RELATIONSHIP OF ANIMAL PROTEIN-RICH DIET TO KIDNEY-STONE FORMATION AND CALCIUM-METABOLISM
RELATIONSHIP OF ANIMAL PROTEIN-RICH DIET TO KIDNEY-STONE FORMATION AND CALCIUM-METABOLISM
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DOI：
10.1210/jcem-66-1-140
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发表时间：
1988-01-01
影响因子：
5.8
通讯作者：
PAK, CYC
中科院分区：
文献类型：
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作者：
BRESLAU, NA;BRINKLEY, L;PAK, CYC
我们希望确定不同类型的膳食蛋白质是否对钙代谢和肾结石形成的倾向有不同的影响。15名年轻的正常受试者在三个为期12天的饮食期间进行了研究，在此期间，他们的饮食含有植物蛋白，植物和鸡蛋蛋白，或动物蛋白。虽然这三种饮食是恒定的钠，钾，钙，磷，镁，和蛋白质的量，他们有逐步更高的硫含量。随着饮食中固定酸含量的增加，尿钙排泄量从103 ±增加。15（.+-. SEM）mg/天（2.6 ±. 0.4 mmol/天）至150 . ±. 13 mg/天（3.7 ±. 0.3 mmol/d）（P < 0.02）。尽管尿钙排泄增加，但尿cAMP排泄和血清PTH和1，25-二羟维生素D水平适度降低，与酸诱导的骨溶解一致。小肠47 Ca吸收分数无变化。不能补偿动物蛋白诱导的尿钙反应可能是骨质疏松症发生的危险因素。动物蛋白质丰富的饮食与最高的未解离尿酸排泄，由于尿pH值的降低。此外，柠檬酸排泄减少，因为酸负荷。然而，草酸排泄低于素食期间[26 . ±. 1 mg/天（290 ±. 10 μ mol/天）对39 ±。2毫克/天（430 . ±. 20 μ mol/天）; P < 0.02]。尿液结晶研究表明，当动物蛋白饮食的电解质组成和蛋白质含量与素食保持相同时，会增加患尿酸结石的风险，但由于相反的因素，不会增加患草酸钙或磷酸钙结石的风险。
We wished to determine whether different types of dietary protein might have different effects on calcium metabolism and on the propensity for renal stone formation. Fifteen young normal subjects were studied during three 12-day dietary periods during which their diet contained vegetable protein, vegetable and egg protein, or animal protein. While these three diets were constant with respect to Na, K, Ca, P, Mg, and quantity of protein, they had progressively higher sulfur contents. As the fixed acid content of the diets increased, urinary calcium excretion increased from 103 .+-. 15 (.+-. SEM) mg/day (2.6 .+-. 0.4 mmol/day) on the vegetarian diet to 150 .+-. 13 mg/day (3.7 .+-. 0.3 mmol/day) on the animal protein diet (P < 0.02). Despite the increased urinary calcium excretion, there was a modest reduction of urinary cAMP excretion and serum PTH and 1,25-dihydroxyvitamin D levels consistent with acid-induced bone dissolution. There was no change in fractional intestinal 47Ca absorption. The inability to compensate for the animal protein-induced calciuric response may be a risk factor for the development of osteoporosis. The animal protein-rich diet was associated with the highest excretion of undissociated uric acid due to the reduction in urinary pH. Moreover, citrate excretion was reduced because of the acid load. However, oxalate excretion was lower than during the vegetarian diet [26 .+-. 1 mg/day (290 .+-. 10 .mu.mol/day) vs. 39 .+-. 2 mg/day (430 .+-. 20 .mu.mol/day); P < 0.02]. Urinary crystallization studies revealed that the animal protein diet, when its electrolytic composition and quantity of protein were kept the same as for the vegetarian diet, conferred as increased risk for uric acid stones, but, because of opposing factors, not for calcium oxalate or calcium phosphate stones.