 supplementation, and during hypocaloric-carbohydrate refeeding. We also studied the effect of sodium supplementation on the RCA during MF. Modified fasting induced a low T3-high rT3 state ("sick euthyroid"). During T3-supplementation plasma T3 levels increased but were in the normal range for normal weight controls. Plasma sodium, potassium, and calcium remained within the normal range during all study periods. After MF (14 days) the mean maximal urinary osmolality was significantly lower compared to prefast values both after dehydration alone (706 +/- 12 mosm/kg H2O v 975 +/- 14, P less than 0.001) and after dehydration plus sc vasopressin administration (676 +/- 19 v 899 +/- 17, P less than 0.001). After 14 days MF followed by 14 days MF + T3-supplementation plasma urea, urinary urea excretion, and the creatinine clearance were significantly greater than after MF alone as was the RCA (764 +/- 15 v 652 +/- 25, P less than 0.002). Sodium chloride supplementation increased RCA (P less than 0.02) but no additive effect of T3 and sodium chloride supplementation was observed. Severe dietary salt restriction induced a significant decline in RCA (P less than 0.005). Refeeding with carbohydrate increased plasma T3 from 79.9 +/- 7.7 to 97 +/- 7.5 ng/100 mL (NS) and decreased plasma rT3 from 0.33 +/- 0.02 to 0.27 +/- 0.02 ng/mL, (P less than 0.02); no significant change in RCA was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
我们对30名肥胖受试者在改良禁食（MF）和补充T3之前、期间以及低热量碳水化合物再喂养期间的肾脏浓缩能力（RCA）进行了研究。我们还研究了在MF期间补充钠对RCA的影响。改良禁食诱导了低T3-高反T3状态（“病态正常甲状腺功能”）。在补充T3期间，血浆T3水平升高，但处于正常体重对照组的正常范围内。在所有研究期间，血浆钠、钾和钙均保持在正常范围内。MF（14天）后，与仅脱水后（706±12 mosm/kg H2O对975±14，P<0.001）以及脱水加皮下注射血管加压素后（676±19对899±17，P<0.001）的禁食前值相比，平均最大尿渗透压显著降低。MF 14天后接着进行14天MF+T3补充，血浆尿素、尿尿素排泄和肌酐清除率均显著高于仅MF后，RCA也是如此（764±15对652±25，P<0.002）。补充氯化钠可增加RCA（P<0.02），但未观察到T3和氯化钠补充的相加效应。严格的饮食盐限制导致RCA显著下降（P<0.005）。碳水化合物再喂养使血浆T3从79.9±7.7升高至97±7.5 ng/100 mL（无统计学意义），并使血浆反T3从0.33±0.02降至0.27±0.02 ng/mL（P<0.02）；未观察到RCA有显著变化。（摘要截断于250字）
