Acute Effect of a Soy Protein-rich Meal-replacement Application on Renal Parameters in Patients with the Metabolic Syndrome

大豆蛋白餐對代謝症候群病人腎臟參數之急性效應

Peter Deibert ； Lisa Lutz ； Daniel König ； Sabine Zitta ； Andreas Meinitzer ； Mara Z Vitolins ； Gerhild Becker ； Aloys Berg

《Asia Pacific Journal of Clinical Nutrition》 20卷4期 (2011/12) Pp. 527-534

https://doi.org/10.6133/apjcn.2011.20.4.05

摘要

背景：大豆蛋白常被使用在肥胖的代餐治療，然而對於腎臟功能參數的影響尚未被充分研究。本研究評估代謝症候群病人及健康對照，在攝取不同量的大豆蛋白後的腎絲球過濾率（GFR）和腎血漿流量（RPF）。方法：10名患有代謝症候群但沒有腎臟疾病症狀的病人及10名健康對照，攝取每公斤體重1公克蛋白質的大豆-優格-蜂蜜烹調商品。病人組還給予一個蛋白質挑戰，每公斤體重0.3公克。結果：病人組的基礎GFR和RPF 均顯著性較高（147±34.8 vs. 116±21.1ml/min, p=0.01 和848±217 vs. 637±121 ml/min, p=0.02），且與體重有強相關。使用不同的演算法去評估GFR 導致低估GFR，特別是有代謝症候群的病人。每公斤體重1 公克蛋白質的急性蛋白質負荷挑戰，導致健康對照的GFR和RPF增加（GFR: +12.6±11.0 % (p=0.01), RPF: +13.6±15.6 % (p=0.04)），有代謝症候群病人則增加更多（GFR: +31.5±32.2 % (p=0.01); RPF: +19.4±22.7 % (p=0.02)）。每公斤體重攝取0.3公克蛋白質不會誘發顯著改變。結論：代謝症候群病人，即使在沒有微白蛋白尿的情況下，其基礎腎功能已經改變了。此外，蛋白質負荷量的感受性也升高了。然而，使用在大豆蛋白基礎代餐治療的蛋白質建議量，不會產生顯著改變。

關鍵字

腎臟功能 ； 代謝症候群 ； 腎絲球過濾率 ； 腎血漿流量 ； 大豆蛋白

並列摘要

Background: Soy protein is used for meal replacement therapy in obesity, however the influence on renal function parameters is not adequately investigated. This study evaluates glomerular filtration rate (GFR) and renal plasma flow (RPF) in patients with the metabolic syndrome and healthy controls after ingestion of different amounts of soy protein. Methods: 10 patients with the metabolic syndrome but no signs of kidney disease and 10 healthy controls ingested 1 g protein/kg body weight of a commercial soy-yoghurt-honeypreparation. The patient group was also given a protein challenge of 0.3 g/kg body weight. Results: Baseline GFR and RPF both were significantly higher in the patient group (147±34.8 vs. 116±21.1 ml/min, p=0.01 and 848±217 vs. 637±121 ml/min, p=0.02) and were strongly correlated with body weight. Use of different algorithms to estimate GFR resulted in underestimation of GFR, particularly in the patients with the metabolic syndrome. The challenge with an acute protein load of 1g protein per kilogram body weight induced a significant increase in GFR and RPF in healthy controls (GFR: +12.6±11.0 % (p=0.01), RPF: +13.6±15.6 % (p=0.04)) and even more in patients with the metabolic syndrome (GFR: +31.5±32.2 % (p=0.01); RPF: +19.4±22.7 % (p=0.02)). The ingestion of 0.3 g protein/ kg body weight did not induce significant changes. Conclusions: Basic renal function is changed in patients with the metabolic syndrome, even without microalbuminuria. In addition, there is an elevated susceptibility for protein load. However, the protein amount recommended for use in soy-protein based meal replacement therapy induced no significant changes.

並列關鍵字

renal function ； metabolic syndrome ； glomerular filtration rate ； renal plasma flow ； soy protein