Previous studies have shown that unsaturated fat-enriched diets may have a beneficial effect on blood pressure in non-insulin-dependent diabetic (NIDDM) patients, whereas little is known about the effects on albuminuria. In a 3-week cross-over design we compared the effects of a currently recommended high-carbohydrate diet (50% carbohydrate, 30% fat [10% monounsaturated fat]) vs a diet rich in monounsaturated fat (30% carbohydrate, 50% fat [30% monounsaturated fat]) on urinary albumin excretion rate, 24-h ambulatory blood pressure and metabolic control in ten NIDDM patients with persistent microalbuminuria. The 24-h ambulatory blood pressure was similar before and after both the high-carbohydrate diet (mean +/- SD: 145/78 +/- 25/10 vs 143/79 +/- 19/10 mmHg (NS) and the monounsaturated fat diet: 140/78 +/- 16/8 vs 143/79 +/- 15/8 mmHg (NS). No changes were observed in day or night-time blood pressures. Urinary albumin excretion rate was unaffected after 3 weeks' treatment by the diets: from (geometric mean x/divided by tolerance factor) 32.4 x/divided by 2.1 to 36.0 x/divided by 1.9 micrograms/min (NS) vs from 34.2 x/divided by 1.9 to 32.1 x/divided by 2.1 micrograms/min (NS). Fasting plasma glucose, serum fructosamine and HbA1c as well as lipid and lipoprotein concentrations were stable during both diets. Compared to the high-carbohydrate diet a reduction in the LDL/HDL cholesterol ratio was observed during the monounsaturated fat diet (p < 0.03). In conclusion, compared to a high-carbohydrate diet, 3 weeks' treatment with a monounsaturated fat diet did not affect the levels of 24-h ambulatory blood pressure or albuminuria in microalbuminuric NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

译文

:先前的研究表明,非胰岛素依赖型糖尿病(NIDDM)患者中,富含不饱和脂肪的饮食可能会对血压产生有益影响,而对蛋白尿的影响知之甚少。在为期3周的交叉设计中,我们比较了目前推荐的高碳水化合物饮食(50%碳水化合物,30%脂肪[10%单不饱和脂肪])与富含单不饱和脂肪(30%碳水化合物,50%脂肪)的饮食效果脂肪[30%单不饱和脂肪])对10例持续性微量白蛋白尿患者的尿白蛋白排泄率,24小时动态血压和代谢控制的影响。高碳水化合物饮食前后的24小时动态血压相似(平均/-SD:145/78 /-25/10 vs 143/79 /-19/10 mmHg(NS)和单不饱和脂肪饮食:140/78 /-16/8 vs 143/79 /-15/8 mmHg(NS)。白天或夜间血压均无变化,饮食治疗3周后尿白蛋白排泄率未受影响:从(几何平均值x /除以公差系数)32.4 x /除以2.1至36.0 x /除以1.9微克/分钟(NS),从34.2 x /除以1.9至32.1 x /除以2.1微克/分钟(空腹血糖,血清果糖胺和HbA1c以及脂质和脂蛋白的浓度在两种饮食中均保持稳定,与高碳水化合物饮食相比,单不饱和脂肪饮食中LDL / HDL胆固醇比率降低(p < 0.03)。总的来说,与高碳水化合物饮食相比,单不饱和脂肪饮食治疗3周不会影响24小时的轻便微白蛋白尿NIDDM患者的血压或白蛋白尿(摘要截断为250个字)

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