Kev Noj Qab Haus Huv Tus Kheej Hauv Cov Neeg Mob Nrog Hom 2 Mob Ntshav Qab Zib Thiab Kab Mob Raum Ntev: Ob-Edged Ntaj Ntawm Kev Noj Qab Haus Huv Protein

Abstract

Hauv hom 2 mob ntshav qab zib mellitus (T2D), muaj kev tsom xam dav dav thiab muaj zog ntawm kev txwv cov carbohydrates. Txawm li cas los xij, qhov no yuav muaj qhov tshwm sim tsis zoo rau cov neeg uas muaj kab mob hauv lub raum tsis sib xws (CKD) txij li kev txo qis ntawm carbohydrates cuam tshuam txog kev noj zaub mov ntau dua, uas yog qhov kev sib cav tseem ceeb hauv cov neeg mob CKD vim nws qhov cuam tshuam tsis meej hauv kev tswj hwm lub raum los yog noj zaub mov zoo. Peb tau soj ntsuam kev ua raws li cov lus pom zoo ntawm cov protein, suav nrog kev noj zaub mov zoo ntawm cov neeg mob T2D nrog lossis tsis muaj CKD. Cov neeg mob tau muab faib ua peb pawg raws li lawv qhov kwv yees Glomerular Filtration Rate (eGFR): me me rau tsis muaj CKD (eGFR > 60 mL/min/1.73 m2), nruab nrab CKD (eGFR 30–6 0 mL/min/1.73 m2 ), los yog advanced CKD (eGFR < 30 mL/min/1.73 m2 ). Hais txog kev ua raws li cov lus pom zoo ntawm cov protein, 17 feem pua ​​​​ntawm cov neeg mob uas tsis muaj CKD siab heev tau noj < {0.8 g / kg / hnub, 29 feem pua ​​​​ntawm cov neeg mob uas muaj CKD nruab nrab noj> 1.3 g / kg / hnub, thiab 60 feem pua. Cov neeg mob uas muaj CKD siab heev tau noj > 1.0 g / kg / hnub. Tsis tas li ntawd, cov neeg mob uas muaj qhov nruab nrab- lossis qib siab CKD zoo li muaj cov leeg nqaij qis, normalized los ntawm qhov siab, piv rau cov neeg mob uas tsis tshua muaj CKD (p <0.001), thaum lub cev qhov ntsuas qhov ntsuas tsis sib txawv ntawm cov neeg mob uas muaj lossis tsis muaj CKD. (p=0.44). Peb pom tias txawm hais tias kev txwv tsis pub noj zaub mov tsis tau qhia nyob rau hauv ob theem ntawm CKD, kwv yees li 10 feem pua ​​​​tau noj cov protein ntau <0.8 g / kg / hnub, nrog rau kev pheej hmoo ntawm malnourishment thiab sarcopenia. Peb cov lus qhia tseem ceeb yog tswj kev noj zaub mov kom tsawg tsawg kawg yog 0.8 g / kg / hnub kom tiv thaiv cov neeg mob kom tsis txhob noj zaub mov tsis zoo thiab sarcopenic.

Ntsiab lus

ntshav qab zib hom 2; mob raum mob; noj cov protein kom tsawg; sarcopenia.

Nyem qhov no mus yuav Cistanche ntxiv

Taw qhia

Cov pej xeem ntawm cov neeg mob ntshav qab zib hom 2 (T2D) muaj ntau txoj hauv kev, thiab qhov no yuav cuam tshuam rau kev xav tau zaub mov noj [1]. Kwv yees li 30-40 feem pua ​​​​ntawm cov neeg uas muaj T2D, piv txwv li, tsim kab mob raum mob (CKD) [2]. Hauv T2D, muaj kev tsom xam dav dav thiab muaj zog ntawm kev txwv tsis pub carbohydrate [3,4]. Txawm li cas los xij, qhov no yuav muaj qhov tshwm sim tsis txaus ntseeg rau cov neeg uas muaj CKD sib xyaw txij li kev txo qis ntawm carbohydrates cuam tshuam qhov feem ntau ntawm cov protein noj zaub mov, cov khoom noj uas muaj kev sib cav tseem ceeb hauv cov neeg mob CKD vim nws qhov tsis meej meej hauv kev tswj hwm lub raum ua haujlwm lossis kev noj zaub mov zoo [ 5, 6] ib.

The recommended daily allowance for adults with T2D as proposed by the American Diabetes Association equals an intake of 1.0–1.5 g/kg ideal body weight/day [7]. Regarding CKD, patients with moderate CKD (estimated Glomerular Filtration Rate (eGFR) < 60 mL/min/1.73 m2 ) are advised to avoid elevated dietary intakes of protein (>1.3 g / kg / hnub) [8]. Txawm li cas los xij, cov neeg mob uas muaj CKD siab heev (eGFR < 30 mL/min/1.73 m2 ) raug qhia kom txo cov protein noj kom tsawg rau 0.8 g / kg / hnub [8,9].

Nws tsis ntev los no tau pom nyob rau hauv T2D tias kev noj zaub mov ntau dua tsis cuam tshuam nrog lub raum ua haujlwm tsis zoo, uas siv rau ntau yam ntawm lub raum ua haujlwm [10]. Ib qho kev koom tes zoo ntawm kev noj zaub mov muaj protein ntau thiab kev txhim kho ntawm CKD kuj tau pom yav dhau los hauv Telmisartan Ib leeg thiab ua ke nrog Ramipril Ntiaj Teb Qhov Kawg Kev Sib Tham (ONTARGET) [11]. Lub raum kev nyab xeeb ntawm kev noj cov protein ntau yog qhov sib txawv nrog qhov kev xav ntawm kev txhawb nqa kev loj hlob ntawm lub raum kab mob los ntawm cov khoom noj muaj protein ntau [12]. Qhov no tso tawm lub teeb tshiab ntawm kev tswj hwm kev noj zaub mov kom tsawg vim tias muaj kev pheej hmoo ntawm kev noj zaub mov tsis txaus thiab sarcopenia vim yog cov khoom noj muaj protein tsawg hauv cov neeg mob CKD yog qhov kev txhawj xeeb loj [13].

