| ObjectiveTo explore the nutrition characteristics of fortified resistant starch(RS)low protein staple food through the laboratory determination.To explore the effect of fortified RS low protein staple food on patients with early type ? diabetic nephropathy(DN)through the clinical intervention trial.It can provide the basis for improving the prognosis of early type ? DN and enriching the nutritional treatment measures of DN and also provide support for the development and utilization of RS in health foods.Methods1.Laboratory determination of fortified RS low protein staple food:We recruited 10 healthy.Blood samples were taken from the fingertip at 8 hours after the day of the election,and blood glucose was measured by the blood glucose meter.Oral 200ml containing 50g glucose was measured at 15,30,45,60,90 and 120 minutes after intake of food.The second text was at 5 days later,the subjects consumed 61 grams of fortified resistant starch low protein staple food(equivalent to 50 grams of carbohydrate),and the same operation measure of blood glucose at different time points.The area under the blood glucose curve was callculated by OriginPro 8 software,and the GI value was calculated by Wolever method.The content of RS was determined by in vitro simulated gastrointestinal enzyme digestion method.After pretreatment,the sample was hydrolyzed by using high temperature resistant alpha amylase to convert the digestible starch into glucose.Then we centrifuged and discarded supernatant,precipitated into a certain concentration of KOH to dissolve RS,converted it into glucose through the effect of starch glucosidase,and measured the glucose content by the glucose kit.The glucose content multiplied by 0.9 was converted into RS content.2.Population intervention trial of fortified RS low protein staple food:According to the inclusion criteria and exclusion criteria of DN,75 cases of early type DN patients were recruited.The patients were randomly divided into intervention group(37 cases)and control group(38 cases).During the experiment,two groups of patients were treated with low salt,low fat,and high quality-low protein diet.The intervention time was 12 weeks.During this period,the patients in the intervention group and the control group all made the standard DN diet according to the sex,age,labor intensity,and the protein intake was controlled in 0.8g/kg/d.The fasting blood glucose(FBG),glycated hemoglobin(HbAlc),cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c),serum albumin(PA),serum prealbumin(ALB),serum urine nitrogen(BUN),serum creatinine(Scr),serum uric acid(UA),urinary creatinine(UCR),the ratio of urine amylase to urine creatinine,urinary ?2 microglobulin(?2-MG),superoxide dismutase(SOD),malondialdehyde(MDA),tumor necrosis factor alpha(TNF-?),and interleukin-6(IL-6)were respectively measured at the beginning of the trial and the end of twelfth weekend.The data were analyzed by SPSS21.0 software,and the continuous variables were presented by mean ± standard deviation(x ± s).Chi square test was used for categorical variables.The paired sample t test was used for change from baseline,and the independent sample t test was used in the comparison between the two groups.The statistical significance was determined by P<0.05.Results1.Laboratory determination of fortified RS low protein staple foodThe blood glucose of fortified RS low protein staple food t at 15,30,45,and 60 min was significantly lower than glucose group(P<0.05).Using glucose as reference food,the GI value of fortified RS low protein staple food was 54.85±11.55.The absorbance value of the tested sample was 1.49,and the RS content of fortified RS low protein staple food was 17.41.2.Population intervention trial of RS low protein staple food2.1 After the end of the trial,34 patients in the intervention group completed the trial,and 36 patients in the control group completed the trial.The total loss rate was 6.67%.There was no significant difference between the two groups in general information(P>0.05).2.2 The FBG and HbAlc levels in the intervention group were significantly lower than baseline(.P<0.05).There was no significant difference in FBG and HbAlc between the control group and the control group(P>0.05).2.3 The serum TC and TG levels in the intervention group were significantly lower than the baseline,and the difference was statistically significant(P<0.05).The level of TG in the control group decreased significantly compared with the baseline,and the difference was statistically significant(P<0.05).There was no significant difference in the other indexes between the intervention group and the control group from baseline to final text(P>0.05).The change from baseline of serum TC levels in the intervention group was significantly higher than those in the control group(P<0.05).2.4 The serum ALB of the intervention group was significantly lower than baseline(P<0.05).There was no significant difference in change from baseline for serum ALB level between the two groups(P>0.05).There was no significant change from baseline for serum PA between the two groups(P>0.05).2.5 The serum UA levels in the intervention group and control group were significantly lower than baseline level(P<0.05),and the intervention group decreased significantly compared with the control group(P<0.05).There was no significant difference in change from baseline for serum BUN and Scr levels between the two groups(P>0.05).2.6 There was no significant decrease in ACR level between the two groups(P>0.05).The urine ?2-MG level in the intervention group was significantly decrease than the baseline level(P<0.05),and the difference of urine ?2-MG between the two groups was statistically significant(P<0.05).2.7 The level of T-SOD in the intervention group was significantly higher than baseline(P<0.05),and the T-SOD level in the control group was not significantly different than baseline(P>0.05).There was no significant difference compared with baseline in the MDA level between the intervention group and the control group(P>0.05).2.8 Compared with the baseline,there was no significant difference in the levels of IL-6 and TNF-? between the intervention group and the control group after the trial(P>0.05).There was no significant difference for the IL-6 and TNF-a between the two groups(P>0.05).Conclusions1.Fortified RS low protein staple food has the characteristics of low GI and high RS content.Therefore,it can meet the RS demand of human body,and make up the glycemic index of common low protein staple food.It is beneficial for early DN patients to enhance the compliance of low protein diet mode,and has high clinical application value.2.Reasonable fortified RS low protein staple food intervention can significantly improve blood glucose and blood lipid levels in patients with early DN,decrease the UA level,reduce the excretion of urine ?2-MG,improve the T-SOD level,and enhance the ability of anti-oxidative stress.Therefore,the application of fortified RS low protein staple food on the disease control of early DN patients is conducive to delaying the progress of DN. |
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