Percheron C, Colette C, Astre C, Monnier L
Department of Metabolism, Lapeyronie Hospital, Montpellier, France.
Nutrition. 1995 Jul-Aug;11(4):345-9.
We investigated the short-term effects of moderate increments or decrements of protein intake on albumin excretion rates of type I diabetic patients. Ten normotensive patients with either normal albumin excretion rates (< 20 micrograms/min, group I, n = 5) or persistent mu-albuminuria (20-200 micrograms/min, group II, n = 5) were fed successively three test diets providing different protein intakes. Each patient was randomly allocated to 3-wk sequences of the following diets: low-protein diet (LPD; median 0.84, range 0.76-0.94 g.kg-1.day-1), medium-protein diet (MPD; median 1.33, range 0.98-2.00 g.kg-1.day-1), and high-protein diet (HPD; median 2.05, range 1.54-2.61 g.kg-1.day-1). The three diets were isoenergetic and isoglucidic. In group I patients, no consistent change was found in mu-albuminuria. In group II patients, LPD resulted in a reduction in mu-albuminuria compared with MPD and HPD. Changes in albumin excretion rates were positively correlated to relative changes in protein intake. This suggests that moderately protein-restricted diets can reduce mu-albuminuria in diabetic patients suffering from incipient nephropathy, the degree of reduction depending on the degree of restriction. Because of poor patient compliance with protein intakes < 0.8 g.kg-1.day-1, we conclude that moderately rather than severely protein-restricted diets should be recommended for long-term prescriptions.
我们研究了蛋白质摄入量适度增加或减少对I型糖尿病患者白蛋白排泄率的短期影响。10名血压正常的患者，其中5名白蛋白排泄率正常（<20微克/分钟，I组），5名持续存在微量白蛋白尿（20 - 200微克/分钟，II组），依次给予三种提供不同蛋白质摄入量的试验饮食。每位患者被随机分配到以下饮食的3周序列中：低蛋白饮食（LPD；中位数0.84，范围0.76 - 0.94克·千克⁻¹·天⁻¹）、中等蛋白饮食（MPD；中位数1.33，范围0.98 - 2.00克·千克⁻¹·天⁻¹）和高蛋白饮食（HPD；中位数2.05，范围1.54 - 2.61克·千克⁻¹·天⁻¹）。这三种饮食等能量且等碳水化合物。在I组患者中，微量白蛋白尿未发现一致变化。在II组患者中，与MPD和HPD相比，LPD导致微量白蛋白尿减少。白蛋白排泄率的变化与蛋白质摄入量的相对变化呈正相关。这表明适度蛋白质限制饮食可降低患有早期肾病的糖尿病患者的微量白蛋白尿，降低程度取决于限制程度。由于患者对蛋白质摄入量<0.8克·千克⁻¹·天⁻¹的依从性较差，我们得出结论，长期处方应推荐适度而非严格的蛋白质限制饮食。
