Nguyen N U, Dumoulin G, Henriet M T, Regnard J
Explorations Fonctionnelles Rénales Métaboliques et Endocriniennes, Centre Hospitalier Universitaire de Besançon, France.
Horm Metab Res. 1995 Mar;27(3):155-8. doi: 10.1055/s-2007-979929.
We have previously shown that an oral glucose load increased both calciuria and oxaluria while the ingestion of fructose induced a rise in calciuria and a decrease in oxaluria. This latter effect remains unclear and might be linked to the reduced intestinal oxalate absorption subsequent to digestive intolerance in some subjects. Such a hypothesis could be enlightened by the study of a parenteral fructose load. Therefore in 7 healthy subjects, we compared the effects of fructose infusion (F) (15 min iv infusion at 0.185 mmol/kg BW/min) to a control glucose infusion (G) on urinary calcium and oxalate. In this study, glycemia and insulinemia increased less after (F) than after (G) (respectively + 21% vs + 216%, p < 0.001 and + 230% vs + 402%, p < 0.05) and phosphatemia decreased less after (F) than after (G) (-7% vs -14%, p < 0.05). Urinary calcium and oxalate increased only after (F) (respectively + 64%, p < 0.01 and + 60%, p < 0.05). Urinary uric acid, another urolithiasis factor, increased after both (F) and (G) (respectively + 45%; p < 0.01 and + 42%; p < 0.01) but uricemia increased only after (F) (+ 25%; p < 0.01). Our results suggest an additional reason to avoid the use of fructose in parenteral nutrition, particularly in individuals with a known history of either calcium oxalate or urate urolithiasis.
我们之前已经表明，口服葡萄糖负荷会增加尿钙和草酸尿，而摄入果糖会导致尿钙升高和草酸尿减少。后一种效应尚不清楚，可能与某些受试者消化不耐受后肠道草酸吸收减少有关。对肠外果糖负荷的研究可能会阐明这一假设。因此，在7名健康受试者中，我们比较了果糖输注（F）（以0.185 mmol/kg体重/分钟的速度静脉输注15分钟）与对照葡萄糖输注（G）对尿钙和草酸的影响。在这项研究中，（F）后血糖和胰岛素血症的增加低于（G）后（分别为+21%对+216%，p<0.001；+230%对+402%，p<0.05），（F）后血磷的降低低于（G）后（-7%对-14%，p<0.05）。仅在（F）后尿钙和草酸增加（分别为+64%，p<0.01；+60%，p<0.05）。另一个尿路结石因素尿酸在（F）和（G）后均增加（分别为+45%；p<0.01和+42%；p<0.01），但仅在（F）后血尿酸增加（+25%；p<0.01）。我们的结果表明，肠外营养中应避免使用果糖，特别是对于有草酸钙或尿酸尿路结石病史的个体，这又多了一个理由。
