Effect of Unripe Banana Flour on Gut-Derived Uremic Toxins in Individuals Undergoing Peritoneal Dialysis: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.
Effect of Unripe Banana Flour on Gut-Derived Uremic Toxins in Individuals Undergoing Peritoneal Dialysis: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.
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DOI：
10.3390/nu13020646
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发表时间：
2021-02-17
期刊：
影响因子：
5.9
通讯作者：
Cuppari L
中科院分区：
文献类型：
--
作者：
de Andrade LS;Sardá FAH;Pereira NBF;Teixeira RR;Rodrigues SD;de Lima JD;Dalboni MA;Aoike DT;Nakao LS;Cuppari L
在慢性肾脏疾病（CKD）中，肠道衍生代谢物（如硫酸吲哚酚（IS）、硫酸对甲苯酯（pCS）和吲哚-3-乙酸（IAA））的蓄积与疾病负担相关。在这种情况下，益生元作为一种策略出现，通过调节肠道微生物群及其代谢产物的产生来减轻此类化合物的积累。本研究的目的是评估未成熟的香蕉粉（UBF-48%抗性淀粉，益生元）对接受腹膜透析（PD）的个体血清中IS，pCS和IAA浓度的影响。进行了一项随机、双盲、安慰剂对照、交叉试验。43名PD患者随机接受UBF（21 g/天）和安慰剂（蜡质玉米淀粉-12 g/天）序贯治疗4周，反之亦然（4周洗脱期）。主要结局为IS、pCS和IAA的总血清和游离血清水平。次要结局为24 h尿排泄和透析清除IS、pCS和IAA、血清炎症标志物[高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和肿瘤坏死因子-α（TNF-α）]、血清脂多糖LPS和饮食摄入。在43名随机化个体中，26名完成了随访（年龄= 55 ± 12岁; 53.8%为男性）。UBF未促进IS（p = 0.70）、pCS（p = 0.70）和IAA（p = 0.74）血清水平的变化。在每日UBF摄入量接近研究中拟定摄入量的受试者亚组（n = 11;安慰剂组：中位79.5 μmol/L（31-142）vs UBF组：62.5 μmol/L（31-133），p = 0.009）中观察到血清总IS降低。其他次要结局未观察到变化。UBF没有促进IS或pCS和IAA血清水平的变化; IS的降低仅见于能够服用21 g/天UBF的参与者亚组。
In chronic kidney disease (CKD), the accumulation of gut-derived metabolites, such as indoxyl sulfate (IS), p-cresyl sulfate (pCS), and indole 3-acetic acid (IAA), has been associated with the burden of the disease. In this context, prebiotics emerge as a strategy to mitigate the accumulation of such compounds, by modulating the gut microbiota and production of their metabolites. The aim of this study was to evaluate the effect of unripe banana flour (UBF—48% resistant starch, a prebiotic) on serum concentrations of IS, pCS, and IAA in individuals undergoing peritoneal dialysis (PD). A randomized, double-blind, placebo-controlled, crossover trial was conducted. Forty-three individuals on PD were randomized to sequential treatment with UBF (21 g/day) and placebo (waxy corn starch—12 g/day) for 4 weeks, or vice versa (4-week washout). The primary outcomes were total and free serum levels of IS, pCS, and IAA. Secondary outcomes were 24 h urine excretion and dialysis removal of IS, pCS, and IAA, serum inflammatory markers [high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α)], serum lipopolysaccharide LPS, and dietary intake. Of the 43 individuals randomized, 26 completed the follow-up (age = 55 ± 12 years; 53.8% men). UBF did not promote changes in serum levels of IS (p = 0.70), pCS (p = 0.70), and IAA (p = 0.74). Total serum IS reduction was observed in a subgroup of participants (n = 11; placebo: median 79.5 μmol/L (31–142) versus UBF: 62.5 μmol/L (31–133), p = 0.009) who had a daily UBF intake closer to that proposed in the study. No changes were observed in other secondary outcomes. UBF did not promote changes in serum levels of IS or pCS and IAA; a decrease in IS was only found in the subgroup of participants who were able to take 21g/day of the UBF.
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DOI：
10.1007/s10482-016-0737-y
发表时间：
2016-10-01
影响因子：
2.6
作者：
Jiang, Shuanghong;Xie, Shan;Chen, Ye
通讯作者：
Chen, Ye
影响因子：
2.5
作者：
Lau WL;Kalantar-Zadeh K;Vaziri ND
通讯作者：
Vaziri ND
影响因子：
7.1
作者：
Birkett, A;Muir, J;ODea, K
通讯作者：
ODea, K
影响因子：
6.1
作者：
Esgalhado, Marta;Kemp, Julie Ann;Mafra, Denise
通讯作者：
Mafra, Denise
影响因子：
5.4
作者：
Jones JM
通讯作者：
Jones JM