Gin H, Combe C, Rigalleau V, Delafaye C, Aparicio M, Aubertin J
Clinique Médicale and Clinique Néphrologique, Université de Bordeaux II, Hôpital Pellegrin Tripode, France.
Am J Clin Nutr. 1994 Mar;59(3):663-6. doi: 10.1093/ajcn/59.3.663.
The metabolic clearance rate (MCR) of insulin was studied in 17 nondiabetic patients with advanced chronic renal failure (creatinine 479 +/- 15 mumol/L, glomerular filtration rate 14.6 +/- 2.9 mL/min) before and after 3 mo of a low-protein, low-phosphorus diet (LPD) providing daily per kilogram 0.3 protein of vegetal origin and 3-5 mg inorganic phosphorus. The energy supply (146 kJ.kg-1 x d-1) was furnished mainly by carbohydrates. The diet was supplemented with a mixture of essential amino acids and keto-analogues. The MCR of insulin was determined by using the euglycemic clamp technique. Before the diet the MCR of insulin was low (450 +/- 127 mL.min-1 x m-2) but increased significantly at the third month (568.8 +/- 148 mL.min-1 x m-2), reaching values close to the MCR of control subjects (630 +/- 135 mL.min-1 x m-2). Identical results have been described during hemodialysis of anephric patients, leading us to hypothesize that an LPD reduces the production of dialyzable factors that interfere with peripheral insulin metabolism.
在17例晚期慢性肾衰竭非糖尿病患者（肌酐479±15μmol/L，肾小球滤过率14.6±2.9mL/min）中，研究了低蛋白、低磷饮食（LPD）3个月前后胰岛素的代谢清除率（MCR）。该饮食每日每千克提供0.3克植物源性蛋白质和3 - 5毫克无机磷，能量供应（146kJ·kg⁻¹·d⁻¹）主要由碳水化合物提供，并补充必需氨基酸和酮类似物的混合物。采用正常血糖钳夹技术测定胰岛素的MCR。饮食前胰岛素的MCR较低（450±127mL·min⁻¹·m⁻²），但在第三个月显著升高（568.8±148mL·min⁻¹·m⁻²），达到接近对照组受试者MCR（630±135mL·min⁻¹·m⁻²）的值。无肾患者血液透析期间也有相同结果，这使我们推测低蛋白、低磷饮食可减少干扰外周胰岛素代谢的可透析因子的产生。
