Remer T, Pietrzik K, Manz F
Research Institute of Child Nutrition, Dortmund, Germany.
J Clin Endocrinol Metab. 1998 Jun;83(6):2132-7. doi: 10.1210/jcem.83.6.4883.
The aim of this study was to determine whether definite diet changes affect adrenocortical activity and/or adrenal androgen metabolism. A controlled experimental diet study with four consecutive diet periods (repeated measure design) was carried out in six healthy adult volunteers. Four nearly isoenergetic diets, two normal (N) moderately protein-rich, one protein-rich (P), and one low protein lactovegetarian (L), were fed. At the end of each 5-day diet period a blood sample and two 24-h urine specimens were obtained from each subject. Plasma levels of dehydroepiandrosterone sulfate (DHEAS) were elevated with diet L (6.5 +/- 1.4 vs. 5.3 +/- 1.1 mumol/L; P < 0.05) compared to diet N, whereas other plasma hormones, including cortisol and insulin-like growth factor I did not vary markedly. A marked increase of 60% was seen in the urinary 24-h output of 3 alpha-androstanediol glucuronide with diet P. Urinary 24-h excretion rates for C peptide, free cortisol, DHEAS, and total 17-ketosteroid sulfates were clearly reduced with diet L compared to those with diet N or P. Our results show that a lactovegetarian diet can reduce adrenocortical activity (at least after a short term diet change). In addition, this vegetarian nutrition leads to a particular metabolic situation (elevated plasma DHEAS and reduced urinary DHEAS output) that usually is characteristic of fasting. Peripheral androgen metabolism as reflected by urinary 3 alpha-androstanediol glucuronide appears to be influenced only by high protein intake (diet P). Further research (controlled dietary long term investigation) is required 1) to validate whether the effects of diet on adrenocortical activity represent sustained endocrine changes and 2) to elucidate the underlying mechanism.
本研究的目的是确定特定的饮食变化是否会影响肾上腺皮质活动和/或肾上腺雄激素代谢。在六名健康成年志愿者中进行了一项对照实验饮食研究,包括四个连续的饮食阶段(重复测量设计)。提供了四种能量相近的饮食,两种正常(N)的适度富含蛋白质的饮食、一种高蛋白(P)饮食和一种低蛋白乳类素食(L)饮食。在每个为期5天的饮食阶段结束时,从每个受试者采集一份血样和两份24小时尿液样本。与饮食N相比,饮食L使硫酸脱氢表雄酮(DHEAS)的血浆水平升高(6.5±1.4对5.3±1.1μmol/L;P<0.05),而其他血浆激素,包括皮质醇和胰岛素样生长因子I没有明显变化。饮食P使尿中3α-雄烷二醇葡萄糖醛酸苷的24小时排出量显著增加60%。与饮食N或P相比,饮食L使C肽、游离皮质醇、DHEAS和总17-酮类固醇硫酸盐的尿24小时排泄率明显降低。我们的结果表明,乳类素食饮食可降低肾上腺皮质活动(至少在短期饮食改变后)。此外,这种素食营养导致一种特殊的代谢状况(血浆DHEAS升高和尿DHEAS排出量降低),这通常是禁食的特征。尿中3α-雄烷二醇葡萄糖醛酸苷所反映的外周雄激素代谢似乎仅受高蛋白摄入(饮食P)的影响。需要进一步研究(对照饮食长期调查)1)以验证饮食对肾上腺皮质活动的影响是否代表持续的内分泌变化,以及2)阐明其潜在机制。