Hauv daim ntawv no, peb tshawb xyuas qhov ua raws li cov lus pom zoo ntawm cov protein hauv kev tshawb fawb ntawm cov neeg mob T2D nrog lossis tsis muaj CKD thiab ntsuas cov khoom noj khoom haus ntawm cov neeg mob no. Tom qab ntawd, raws li qhov kev tshawb pom, peb sib tham thiab kho tus kheej cov lus pom zoo rau cov neeg mob T2D nrog lossis tsis muaj CKD.

Cistanche tubulosa

Cov ntaub ntawv thiab cov txheej txheem

1. Kawm Tsim

Peb tau ua ib txoj kev tshawb fawb hauv Cov Ntshav Qab Zib thiab Kev Ua Neej Nyob Cohort Twente (DIALECT), kev tshawb fawb hauv ntiaj teb kev soj ntsuam tiag tiag hauv cov neeg mob T2D kho hauv kev saib xyuas theem nrab hauv Netherlands [14]. Cov pab pawg tau teeb tsa los tshawb xyuas qhov cuam tshuam luv luv thiab ntev ntawm kev ua neej nyob hauv cov neeg uas muaj T2D uas tau txais kev saib xyuas niaj hnub thiab tsis muaj kev cuam tshuam txog kev kawm. Txoj kev tshawb no tau txais kev pom zoo los ntawm cov koom haum saib xyuas hauv zos (METCTwente, NL57219.044.16; METC-Groningen, 1009.68020), tau sau npe hauv Lub Netherlands Trial Register (NTR sim code 5855), thiab tau ua raws li Cov Lus Qhia ntawm Kev Kho Mob Zoo. Kev tshaj tawm ntawm Helsinki.

2. Cov pejxeem

Cov neeg tshawb nrhiav muaj 433 tus neeg mob uas muaj ntshav qab zib hom 2 hnub nyoog> 18 xyoo. Cov neeg mob nyob ntawm kev kho lub raum los yog cov neeg mob uas tsis muaj peev xwm nkag siab txog lub tswv yim ntawm kev pom zoo tau raug cais tawm ntawm kev koom tes. Rau txoj kev tshawb fawb tam sim no, peb tsis suav cov neeg mob uas tsis muaj lub hom phiaj kev noj zaub mov kom tsawg (n=42), cov ntaub ntawv uas ploj lawm lossis tsis tiav cov ntaub ntawv ntawm lub cev (n=26), thiab cov ntaub ntawv tsis txaus ntawm kev noj zaub mov noj (n { {5}}), tawm 361 tus neeg mob rau kev tshuaj xyuas.

3. Lub raum ua haujlwm

Lub raum muaj nuj nqi raug soj ntsuam los ntawm kwv yees Glomerular Filtration Rate (eGFR) siv lub raum Kab Mob Kab Mob Sib Kis (CKD-EPI) cov qauv [15]. Peb siv cystatin-C-raws li eGFR los txhais me me rau tsis muaj CKD (eGFR> 60 mL / min / 1.73 m2), nruab nrab CKD (eGFR 30–60 mL / min / 1.73 m2) lossis CKD siab heev (eGFR < 30 mL / min / 1.73 m2 ) txij li creatinine-based eGFR tuaj yeem tshaj- lossis qis dua rau lub raum ua haujlwm hauv kev teb rau kev hloov pauv cov leeg nqaij [16].

4. Kev ntsuas kev noj haus

Lub hom phiaj tag nrho cov protein kom tsawg (g / hnub) tau txiav txim los ntawm Maroni mis: 6.25 × (({2}}.0276 × urinary urea excretion (mmol / 24-h)) ntxiv rau (0.031 × lub cev hnyav)) ntxiv rau cov zis tso zis [17]. Qhov zoo tshaj plaws lub cev hnyav tau siv los kwv yees tag nrho cov protein kom tsawg hauv g / kg / hnub, raws li BMI ntawm 25 kg / m2, sib haum nrog cov lus pom zoo tam sim no.

Tag nrho cov khoom siv hluav taws xob tau txiav txim siab siv cov lus nug ib nrab-quantitative Food Frequency Questionnaire (FFQ), uas tau piav qhia ntau qhov chaw [18].

5. Kev soj ntsuam txog kev noj zaub mov zoo

Lub cev qhov Performance index (BMI) yog xam raws li qhov hnyav muab faib los ntawm squared qhov siab (kg / m2). Cov leeg nqaij tau kwv yees los ntawm 24-h tso zis creatinine excretion tus nqi (CER, mmol/24-h), uas ncaj qha cuam tshuam txog kev ua haujlwm metabolic cov leeg nqaij tsis muaj zog ntawm lub raum ua haujlwm [19]. Cov neeg mob tau hais kom sau lawv cov zis 24-h tso zis kom tau CER tso zis los ntawm kev muab cov concentrations no nrog qhov ntim ntawm 24-h cov zis sau. Cov neeg mob tau qhia kom khaws lub kaus mom hauv qhov chaw txias tsaus, nyiam dua hauv lub tub yees. Txhawm rau txheeb xyuas qhov sib txawv ntawm cov leeg nqaij vim qhov siab sib txawv, kev tshuaj ntsuam tau ua nrog CER normalized los ntawm qhov siab (CER / m2) [20].

