Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus.
Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus.
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DOI：
10.5414/cnp64001
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发表时间：
2005-07
影响因子：
1.1
通讯作者：
T. Stephenson;K. Setchell;C. Kendall;D. Jenkins;James W. Anderson;P. Fanti
中科院分区：
文献类型：
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作者：
T. Stephenson;K. Setchell;C. Kendall;D. Jenkins;James W. Anderson;P. Fanti
背景：在西方世界，糖尿病肾病是终末期肾脏疾病最常见的病因。饮食摄入，包括蛋白质的数量和类型，似乎影响肾脏疾病的进展。本初步研究验证了糖尿病患者饮食中用大豆蛋白代替动物蛋白有助于纠正肾小球高滤过的假设。方法12名患有1型糖尿病（病程15.1 +/- 2.3年）和高滤过（肾小球滤过率，GFR > 120 ml/min/1.73 m2）的年轻成人（年龄29.9 +/- 2.4岁）完成了一项交叉饮食干预试验。在对基线特征和饮食习惯进行为期四周的评估后，研究对象被分配到对照饮食或大豆饮食中，为期八周，之后每个研究对象都被转移到另一个八周的替代饮食中。结果大豆日粮（143 +/- 7.4 ml/min/1.73 m2） 8周后，与基线（159 +/- 7.7 ml/min/1.73 m2）和对照日粮（161 +/- 10.0 ml/min/1.73 m2）相比，平均GFR显著降低（p < 0.02）。大豆异黄酮的尿排泄量在大豆饲粮（染料木素1,014.6 +/- 274.1 nmol/h，大豆黄素2,645.1 +/- 989.6 nmol/h）结束时显著高于基线（染料木素53.7 +/- 31.1 nmol/h，大豆黄素151.1 +/- 74.1 nmol/h）和对照组饲粮（染料木素41.1 +/- 13.3 nmol/h，大豆黄素127.5 +/- 54.0 nmol/h）。大豆饮食显著降低总胆固醇和低密度脂蛋白胆固醇，分别为7%和9%。结论：实施以大豆为基础的饮食似乎可以降低患有1型糖尿病和肾小球高滤过的年轻成年人的GFR、总胆固醇和低密度脂蛋白胆固醇，从而对他们的临床表现产生积极影响。
BACKGROUND Diabetic nephropathy is the most frequent cause of end-stage renal disease in the Western world. Dietary intake, including protein amount and type, seems to affect the progression of renal disease. This pilot study tested the hypothesis that substituting soy protein for animal protein in the diets of diabetics would help correct glomerular hyperfiltration. METHODS Twelve young adults (aged 29.9 +/- 2.4 years) with type 1 diabetes mellitus (duration of diabetes 15.1 +/- 2.3 years) and hyperfiltration (glomerular filtration rate, GFR > 120 ml/min/1.73 m2) completed a crossover, dietary intervention trial. After a four-week assessment of baseline characteristics and dietary habits, subjects were assigned to either a control or soy diet for eight weeks after which each subject was crossed over to the alternative diet for another eight-week period. RESULTS Mean GFR was significantly reduced (p < 0.02) after eight weeks on the soy diet (143 +/- 7.4 ml/min/1.73 m2) compared with baseline (159 +/- 7.7 ml/min/ 1.73 m2) and control diets (161 +/- 10.0 ml/min/1.73 m2). Urinary excretion of the soy isoflavones was significantly higher (p < 0.01) at the end of the soy diet (genistein 1,014.6 +/- 274.1 nmol/h, daidzein 2,645.1 +/- 989.6 nmol/h) compared with baseline (genistein 53.7 +/- 31.1 nmol/h, daidzein 151.1 +/- 74.1 nmol/h) and control diets (genistein 41.1 +/- 13.3 nmol/h, daidzein 127.5 +/- 54.0 nmol/h). The soy diet significantly reduced total and LDL cholesterol by 7% and 9%, respectively. CONCLUSIONS Implementation of a soy-based diet appears to reduce the GFR and total and LDL cholesterol of young adults with type 1 diabetes and glomerular hyperfiltration, thus affecting positively their clinical profile.