| 摘要: | 我國糖尿病的盛行率約為9.2%，而糖尿病患者中有27.4%最終會罹患腎臟病變，是我國血液透析成因第一名。又健保每年花費大約350億在血液透析相關支出，為健保單一給付金額最高的疾病。故如何延緩腎臟功能的惡化，應可有效改善健保支出及國人健康。高血糖會誘發氧化壓力，導致發炎反應進而造成腎臟損傷；動物實驗已經證實，大豆蛋白可延緩初期腎臟病的進程，且有抗氧化、抗發炎的效果。本實驗探討大豆蛋白的抗氧化、抗發炎作用對於末期糖尿病腎臟病變是否仍然有效。將台中童綜合醫院腎臟內科門診的末期糖尿病腎臟病變患者45位，隨機分配至大豆蛋白營養品(n=24)或酪蛋白營養品(n=21)，每日飲用2包，分別於第0、第4個月測量體位、分析空腹血糖(FPG)、血脂值、腎功能(估計腎絲球過濾率(eGFR)及肌酸酐)、脂質過氧化程度(丙二醛)及發炎反應(介白素-6、高敏感度C反應蛋白、可溶性細胞間黏附因子-1(s-ICAM-1)及可溶性血管細胞黏附因子-1)，並追蹤停止攝取營養品後3個月的血壓、FPG、血脂質及腎功能。結果顯示4個月後，兩組的s-ICAM-1皆有改善，而大豆蛋白組的FPG、血清三酸甘油酯(TG)濃度及eGFR明顯較酪蛋白組改善，且停止攝取後3個月，其血清TG濃度仍維持顯著改善。
Prevalence of diabetes mellitus is 9.2% in Taiwan, and there is 27.4% of diabetes mellitus patients will aggravate to nephropathy at least, which is the number one reason of hemodialysis. It has pays 35 billion national health insurance in hemodialysis related every year, which is the most expensive disease. It will improve national health insurance problems and health of nationals by delaying the aggravation of renal function and time to hemodialysis. Hyperglycemia induces oxidative stress, which leads to inflammatory response and renal injury. From the animal experiments, soy protein slows processes of first stages renal diseases; some researches suggest that soy protein has effects of anti-inflammation and anti-oxidation. This study discussed that soy protein if worked on end stages renal disease (ESRD). The 45 subjects of our study were ESRD patients of kidney outpatient of Tungs’ Taichung MertroHarbor Hospital in Taichung city. They were distributed to soy protein (n=24) or casein (n=21) in randomly, and drinked 2 packs supplements everyday for 4 months. The height, body weight, fasting plasma glucose (FPG), blood pressure (BP), blood lipids, renal function (eGFR and creatinine), lipid peroxidation (MDA), inflammatory response (IL-6, hs-CRP, sICAM-1 and sVCAM-1) were analyze in baseline and 4th month, and BP, FPG, blood lipids and renal function were analyze in 3 months discontinue. It showed that the inflammatory response of the 2 teams were improved siginificantly, the FPG, serum triglycerol (TG) concentration and eGFR of soy protein had improved significantly than casein, and the serum TG concentration was still improved after 3 months discontinue. |
