ISSN:
1432-0428
Keywords:
Microalbuminuria
;
lipoproteins
;
linoleic acid
;
polyunsaturated fatty acids
;
diet
;
Type 1 (insulin-dependent) diabetes mellitus
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary We conducted a 2-year prospective randomised study to investigate the effects of a linoleic-acid-enriched diet on albuminuria and lipid levels in Type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion (overnight urinary albumin excretion rate between 10 and 200 μg/min). Thirty-eight patients were randomly assigned to increase dietary polyunsaturated: saturated fatty acids ratio to 1.0 by replacement of saturated fat with linoleic-acid-rich products (n=18, two dropouts, analysis was performed in n=16) or to continue their usual diet (n=20). The total fat and protein content of the diet was unaltered. Clinical characteristics, albuminuria, blood pressure, glomerular filtration rate, metabolic control and dietary composition were similar in the two groups at baseline. In the high linoleic acid diet group, linoleic intake rose from 7±4 to 11±2 energy % and polyunsaturated: saturated fatty acids ratio rose from 0.60±0.28 to 0.96±0.16 (p〈0.001 compared to usual diet group). The median increase albuminuria was 58% (95% confidence interval, 13 to 109) during the first year (p〈0.02) and 55% (95% confidence interval, 11 to 127) (p〈0.01) during the second year. Glomerular filtration rate remained unaltered and filtration fraction tended to rise (p〈0.05 compared to usual diet group). In the usual diet group, albuminuria did not significantly increase by 16% (95% confidence interval, -17 to 38) and glomerular filtration rate declined during the second year. Blood pressure tended to rise similarly in both groups. Multiple regression analysis showed an independent effect of the high linoleic acid diet on the progression of albuminuria as well as the lack of decrease in glomerular filtration rate. Low density lipoprotein cholesterol and apolipoprotein B levels decreased in the high linoleic acid diet group (p〈0.05). High density lipoprotein cholesterol declined in both groups (p〈0.05). It is concluded that a linoleic-acid-enriched diet reduces atherogenic lipoproteins but does not have a beneficial effect on and might even promote renal functional abnormalities in Type 1 diabetic patients with elevated urinary albumin excretion.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00402550
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