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[1]王 静,阮 芸,谭擎缨,等.α-酮酸在早期2型糖尿病肾病治疗中 的作用[J].医学研究与战创伤救治(原医学研究生学报),2008,10(06):426.
　WANG Jing,RUAN Yun,TAN Qing-ying,et al.The effect of α-keto acid on early diabetic nephropathy in type 2 diabetes mellitus[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(06):426.
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α-酮酸在早期2型糖尿病肾病治疗中 的作用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第10卷
期数:
2008年06期
页码:
426
栏目:
出版日期:
2008-11-20

文章信息/Info

Title:
The effect of α-keto acid on early diabetic nephropathy in type 2 diabetes mellitus
文章编号:
1672-271X(2008)06-0426-04
作者:
王 静; 阮 芸; 谭擎缨; 阮 勇; 姚乐燕
解放军第117医院，浙江杭州 310013
Author(s):
WANG Jing; RUAN Yun; TAN Qing-ying; RUAN Yong;  YAO Le-yan
The 117th Hospital of PLA,Hangzhou 310013,Zhejiang,China
关键词:
α-酮酸; 2型糖尿病; 糖尿病肾病; 胰岛素敏感性
Keywords:
α-keto acid;  Type 2 diabetes mellitus;  Diabetic nephropathy;  Insulin sensitivity
分类号:
R587.24
DOI:
-
文献标志码:
A
摘要:
目的 观察α-酮酸在早期2型糖尿病肾病治疗中的作用。方法 将60例微量白蛋白尿期2型糖尿病肾病患者随机分为:(1)治疗组(n=30),予以低蛋白饮食(蛋白质0.6 g·kg－1·d－1，包括α-酮酸2.4 g，3/d);(2)对照组(n=30)，予以常规蛋白饮食(蛋白质1.0 g·kg－1·d－1，不服用α-酮酸)。分别于治疗前、治疗24周后测定:(1)肾脏相关指标:血清尿素(BUN)、肌酐(Cr)、肾小球滤过率(GFR)、尿白蛋白(Alb)、尿转铁蛋白(TRF)；(2)营养相关指标:血红蛋白(Hb)、血清白蛋白、体重指数(BMI)；(3)代谢相关指标:空腹血糖(FPG)、餐后2h血糖(PPG)、糖化血红蛋白(HbAlc)、空腹血清胰岛素(FINS)、血清甘油三酯(TG)、血清胆固醇(TC)。计算胰岛素敏感指数(ISI)及胰岛素抵抗指数(HOMA-IR)。结果 24周后治疗组尿Alb定量、尿TRF较对照组明显下降(P<0.01),血FINS及胰岛素抵抗指数也明显降低(P<0.05)、ISI提高(P<0.05),两组间血清Alb、Hb、FPG、PPG、HbA1c及血脂等无明显差异。结论 α-酮酸联合低蛋白饮食(LPD)可显著减少2型糖尿病早期肾病患者的尿Alb，保护肾功能，提高机体对胰岛素敏感性，且未加重代谢紊乱，无营养不良的发生。
Abstract:
Objective To evaluate the effect of low-protein diet supplemented with α-keto acid on early diabetic nephropathy in type 2 diabetes mellitus. Methods Sixty patients with microalbuminuria were divided into 2 groups. Thirty were assigned to a low-protein diet supplement with α-keto acid (0.6 g·kg-1·d-1 diet protein including α-keto acid 7.2 g/d) and another thirty were assigned to routine diet (1.0 g·kg-1·d-1 diet protein without α-keto acid). Before and after treatment for 24 weeks, the level of urine albumin (Alb), transferrin (TRF), serum urea (BUN), serum creatinine (Cr) and glomerular filtration rate (GFR) were measured to evaluate degree of kidney damage, serum albumin, blood hemoglobin (Hb) and body mass index (BMI) were determined to evaluate nutritional status in the patients, and fast plasma glucose (FPG),postprandial plasma glucose (PPG), fast serum insulin (FINS), blood glycohemoglobin (HbA1c), serum cholesterol (TC) and serum triglyceride (TG) were measured to evaluate the metabolic status. Insulin sensitivity index (ISI) and HOMA-IR were calculated. Results After 24 weeks of experiment, the levels of albumiuria and transferrin in test group significantly decreased (P<0.01). ISI increased and serum insulin and HOMA-IR decreased in experiment group compared with those in control group (P<0.05). The nutrition parameters and metabolic parameters had not significant difference between two groups.Conclusion Low-protein diet supplemented with α-keto acid beneficially reduced albuminuria in type 2 diabetes mellitus with microalbuminuria, so as to improve ISI and delay the development of diabetic nephropathy.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-11-22