医学
肾功能
内科学
内分泌学
排泄
2型糖尿病
糖尿病
胆固醇
交叉研究
载脂蛋白B
血脂谱
病理
安慰剂
替代医学
作者
Jorge Luiz Gross,Themis Zelmanovitz,Cileide Cunha Moulin,Vanessa D. de Mello,Magda Susana Perassolo,Cristiane Bauermann Leitão,Alice Hoefel,A Paggi,Mirela Jobim de Azevedo
出处
期刊:Diabetes Care
[American Diabetes Association]
日期:2002-04-01
卷期号:25 (4): 645-651
被引量:103
标识
DOI:10.2337/diacare.25.4.645
摘要
OBJECTIVE—To assess the effect of replacing red meat with chicken in the usual diet and the effect of a low-protein diet on glomerular filtration rate (GFR), urinary albumin excretion rate (UAER), and lipid levels in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—A randomized, crossover, controlled trial was conducted with 28 patients with type 2 diabetes (seven women; mean age 58.1 years): 15 patients were normoalbuminuric (UAER <20 μg/min), and 13 patients were microalbuminuric (UAER 20–200 μg/min). A chicken-based diet (red meat replaced with chicken) and a low-protein diet were compared with the patients’ usual diet. Patients followed each diet for 4 weeks with a 4-week washout period between. GFR (51Cr-EDTA single-injection technique), 24-h UAER (immunoturbidimetry), apolipoprotein B, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were measured after each diet. RESULTS—Normoalbuminuric and microalbuminuric patients with diabetes were analyzed separately. In normoalbuminuric patients, GFR after the chicken (101.3 ± 22.9 ml · min−1 · 1.73 m−2) and low-protein diets (93.8 ± 20.5 ml · min−1 · m−2) was lower than after the usual diet (113.4 ± 31.4 ml · min−1 · 1.73 m−2; P < 0.05). In microalbuminuric patients, apolipoprotein B levels were lower after the chicken (113.5 ± 36.0 mg/dl) and low-protein diets (103.5 ± 40.1 mg/dl) than after the usual diet (134.3 ± 30.7 mg/dl; P < 0.05). Only the chicken diet reduced UAER (median 34.3 μg/min) compared with the low-protein (median 52.3 μg/min) and usual (median 63.8 μg/min) diets (P < 0.05). Glycemic control and blood pressure did not change after the diets. CONCLUSIONS—A normoproteic diet with chicken as the only source of meat may represent an alternative strategy for treatment of patients with type 2 diabetes and microalbuminuria.
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