Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy
Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy
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DOI：
10.1038/sj.ijo.0803009
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发表时间：
2005-09-01
影响因子：
4.9
通讯作者：
Shirai, K
中科院分区：
文献类型：
--
作者：
Saiki, A;Nagayama, D;Shirai, K
目的：评价低热量配方饮食对肥胖糖尿病肾病患者肾功能和蛋白尿的影响及安全性。产品设计：为期4周的低热量饮食的安全性和有效性的前瞻性研究（11-19 kcal/kg/天）正常蛋白质（0.9-1.2 g/kg/d）的饮食，部分补充配方饮食。（BMI：30.4 +/- 5.3 kg/m（2），HbA 1c：7.1 +/-1.4%，血清肌酐：172.4 +/- 57.5 mmol/l，尿蛋白：3.3 +/- 2.6 g/d）.结果：平均体重下降6.2 +/- 3.0 kg.平均收缩压、肌酐、血尿素氮、尿蛋白和8-羟基脱氧鸟苷分别显著降低7.5 +/- 12.7 mmHg、41.6 +/- 23.9 mmol/l、1.50 +/- 1.61 mmol/l、1.8 +/- 1.7 g/d和3.1 +/- 3.6 ng/mg肌酐。无患者血清肌酐和尿蛋白升高。平均肌酐清除率（40.6 +/- 17.9至46.1 +/- 14.6 ml/s/ 1.73 m2）和血清白蛋白无显著变化。Delta血清肌酐和Delta尿蛋白与Delta体重相关（r分别为0.62和0.49）和Delta内脏脂肪面积（r分别为0.58和0.58），但与Δ收缩压、Δ空腹血糖和Δ皮下脂肪面积无相关性。这些结果表明，使用配方饮食减肥可能会在短期内安全地改善肥胖糖尿病肾病患者的肾功能和蛋白尿。
OBJECTIVE: To evaluate the effect and safety of treatment with low-calorie formula diet on renal function and proteinuria in obese patients with diabetic nephropathy. DESIGN: Prospective study on safety and efficacy of a 4-week low-calorie (11-19 kcal/kg/day) normal-protein (0.9-1.2 g/kg/day) diet partly supplemented with formula diet.SUBJECTS: In all, 22 obese patients with diabetic nephropathy (BMI: 30.4 +/- 5.3 kg/m(2), HbA1c: 7.1 +/- 1.4%, serum creatinine: 172.4 +/- 57.5 mmol/l, urinary protein: 3.3 +/- 2.6 g/day).RESULTS: The mean body weight decreased by 6.2 +/- 3.0 kg. The mean systolic blood pressure, creatinine, blood urea nitrogen, urinary protein, and 8-hydroxydeoxyguanosine decreased significantly by 7.5 +/- 12.7 mmHg, 41.6 +/- 23.9 mmol/l, 1.50 +/- 1.61 mmol/l, 1.8 +/- 1.7 g/day, and 3.1 +/- 3.6 ng/mg creatinine, respectively. No patient had increased serum creatinine and urinary protein. Mean creatinine clearance (40.6 +/- 17.9 to 46.1 +/- 14.6 ml/s/ 1.73 m(2)) and serum albumin showed no significant changes. Delta serum creatinine and Delta urinary protein correlated with Delta body weight (r 0.62 and 0.49, respectively) and Delta visceral fat area (r 0.58 and 0.58, respectively), but did not correlate with Delta systolic blood pressure, Delta fasting blood glucose and Delta subcutaneous fat area.CONCLUSION: These results suggested that weight reduction using formula diet might improve renal function and proteinuria safely for a short term in obese patients with diabetic nephropathy.