Lub cev ua haujlwm tau raug soj ntsuam los ntawm cov lus nug luv luv yav dhau los los ntsuas Kev Noj Qab Haus Huv Txhim Kho Lub Cev Lub Cev (SQUASH) [21]. Peb tau qhab nia cov neeg mob ua tau raws li Dutch Healthy Exercise Norm yam tsawg kawg ntawm 30-min nruab nrab-siv kev ua ub no rau tsawg kawg 5 hnub hauv ib lub lis piam [22]. Lwm cov txheej txheem kawm tau piav qhia ntau qhov chaw [14,23].

6. Kev Tshawb Fawb Txog Kev Tshawb Fawb

Tag nrho cov kev txheeb xyuas kev txheeb cais tau ua tiav siv SPSS version 27.0 (IBM, Chicago, Illinois). Feem ntau faib cov hloov pauv tau nthuav tawm raws li qhov txhais tau tias ± tus qauv sib txawv thiab dichotomous sib txawv raws li tus lej (feem pua). Ib tug ob-tailed p-tus nqi < 0.05 tau suav tias yog qhov tseem ceeb.

Tag nrho cov protein ntau tau muab faib ua plaub pawg:<0.8 g/kg/day, 0.8 to 1.0 g/kg/day, 1.0 to 1.3 g/kg/day, and >1.3 g / kg / hnub. Kev ua raws li cov lus pom zoo ntawm cov protein tau txhais tias yog 1. 10}}.8–1.0 g/kg/hnub (advanced CKD). Qhov sib txawv ntawm cov yam ntxwv ntawm pawg CKD tau sim los ntawm kev siv ib txoj kev ANOVA rau ib txwm faib cov hloov pauv thiab chi-square test rau dichotomous variables.

Cistanche hmoov

Kev sib tham

Hauv txoj kev tshawb no ntawm 361 tus neeg mob T2D nrog lossis tsis muaj CKD, peb tau tshawb xyuas kev ua raws li cov lus pom zoo ntawm cov protein, thiab peb tau soj ntsuam cov khoom noj khoom haus ntawm cov neeg mob no. Cov kev tshawb pom tseem ceeb yog tias kev ua raws li kev noj zaub mov noj protein tsis zoo: tsis ua raws li cov lus pom zoo rau kev noj zaub mov muaj protein ntau kuj tshwm sim hauv cov neeg mob uas tsis muaj CKD uas tsis tau txais cov lus qhia tshwj xeeb rau kev noj zaub mov kom tsawg. Tsis tas li ntawd, cov neeg mob uas muaj mob nruab nrab lossis qib siab CKD muaj cov leeg nqaij qis dua piv rau cov neeg mob uas tsis muaj CKD.

Kev kho tus kheej ntawm cov lus pom zoo noj protein, noj CKD rau hauv tus account, zoo li yog qhov tseem ceeb. Tau ntau xyoo, kev noj zaub mov muaj protein ntau hauv cov neeg mob CKD yog ib lub ntsiab lus tseem ceeb ntawm kev sib cav tswv yim [24]. Kev noj zaub mov muaj protein ntau ib txwm muaj cuam tshuam los ua qhov ua rau muaj kev cuam tshuam ntawm lub raum tsis ua haujlwm hauv CKD [25]. Kev noj zaub mov muaj protein ntau tuaj yeem ua rau glomerular hyperfiltration thiab tuaj yeem ua rau muaj cov tshuaj lom cov protein metabolites, thaum noj zaub mov tsis muaj protein ntau tau txais los ua ib feem ntawm kev kho mob txhawm rau txhawb rau lub raum ntev [26]. Yog li ntawd, yav dhau los, cov zaub mov muaj protein tsawg ntawm 0.6–{8}}.8 g/kg/hnub tau qhia rau cov neeg mob CKD. Tom qab ntawv cov ntaub ntawv nyob rau hauv thaum ntxov 2000s qhia hais tias mus sij hawm ntev noj cov zaub mov uas tsis muaj protein ntau (<0.8 g/kg/day) did not conclusively result in delayed progression of CKD [27], while it is strongly associated with an elevated risk of sarcopenia [28].

Raws li cov lus qhia tam sim no, tsis muaj lus qhia los txwv kev noj zaub mov muaj protein ntau hauv cov theem ua ntej ntawm CKD. Yog li ntawd, nyob rau hauv cov theem CKD ua ntej, kev noj cov protein ntau tuaj yeem yog ib feem ntawm txoj hauv kev uas suav nrog cov khoom xws li cov leeg nqaij kom tiv thaiv cov txheej txheem tsis txaus ntseeg ntawm cov leeg nqaij poob thiab lub cev tsis ua haujlwm. Txoj kev no haum zoo heev hauv kev noj zaub mov nrog kev txwv ntawm carbohydrates. Cov txheej txheem tam sim no ua, txawm li cas los xij, qhia kom txo qis kev noj zaub mov kom tsawg rau {{0}}.8 g/kg/hnub rau cov neeg uas muaj qib CKD ntau dua (eGFR < 30 mL/min/1.73 m2 ). Cov lus qhia no yog kev lag luam tawm txij li kev noj haus hauv qab no ua rau muaj kev pheej hmoo ntawm sarcopenia, thaum qib siab dua tau ib txwm suav tias yog qhov tsis zoo rau lub raum ua haujlwm ntev. Hauv kev xyaum kho mob, kom ncav cuag lub hom phiaj tshwj xeeb rau kev noj cov protein, nws raug pom zoo kom xa cov neeg mob uas muaj CKD siab heev rau kev tawm tswv yim los ntawm kws kho mob, tshwj xeeb tshaj yog tiv thaiv kev noj zaub mov tsis txaus. Nws yog ib qho tseem ceeb uas yuav tsum tau hais txog qhov kev tshawb pom tsis ntev los no los ntawm kev soj ntsuam DIALECT pawg pom tau tias kev noj zaub mov ntau dua, nrog qhov nruab nrab ntawm 1.22 ± 0.33 g / kg / hnub hauv cov neeg muaj T2D, tsis cuam tshuam nrog lub raum ua haujlwm tsis zoo [10], thiab cov txiaj ntsig no siv rau ntau yam ntawm lub raum ua haujlwm. Nws zoo nkaus li, yog li ntawd, thaum tawm tswv yim rau cov neeg mob no, nws tseem ceeb dua kom tsis txhob noj cov protein kom tsawg, tsis yog siab dhau, thiab tias nws muaj kev nyab xeeb rau lub raum mus ntev kom tau txais cov protein ntau dua.

