Hoffer L J, Taveroff A, Schiffrin A
McGill Nutrition and Food Science Centre, McGill University, Montreal, Quebec, Canada.
Am J Physiol. 1997 Jan;272(1 Pt 1):E59-67. doi: 10.1152/ajpendo.1997.272.1.E59.
Eight normal subjects, four subjects with intensively treated insulin-dependent diabetes mellitus (IDDM), and six subjects with conventionally treated IDDM consumed a test meal of 0.5 g protein and 10 kcal per kg body weight, first while adapted to a conventional diet high in protein, and then again after 5 days of dietary protein restriction. Metabolic N balance (N consumed minus urea production) and net protein utilization were measured over the 9 h after consumption of the test meal, as was recovery in urea of 15N from a tracer dose of [15N]alanine included in each test meal. After the first test meal, N balance and net protein utilization were similar and close to zero for all groups. After the second test meal, N balance and net protein utilization became positive for all groups (P < 0.05) but significantly less so (P < 0.05) for the conventionally treated than for the normal and intensively treated diabetic subjects. 15N recovery in urea was reduced for all groups after the second test meal (P < 0.05) but probably less effectively (P < 0.09) for the conventionally treated diabetic subjects. Metabolic adaptation to protein restriction may be less effective than normal in conventionally treated IDDM.
8名正常受试者、4名接受强化治疗的胰岛素依赖型糖尿病（IDDM）患者和6名接受常规治疗的IDDM患者，首先在适应高蛋白常规饮食时，然后在饮食蛋白质限制5天后，均食用了每千克体重含0.5克蛋白质和10千卡热量的试验餐。在食用试验餐后的9小时内测量代谢氮平衡（摄入氮减去尿素生成量）和净蛋白质利用率，同时还测量了每次试验餐中示踪剂量的[15N]丙氨酸在尿素中的15N回收率。第一次试验餐后，所有组的氮平衡和净蛋白质利用率相似且接近零。第二次试验餐后，所有组的氮平衡和净蛋白质利用率均变为正值（P<0.05），但接受常规治疗的患者比正常受试者和接受强化治疗的糖尿病患者显著降低（P<0.05）。第二次试验餐后，所有组的尿素中15N回收率均降低（P<0.05），但接受常规治疗的糖尿病患者降低的效果可能较差（P<0.09）。在接受常规治疗的IDDM中，对蛋白质限制的代谢适应可能不如正常情况有效。
