RESUMO
OBJECTIVE: To assess the effect of replacing red meat with chicken in the usual diet and the effect of a low-protein diet on glomerular filtration rate (GFR), urinary albumin excretion rate (UAER), and lipid levels in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A randomized, crossover, controlled trial was conducted with 28 patients with type 2 diabetes (seven women; mean age 58.1 years): 15 patients were normoalbuminuric (UAER <20 microg/min), and 13 patients were microalbuminuric (UAER 20-200 microg/min). A chicken-based diet (red meat replaced with chicken) and a low-protein diet were compared with the patients' usual diet. Patients followed each diet for 4 weeks with a 4-week washout period between. GFR ((51)Cr-EDTA single-injection technique), 24-h UAER (immunoturbidimetry), apolipoprotein B, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were measured after each diet. RESULTS: Normoalbuminuric and microalbuminuric patients with diabetes were analyzed separately. In normoalbuminuric patients, GFR after the chicken (101.3 +/- 22.9 ml x min(-1) x 1.73 m(-2)) and low-protein diets (93.8 +/- 20.5 ml x min(-1) x m(-2)) was lower than after the usual diet (113.4 +/- 31.4 ml x min(-1) x 1.73 m(-2); P < 0.05). In microalbuminuric patients, apolipoprotein B levels were lower after the chicken (113.5 +/- 36.0 mg/dl) and low-protein diets (103.5 +/- 40.1 mg/dl) than after the usual diet (134.3 +/- 30.7 mg/dl; P < 0.05). Only the chicken diet reduced UAER (median 34.3 microg/min) compared with the low-protein (median 52.3 microg/min) and usual (median 63.8 microg/min) diets (P < 0.05). Glycemic control and blood pressure did not change after the diets. CONCLUSIONS: A normoproteic diet with chicken as the only source of meat may represent an alternative strategy for treatment of patients with type 2 diabetes and microalbuminuria.
Assuntos
Albuminúria , Diabetes Mellitus Tipo 2/fisiopatologia , Proteínas Alimentares/farmacologia , Taxa de Filtração Glomerular/efeitos dos fármacos , Carne , Adulto , Animais , Apolipoproteínas B/sangue , Glicemia/metabolismo , Pressão Sanguínea , Galinhas , Colesterol/sangue , Estudos Cross-Over , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Feminino , Frutosamina/sangue , Hemoglobinas Glicadas/análise , Humanos , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Aves Domésticas , Valores de Referência , Fumar , Triglicerídeos/sangueRESUMO
To assess performance of measurements of urinary albumin concentration and urinary albumin to creatinine ratio in diurnal random urine specimen for the screening of diabetic nephropathy...
Assuntos
Humanos , Nefropatias Diabéticas/diagnóstico , Albuminas/química , Estudos de Coortes , UrináliseRESUMO
O uso de substâncias psicoestimulantes relaciona-se a padrSes de comportamento individual em meio familiar e social. Neste estudo transversal os autores avaliam o consumo atual ou passado de derivados anfetamínicos entre estudantes da Universidade Federal do Rio Grande do Sul. O total de respostas válidas para análise foi de 604 (98,4 por cento do total de 614 entrevistados ). A prevalência geral de uso foi de 13,6 por cento, equilibrada entre os sexos. Foram identificados dois padrSes comportamentais definidos de uso, basicamente como anorexígeno ou como estimulante, o primeiro predominantemente entre mulheres e o segundo mais frequente entre os homens. O convívio com consumidores de anfetaminas na família ou entre amigos mostrou-se fator de risco para o consumo dessas substâncias