Peb qhov kev pom zoo tseem ceeb yog li ntawd yuav tsum zam kom tsis txhob noj cov zaub mov muaj protein ntau dhau thiab hais qhia tias kev noj zaub mov muaj protein tsawg tsawg kawg yog 0.8 g / kg / hnub yuav tsum tau tswj kom tsis txhob muaj kev noj zaub mov tsis zoo rau cov neeg mob T2D. Kev tshawb fawb ntxiv yog xav tau los soj ntsuam cov kev sib koom ua ke ntawm kev noj zaub mov muaj protein ntau thiab kev pheej hmoo ntawm sarcopenia hauv cov neeg mob CKD siab. Tseem, nws yuav tsum tau hais qhia tias DIALECT cov ntaub ntawv tsis txheeb xyuas qhov kev nyab xeeb ntawm kev noj zaub mov muaj protein ntau, thiab yog li ntawd, kev ceeb toom rau kev noj zaub mov muaj protein ntau tseem nyob hauv qhov chaw. Qhov no yog qhov tshwj xeeb tshaj yog rau cov neeg mob uas muaj CKD nruab nrab, ntawm 29 feem pua ​​​​ntawm cov khoom noj muaj protein ntau tshaj qhov pom zoo. Txij li thaum kev tawm tswv yim txog kev noj haus txog CKD tsuas yog txwv rau lub tsev kho mob ua ntej lim ntshav (piv txwv li, cov neeg mob uas muaj eGFR < 30 mL / min / 1.73 m2 ), nws tsis zoo li cov neeg mob hauv pawg neeg tau txais kev noj qab haus huv yav dhau los rau kev txwv cov protein. Qhov no tuaj yeem cuam tshuam txog kev hloov pauv ntawm kev noj zaub mov muaj feem cuam tshuam nrog ntshav qab zib, hais txog kev txwv tsis pub carbohydrates, uas ib txwm cuam tshuam txog kev noj zaub mov ntau dua. Yog li, qhov no qhia txog qhov yuav tsum tau muaj kev tawm tswv yim txog kev noj haus ntawm cov theem ua ntej ntawm CKD.

Cistanche capsules

Nws yuav tsum tau paub, txawm li cas los xij, cov lus pom zoo ntawm kev noj haus yuav muaj qhov tsis txaus ntseeg. Tshwj xeeb, thaum cov neeg mob tau ceeb toom kom tsis txhob noj ntau dua li cov protein ntau hauv ib hnub, qhov no tuaj yeem ua rau txo qis cov protein kom tsawg dua li qhov xav tau thiab ua rau muaj kev pheej hmoo ntawm kev noj zaub mov tsis txaus. Qhov no yuav tsum ua rau muaj kev txhawj xeeb, tshwj xeeb tshaj yog hais txog kev noj zaub mov zoo ntawm cov neeg mob CKD vim tias qhov kev pheej hmoo ntawm sarcopenia nce zuj zus nrog qis eGFR [13,29]. Lub xeev tsis ua haujlwm metabolic ntawm cov neeg mob nrog CKD tuaj yeem ua rau tsis muaj kev cuam tshuam cov leeg nqaij protein catabolism, uas yog cuam tshuam nrog cov txiaj ntsig tsis zoo [30]. Nyob rau sab saum toj ntawm qhov kev pheej hmoo siab ntawm kev tuag ntxov ntxov vim CKD, cov neeg mob CKD thiab concomitant sarcopenia yuav muaj kev pheej hmoo siab ntxiv ntawm cov txiaj ntsig tsis zoo [31]. Yog li ntawd, txhawm rau txhim kho lub neej zoo thiab kev ua neej ntev, nws yog qhov tseem ceeb tshaj plaws los tiv thaiv sarcopenia hauv cov neeg mob CKD.

Peb cov txiaj ntsig tau qhia tias kev sib xyaw ua ke ntawm T2D nrog CKD yog nrog los ntawm kev sib koom ua ke ntawm cov khoom noj muaj protein tsawg tsawg, kev ua kom lub cev tsis muaj zog, thiab cov leeg nqaij tsis muaj zog, thaum BMI sib npaug ntawm cov rog rog. Raws li qhov xav tau, cov neeg mob me me rau tsis muaj CKD muaj cov leeg nqaij ntau dua piv rau cov neeg mob uas muaj mob nruab nrab lossis qib siab CKD. Qhov no zoo ib yam nrog ntau dua ntawm sarcopenic rog nyob rau hauv cov neeg mob uas muaj nruab nrab los yog siab heev CKD, uas yav tas los soj ntsuam nyob rau hauv cov pej xeem T2D [23,32]. Los ntawm cov leeg nqaij, nce lub zog kom tsawg yuav yog ib yam khoom uas yuav tsum tau xav txog ib sab ntawm kev noj cov protein ntau ntxiv. Txawm li cas los xij, qhov no zoo li qhov tsis txaus ntseeg vim tias ob feem peb ntawm cov neeg mob uas muaj T2D suav nrog hauv peb txoj kev tshawb fawb raug kev txom nyem los ntawm kev rog.

