Sources of Protein and Polyunsaturated Fatty Acids of the Diet and Microalbuminuria in Type 2 Diabetes Mellitus

BACKGROUND: Albuminuria excretion rate above the reference range and below albustix positive proteinuria (20-199 μg/min) is known as microalbuminuria and has been associated with an increased risk of death and progression to renal failure. Besides hyperglicemia and high blood pressure levels, dietar...

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Published in:Journal of the American College of Nutrition 2008-10, Vol.27 (5), p.528-537
Main Authors: Almeida, Jussara C, Zelmanovitz, Themis, Vaz, Juliana S, Steemburgo, Thais, Perassolo, Magda S, Gross, Jorge L, Azevedo, Mirela J
Format: Article
Language:English
Subjects:
adults
Aged
Albuminuria - etiology
Albuminuria - physiopathology
animal source protein
Biological and medical sciences
blood glucose
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications
Diabetic Nephropathies
diet
Diet - adverse effects
Diet Records
dietary fat
Dietary Fats - administration & dosage
dietary intake
dietary protein
Dietary Proteins - administration & dosage
DN = diabetic nephropathy
excretion
Fatty Acids, Unsaturated - administration & dosage
Feeding. Feeding behavior
Female
foods
Fundamental and applied biological sciences. Psychology
Humans
Logistic Models
Male
margarine
MICRO = microalbuminuric
microalbuminuria
Middle Aged
noninsulin-dependent diabetes mellitus
NORMO = normoalbuminuric
nutrient intake
patients
plant fats and oils
plant oils
polyunsaturated fatty acids
protein intake
PUFAs = polyunsaturated fatty acids
renal failure
Risk Factors
serum albumin
type 2 diabetes mellitus
UAE = urinary albumin excretion
urine
Vertebrates: anatomy and physiology, studies on body, several organs or systems
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Summary:BACKGROUND: Albuminuria excretion rate above the reference range and below albustix positive proteinuria (20-199 μg/min) is known as microalbuminuria and has been associated with an increased risk of death and progression to renal failure. Besides hyperglicemia and high blood pressure levels, dietary factors can also influence albuminuria. OBJECTIVE: To evaluate possible associations of dietary components (macronutrients and selected foods) with microalbuminuria in type 2 diabetic patients. METHODS: In this cross-sectional study, 119 normoalbuminuric [NORMO; 24-h urinary albumin excretion (UAE) < 20 μg/min; immunoturbidimetry] and 62 microalbuminuric (MICRO; UAE 20-199 μg/min) type 2 diabetic patients, attending the Endocrine Division, Hospital de Clínicas de Porto Alegre (Brazil), without previous dietary counseling, underwent 3-day weighed-diet records, and clinical and laboratory evaluation. RESULTS: MICRO patients consumed more protein (20.5 ± 4.4 vs. 19.0 ± 3.5% of total energy; p = 0.01) with a higher intake from animal sources (14.5 ± 4.7 vs. 12.9 ± 3.8% of total energy; p = 0.015) than NORMO patients. The intakes of PUFAs (8.6 ± 2.9 vs. 9.7 ± 3.3% of total energy; p < 0.03), PUFAs from vegetable sources (7.3 ± 3.4 vs. 8.6 ± 3.7% of total energy; p = 0.029), plant oils [0.2 (0.1-0.6) vs. 0.3 (0.1-0.9) mg/kg weight; p = 0.02] and margarines [3.3 (0-75.7) vs. 7.0 (0-51.7) g/day; p = 0.01] were lower in MICRO than in NORMO. In multivariate logistic regression models, adjusted for age, gender, presence of hypertension and fasting plasma glucose, intake of total protein (% of total energy; OR 1.104; 95% CI 1.008-1.208; p = 0.032) was positively associated with microalbuminuria. The intakes of total PUFAs (% of total energy; OR 0.855; 95%CI 0.762-0.961; p = 0.008), PUFAs from vegetable sources (% of total energy; OR 0.874; 95%CI 0.787-0.971; p = 0.012) and plant oils (mg/kg weight; OR 0.036; 95% CI 0.003-0.522; p = 0.015) were negatively associated with microalbuminuria. CONCLUSIONS: In type 2 diabetic patients, the high intake of protein and the low intake of PUFAs, particularly from plant oils, were associated with the presence of microalbuminuria. Reducing protein intake from animal sources and increasing the intake of lipids from vegetable origin might-reduce the risk of microalbuminuria.
ISSN:0731-5724
1541-1087
DOI:10.1080/07315724.2008.10719735