Gentile M G, Fellin G, Cofano F, Delle Fave A, Manna G, Ciceri R, Petrini C, Lavarda F, Pozzi F, D'Amico G
Division of Nephrology, San Carlo Hospital, Milano, Italy.
Clin Nephrol. 1993 Dec;40(6):315-20.
Our aim was to determine whether a longer period of treatment with a vegetarian soy diet with addition of fish oil supplements would accentuate the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients we found in a previous study. After an 8-week baseline period on free diet, patients were randomly allocated either on soy diet alone (SD) or to SD plus 5 g/day of fish oil (SD + FO) orally for two months. Then they crossed over to the other treatment for two additional months. They finally resumed eating the free diet for 3 months. We selected 20 outpatients with chronic glomerulonephritis, proteinuria in the nephrotic range, fasting serum cholesterol > 250 mg/dl, mean serum creatinine concentrations 1.75 +/- 0.23 mg/dl. Serum lipid profile, urinary protein loss and nutritional parameters were monitored. With the soy diet, we obtained a significant decrease both of hyperlipidemia and of proteinuria. The effect of the soy diet on proteinuria increased over the 4 months. The addition of a moderate amount (5 g/day) of fish oil in a randomized cross-over design had no further beneficial effect. Stability of serum albumin, transferrin and the body mass index documented good nutritional status. In conclusion, the dietary manipulation with our vegetarian soy diet confirmed the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients. Such effects persisted and even ameliorated after 4 months of diet. The addition of moderate oral supplements of fish oil did not potentiate the beneficial effect.
我们的目的是确定在素食大豆饮食中添加鱼油补充剂进行更长时间的治疗，是否会增强我们在先前研究中发现的对肾病患者高脂血症和蛋白尿的有益影响。在自由饮食的8周基线期后，患者被随机分配至单独接受大豆饮食（SD）或接受大豆饮食加5克/天鱼油（SD + FO）口服，为期两个月。然后他们交叉接受另一种治疗，为期两个月。最后他们恢复自由饮食3个月。我们选择了20名患有慢性肾小球肾炎、肾病范围蛋白尿、空腹血清胆固醇>250毫克/分升、平均血清肌酐浓度1.75±0.23毫克/分升的门诊患者。监测血清脂质谱、尿蛋白丢失和营养参数。采用大豆饮食后，我们使高脂血症和蛋白尿均显著降低。大豆饮食对蛋白尿的影响在4个月内有所增加。在随机交叉设计中添加适量（5克/天）鱼油没有进一步的有益效果。血清白蛋白、转铁蛋白的稳定性以及体重指数表明营养状况良好。总之，我们的素食大豆饮食进行的饮食干预证实了对肾病患者高脂血症和蛋白尿的有益影响。这种影响在饮食4个月后持续存在甚至有所改善。添加适量口服鱼油补充剂并未增强有益效果。