Hais txog lub cev hnyav, peb tau ua dhau los ua pov thawj tias cov neeg mob hauv DIALECT pawg muaj BMI uas ruaj khov nyob rau ntau xyoo lawm, qee qhov sib piv nrog qhov kev xav tias lub cev hnyav hauv cov neeg muaj hnub nyoog nruab nrab maj mam nce ntau xyoo [33]. Ib qho kev piav qhia tuaj yeem pom nyob rau hauv cov ntaub ntawv dav dav uas qhia tias qhov kev poob qis ntawm cov leeg nqaij maj mam tshwm sim hauv cov neeg muaj hnub nyoog nruab nrab uas muaj hnub nyoog nce ntxiv, txawm tias nrawm rau cov hnub nyoog laus [34,35]. Yog li ntawd, peb xav tias nyob rau hauv peb cov pej xeem, cov kev hloov hauv lub cev muaj pes tsawg leeg tshwm sim nyob rau hauv uas ib tug poob ntawm cov nqaij ntshiv tej zaum yuav npog los ntawm ib tug nce nyob rau hauv cov rog rog, uas cov rog rog tau raug pov thawj yuav tsum tau nce mus txog 75 xyoo ntawm lub hnub nyoog [36]. . Yog li ntawd, nws yuav tsim nyog los soj ntsuam cov kev hloov hauv lub cev muaj pes tsawg leeg es tsis yog BMI kom pom ntxov thiab muaj txiaj ntsig zoo tiv thaiv sarcopenia.

Raws li tau hais tseg, kev tawm tswv yim ntawm cov neeg mob CKD los ntawm tus kws kho mob noj zaub mov tau qhia los ntsuas tag nrho cov khoom noj muaj txiaj ntsig [37], uas tau dhau los ua cuam tshuam rau theem ntawm qhov mob hnyav. Raws li ib feem ntawm qhov no, nws yog qhov tseem ceeb los ntsuas lawv qhov kev noj zaub mov muaj protein ntau tam sim no. Qhov no ua rau txo qis ntawm cov protein noj zaub mov nkaus xwb rau cov neeg uas muaj ntau ntau ntawm cov protein noj zaub mov thiab tiv thaiv iatrogenic malnutrition. Tom ntej no mus rau qhov kev ntsuam xyuas ntawm kev noj zaub mov muaj protein ntau ua ke nrog rau lwm cov macronutrients thiab tag nrho cov khoom siv zog, qhov ua rau muaj kev noj zaub mov tsis zoo (piv txwv li, tsis qab los noj mov, noj zaub mov tsis zoo, lossis kev siv tsis raug ntawm cov lus qhia noj zaub mov tsis raug tau txais los ntawm cov kws kho mob) raug coj mus rau hauv tus account.

Nws yog qhov paub zoo tias kev tswj hwm lossis txhim kho cov leeg nqaij, cov neeg mob yuav tsum tsis txhob ua kom cov protein ntau ntxiv, tab sis kuj txhim kho lub cev ua si [38]. Yog li ntawd, tus kheej txoj hauv kev rau kev noj zaub mov muaj protein ntau kuj suav nrog kev soj ntsuam ntawm lub cev qoj ib ce, piv txwv li, cov leeg nqaij thiab qib kev ua si lub cev. Peb tau pom yav dhau los pom kev sib raug zoo ntawm kev noj zaub mov muaj protein ntau thiab cov leeg nqaij hauv tag nrho cov neeg T2D hauv DIALECT pawg thiab tseem muaj kev sib koom ua ke ntawm cov leeg nqaij thiab lub cev ua si [23,32]. Qhov no qhia tau hais tias qhov kev ntsuam xyuas ntawm cov leeg nqaij thiab lub cev ua si yuav muaj txiaj ntsig zoo hauv kev ntsuam xyuas ntawm qhov tshwm sim thiab qhov hnyav ntawm sarcopenia. Txij li cov neeg mob nrog CKD feem ntau yuav raug kev txom nyem los ntawm sarcopenia, qhov no qhia txog qhov tseem ceeb ntawm kev ua kom lub cev muaj zog hauv cov neeg mob CKD kom tswj cov leeg nqaij. Hauv cov pej xeem T2D dav dav, muaj ntau txoj hauv kev los txhim kho lub cev kev ua si mus txog tsawg kawg yog 30-min ntawm kev siv zog nruab nrab ib hnub txij li tsuas yog 58 feem pua ​​​​ntawm cov neeg mob DIALECT ua raws li cov lus qhia rau kev siv lub cev [22 ]. Yog li ntawd, cov lus pom zoo tsis ntev los no tseem tsom rau kev ua si lub cev lossis kev tawm dag zog, nyiam ua txhua hnub los ntawm txhua tus neeg laus, ntev li ntev tau [39,40].

Qhov zoo dua, kev noj zaub mov muaj protein ntau, cov leeg nqaij, thiab qib kev ua haujlwm ntawm lub cev yuav tsum tau soj ntsuam thiab saib xyuas hauv kev kho mob niaj hnub, thiab peb tau ua qhov no los ntawm kev sau 24-h cov zis kuaj. Lwm txoj hauv kev, tej zaum yuav muaj kev hnyav dua tuaj yeem yog qhov kev ntsuam xyuas ntawm lub cev kev ua si thiab cov leeg nqaij muaj zog los ntawm kev ntsuam xyuas ntawm tes tuav lub zog lossis taug kev ceev. Thaum kawg, nws yuav tsim nyog los txheeb xyuas cov hnub nyoog tshwj xeeb ntawm qhov qis, nruab nrab, thiab cov txiaj ntsig siab rau cov leeg nqaij kom paub txog sarcopenia. Peb tau pom yav dhau los hauv pawg DIALECT tias qhov 24-h tso zis creatinine excretion tus nqi tuaj yeem siv los ua qhov taw qhia ntawm cov leeg nqaij hauv kev kho mob niaj hnub thiab nws tseem yog qhov qhia txog kev ua lub cev [41].

Cistanche extract

Hauv cov ntsiab lus, hauv kev kho cov neeg muaj T2D, nws yog ib qho tseem ceeb kom tsis txhob saib xyuas kev noj zaub mov kom tsawg. Rau kev tawm tswv yim txog kev noj haus, yuav tsum muaj kev ntsuam xyuas tus kheej, suav nrog tus neeg mob tus yam ntxwv, xws li kev noj cov protein tam sim no, muaj CKD, cov leeg nqaij, thiab kev ua si lub cev. Cov neeg mob nrog CKD, txawm tias nyob rau theem nrab, muaj kev pheej hmoo siab ntawm sarcopenia thiab tsis muaj zog lub cev. Hauv cov neeg mob no, qhov tseem ceeb yuav tsum tsis txhob poob qis nrog cov protein kom tsawg, tshwj xeeb tshaj yog vim cov pov thawj tsis ntev los no qhia tau hais tias kev noj cov protein ntau dua tsis tau nrog rau lub raum ua haujlwm tsis zoo, raws li tau hais yav dhau los.

Cov ntaub ntawv

1. American Diabetes Association. Cov lus pom zoo thiab kev cuam tshuam rau ntshav qab zib: Daim ntawv tshaj tawm ntawm American Diabetes Association. Diabetes Care 2008, 31 (Suppl. 1), S61–S78. [CrossRef]

2. American Diabetes Association. 11. Microvascular Complications and Foot Care: Cov qauv kev kho mob hauv ntshav qab zib-2021. Diabetes Care 2018, 44 (Suppl. 1), S151–S167. [CrossRef]

3. Snorgaard, O.; Poulsen, GM; Andersen, HK; Astrup, A. Kev tshuaj xyuas thiab kev tshuaj xyuas meta-kev txwv kev noj zaub mov carbohydrate hauv cov neeg mob ntshav qab zib hom 2. BMJ Qhib Diabetes Res. Xyoo 2017, 5, e000354. [CrossRef] [PubMed]

4. Sainsbury, E.; Kizirian, NV; Puab, SR; Gill, T.; Colagiuri, S.; Gibson, AA Cov nyhuv ntawm kev noj zaub mov carbohydrate txwv kev tswj glycemic hauv cov neeg laus uas muaj ntshav qab zib: Kev tshuaj xyuas thiab kev tshuaj ntsuam meta. Ntshav Qab Zib Res. Clin. Xyaum. 2018, 139, 239–252. [CrossRef] [PubMed]

5. Kalantar-Zadeh, K.; Fouque, D. Kev Tswj Xyuas Kev Noj Qab Haus Huv ntawm Kab Mob Raum Mob. N. Engl. J. Med. 2017, 377, 1765–1776. [CrossRef] [PubMed]

6. Koom tes nrog WHO/FAO/UNU Kev Sib Tham. Protein thiab amino acid xav tau nyob rau hauv tib neeg kev noj haus. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv. Tech. Rep. Ser. 2007, 935, 1–265. [CrossRef]

7. American Diabetes Association. 5. Txhim kho tus cwj pwm hloov thiab kev noj qab nyob zoo los txhim kho cov txiaj ntsig kev noj qab haus huv: Cov qauv kev kho mob hauv ntshav qab zib-2021. Diabetes Care 2021, 44 (Suppl. 1), S53–S72. [CrossRef]

8. Kab mob raum: Txhim kho cov txiaj ntsig thoob ntiaj teb (KDIGO). KDIGO 2012 Cov Lus Qhia Txog Kev Kho Mob rau Kev Ntsuam Xyuas thiab Kev Tswj Xyuas Kab Mob Raum Mob. Raum Int. Suppl. 2013, 3, 73–90. [CrossRef]

9. Wu, G. Kev noj zaub mov muaj protein ntau thiab tib neeg noj qab haus huv. Food Funct. 2016, 7, 1251–1265. [CrossRef]

10. Oosterwijk, MM; Grothof, D.; Navis, G.; Bakker, SJ; Laverman, GD High-Normal Protein Intake tsis cuam tshuam nrog kev ua haujlwm ntawm lub raum sai dua rau cov neeg mob ntshav qab zib hom 2: Kev soj ntsuam yav tom ntej hauv DIALECT Cohort. Diabetes Care 2021, 45, 35–41. [CrossRef]

11. Dunkler, D.; Khol, M.; Teo, KK; Heinze, G.; Dehghan, M.; Klas, CM; Gao, P.; Yusuf, S.; Mann, JFE; Oberbauer, R. Kev noj zaub mov muaj feem cuam tshuam rau qhov tshwm sim lossis kev mob raum mob rau cov neeg mob ntshav qab zib hom 2 hauv European Union. Nephrol. Hu rau. Hloov. 2015, 30 (Suppl. 4), iv76–iv85. [CrossRef] [PubMed]

12. Koj, G.; Rhee, CM; Kalantar-Zadeh, K.; Joshi, S. Qhov Teebmeem ntawm Cov Khoom Noj Muaj protein ntau rau lub raum noj qab haus huv thiab kav ntev. J. Am. Soc. Nephrol. Xyoo 2020, 31, 1667–1679. [CrossRef] [PubMed]

13. Kovesdy, CP; Koob, JD; Kalantar-Zadeh, K. Kev tswj cov protein-zog nkim nyob rau hauv uas tsis yog-dialysis-dependent mob raum kab mob: Reconciling tsawg protein kom tsawg nrog kev noj haus kev kho mob. Am. J. Clin. Nutr. 2013, 97, 1163–1177. [CrossRef] [PubMed]

14. Gant, CM; Binnenmars, SH; van den Berg, E.; Bakker, SJL; Navis, G.; Laverman, GD Integrated Assessment of Pharmacological and Nutritional Cardiovascular Risk Management: Blood Pressure Control in the Diabetes and LifeEstyle Cohort Twente (DIALECT). Nutrients 2017, 9, 709. [CrossRef]

15. Inker, LA; Schmid, CH. Tighiouart, H.; Eckfeldt, JH; Feldman, HI; Greene, T.; Kusek, JW; Manzi, J.; Van Lente, F.; Zhang, YL; ua al. Kev kwv yees glomerular pom tus nqi los ntawm cov ntshav creatinine thiab cystatin CN Engl. J. Med. 2012, 367, 20–29. [CrossRef]

16. Mussap, M.; Vestra, MD; Fioretto, P.; Saller, UA; Varagnolo, M.; Nosadini, R.; Plebani, M. Cystatin C yog ib qho rhiab heev dua li creatinine rau kev kwv yees ntawm GFR hauv cov neeg mob ntshav qab zib hom 2. Raum Int. 2002, 61, 1453–1461. [CrossRef]

17. Maroni, BJ; Steinman, TI; Mitch, WE Ib txoj hauv kev rau kev kwv yees kev noj nitrogen ntawm cov neeg mob raum tsis ua haujlwm. Raum Int. Xyoo 1985, 27, 58–65. [CrossRef]

18. Feunekes, GI; Van Staveren, WA; De Vries, JH; Burma, J.; Hautvast, JG Cov txheeb ze thiab biomarker-raws li kev siv tau ntawm daim ntawv nug zaub mov-zaum kwv yees noj cov rog thiab cov roj cholesterol. Am. J. Clin. Nutr. Xyoo 1993, 58, 489–496. [CrossRef]

19. Heymsfield, SB; Arteaga, C.; McManus, C.; Smith, J.; Moffitt, S. Kev ntsuas cov leeg nqaij hauv tib neeg: Kev siv tau ntawm 24- teev urinary creatinine txoj kev. Am. J. Clin. Nutr. Xyoo 1983, 37, 478–494. [CrossRef]

20. Fielding, RA; Velas, B.; Evans, WJ; Bhasin, S.; Morley, JE; Newman, AB; van Kan, GA; Andrieu, S.; Bauer, J.; Breuille, D.; ua al. Sarcopenia: Ib qho mob uas tsis tau kuaj pom hauv cov neeg laus. Tam sim no Consensus Definition: Prevalence, Etiology, thiab Consequences. International Working Group ntawm Sarcopenia. J. Am. Med. Dir. Assoc. 2011, 12, 249–256. [CrossRef]

21. Wendel-Vos, GW; Schuit, AJ; Saris, WH; Kromhout, D. Reproducibility thiab txheeb ze siv tau ntawm daim ntawv nug luv luv los soj ntsuam kev noj qab haus huv-txhim kho lub cev ua si. J. Clin. Epidemiol. 2003, 56, 1163–1169. [CrossRef]

22. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv. Cov lus pom zoo thoob ntiaj teb hais txog kev ua lub cev rau kev noj qab haus huv; WHO Xovxwm: Geneva, Switzerland, 2010.

23. Hagedoorn, IJM; Braber, ND; Oosterwijk, MM; Gant, CM; Navis, G.; Vollenbroek-Hutten, MMR; Van Beijnum, B.-JF; Bakker, SJL; Laverman, GD Kev ua lub cev tsis muaj zog hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus nyuaj yog cuam tshuam nrog cov leeg nqaij qis thiab noj cov protein tsawg. J. Clin. Med. 2020, 9, 3104. [CrossRef]

24. Levey, AS; Greene, T.; Beck, GJ; Caggiula, AW; Kusek, JW; Hunsicker, LG; Klahr, S. Kev txwv tsis pub noj cov protein thiab kev loj hlob ntawm cov kab mob hauv lub raum: Dab tsi yog tag nrho cov txiaj ntsig ntawm MDRD txoj kev tshawb fawb pom? J. Am. Soc. Nephrol. Xyoo 1999, 10, 2426–2439. [CrossRef]

25. Kab mob raum: Txhim kho cov txiaj ntsig thoob ntiaj teb (KDIGO). KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Raum Int. 2020, 98, S1–S115. [CrossRef] [PubMed]

26. Tonneijck, L.; Muskiet, M.; Sib, M.; Van Bommel, EJ; Heerspink, HJL; Van Raalte, DH; Joles, JA Glomerular hyperfiltration hauv ntshav qab zib: Mechanisms, soj ntsuam qhov tseem ceeb, thiab kev kho mob. J. Am. Soc. Nephrol. Xyoo 2017, 28, 1023–1039. [CrossRef] [PubMed]

27. Levey, AS; Greene, T.; Sarnak, MJ; Wang, X.; Beck, GJ; Kusek, JW; Collins, AJ; Kopple, JD Cov nyhuv ntawm kev noj zaub mov muaj protein ntau txwv rau kev loj hlob ntawm cov kab mob raum: Kev soj ntsuam mus sij hawm ntev ntawm Kev Hloov Kho Kev Noj Qab Haus Huv Hauv Lub Raum Kab Mob (MDRD) Txoj Kev Kawm. Am. J. Raum Dis. Xyoo 2006, 48, 879–888. [CrossRef]

28. Morley, JE; Argiles, JM; Evans, WJ; Bhasin, S.; Cella, D.; Deutz, NE; Doehner, W.; Fearon, KC; Ferrucci, L.; ib. Hellerstein, MK. ua al. Cov lus pom zoo rau kev tswj hwm ntawm Sarcopenia. J. Am. Med. Dir. Assoc. 2010, 11, 391–396. [CrossRef]

29. Fouque, D.; Kalantar-Zadeh, K.; Koob, J.; Cano, N.; Chauvau, P.; Khob, L.; Franch, H.; Guarnieri, G.; Ikizler, TA; Cais, G.; ua al. Lub tswv yim nomenclature thiab kev kuaj mob rau cov protein-zog nkim nyob rau hauv mob raum mob thiab mob raum. Raum Int. 2008, 73, 391–398. [CrossRef]

30. Slee, AD Tshawb nrhiav cov kab mob metabolic hauv cov kab mob raum ntev. Nutr. Metab. 2012, 9, 36. [CrossRef]

31. Lin, TY; Peng, CH; Hung, SC; Tarng, DC Lub Cev muaj pes tsawg leeg yog txuam nrog cov txiaj ntsig ntawm kev kho mob hauv cov neeg mob uas tsis yog-dialysis-dependent mob raum mob. Raum Int. Xyoo 2018, 93, 733–740. [CrossRef]

32. Jalving, AC; Oosterwijk, MM; Hagedoorn, IJM; Navis, G.; Bakker, SJL; Laverman, GD Clinical and Dietary Determinants of Muscle Mass in Patients with Type 2 Diabetes: Data from the Diabetes and Lifestyle Cohort Twente. J. Clin. Med. 2021, 10, 5227. [CrossRef] [PubMed]

33. Gant, CM; Mensink, ib.; Binnenmars, SH; van der Palen, J.; Bakker, SJL; Navis, G.; Laverman, GD Lub Cev hnyav hauv lub cev hauv DIAbetes thiab LifeEstyle Cohort Twente (DIALECT-1)—A 20- xyoo kev soj ntsuam. PLoS IB 2019, 14, e0218400. [CrossRef] [PubMed]

34. Cruz-Jentoft, AJ; Sayer, AA Sarcopenia. Lancet 2019, 393, 2636–2646. [CrossRef]

35. Kalyani, RR; Corriere, M.; ib. Ferrucci, L. Cov hnub nyoog muaj feem cuam tshuam txog cov nqaij ntshiv thiab kab mob: Cov txiaj ntsig ntawm ntshav qab zib, rog rog, thiab lwm yam kab mob. Lancet Diabetes Endocrinol. 2014, 2, 819–829. [CrossRef]

36. Kyle, UG; Genton, L.; ib. Hans, D.; Karsegard, L.; ib. Slosman, DO; Pichard, C. Cov hnub nyoog sib txawv ntawm cov rog tsis muaj rog, cov leeg pob txha, lub cev ntawm tes, thiab cov rog rog ntawm 18 thiab 94 xyoo. Eur. J. Clin. Nutr. 2001, 55, 663–672. [CrossRef] [PubMed]

37. Evert, AB; Dennison, M.; ib. Gardner, CD; Garvey, NWS; Lau, KHK; MacLeod, J.; Mitri, J.; Pereira, RF; Rawlings, K.; Robinson, S.; ib. ua al. Khoom noj khoom haus kho mob rau cov neeg laus uas muaj ntshav qab zib los yog prediabetes: Daim ntawv qhia kev pom zoo. Diabetes Care 2019, 42, 731–754. [CrossRef]

38. Paddon-Jones, D.; Rasmussen, BB Noj cov zaub mov cov lus pom zoo thiab kev tiv thaiv ntawm sarcopenia. Curr. Opin. Clin. Nutr. Metab. Saib 2009, 12, 86–90. [CrossRef]

39. Deutz, NPE; Bauer, JM; Barazzoni, R.; Biolo, G.; Boirie, Y.; Bosy-Westphal, A.; Cederholm, T.; Cruz-Jentoft, AJ; Krznariç, Z.; Nair, KS; ua al. Kev noj cov protein ntau thiab kev tawm dag zog kom pom cov leeg nqaij ua haujlwm nrog kev laus: Cov lus pom zoo los ntawm ESPEN Cov Kws Tshaj Lij Pab Pawg. Clin. Nutr. 2014, 33, 929–936. [CrossRef]

40. Liao, C.-D.; Tsau, J.-Y.; Wu, Y.-T.; Cheng, C.-P.; Chen, H.-C.; Huang, Y.-C.; Chen, H.-C.; Liu, T.-H. Kev cuam tshuam ntawm cov protein ntxiv ua ke nrog kev tawm dag zog ntawm lub cev muaj pes tsawg leeg thiab kev ua haujlwm ntawm lub cev hauv cov neeg laus: Kev tshuaj xyuas thiab kev tshuaj xyuas meta. Am. J. Clin. Nutr. 2017, 106, 1078–1091. [CrossRef]

41. Oosterwijk, MM; den Braber, N.; Bakker, SJL; Laverman, GD Urinary Creatinine Excretion yog ib qho qhia txog tag nrho lub cev lub cev ua haujlwm thiab ua haujlwm. J. Cachexia Sarcopenia Muscle, 2022; hauv xovxwm.

Milou M. Oosterwijk 1, Gerjan Navis 2, Stephan JL Bakker 2 thiab Gozewijn D. Laverman 1,3

1 Ziekenhuis Groep Twente, Department of Internal Medicine/Nephrology, 7609 PP Almelo, Lub Netherlands; g.laverman@zgt.nl

2 Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, Lub Netherlands; g.j.navis@umcg.nl (GN); s.j.l.bakker@umcg.nl (SJLB)

3 Department of Biomedical Signals thiab Systems, Kws qhia ntawv ntawm Hluav Taws Xob Engineering, lej thiab Computer Science, University of Twente, 7522 NB Enschede, Netherlands