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A very-low-protein diet ameliorates advanced diabetic nephropathy through autophagy induction by suppression of the mTORC1 pathway in Wistar fatty rats, an animal model of type 2 diabetes and obesity.

Diabetologia
June 1, 2016
Munehiro Kitada et al. (8 authors)
Journal ArticleAnimal Study
Study Details

Study Goal

The researchers aimed to investigate the renoprotective effects of a low-protein diet (LPD) and its underlying molecular mechanism in a rat model of type 2 diabetes and obesity.

Results Summary

The LPD (5.77% protein) improved renal function and histology, particularly tubulointerstitial damage, by restoring autophagy through suppression of the mTORC1 pathway. The diet also partially decreased HbA1c levels without affecting blood pressure.

Population

Diabetic male Wistar fatty (fa/fa) rats (WFRs)

Effective Dosage

5.77% protein diet

Duration

20 weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low-protein diet (LPD) (5.77% protein)
decrease
damage as shown by the assessment of renal function and histology, particularly tubulointerstitial damage in diabetic kidneys
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
clearly ameliorated
#1
low-protein diet (LPD) (5.77% protein)
decrease
p-S6RP levels
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
significantly suppressed
#2
low-protein diet (LPD) (5.77% protein)
increase
microtubule-associated protein light chain 3-II levels
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
increased
#3
low-protein diet (LPD) (5.77% protein)
decrease
HbA1c levels
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
partially decreased
#4
low-protein diet (LPD) (5.77% protein)
no change
mean BP
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
no differences
#5
very-low-protein diet
increase
advanced diabetic renal injuries, including tubulointerstitial damage
Diabetic male Wistar fatty (fa/fa) rats (WFRs)
-
improved
#6
Abstract

AIMS/HYPOTHESIS: The efficacy of a low-protein diet (LPD) on diabetic nephropathy is controversial. We aimed to investigate the renoprotective effects of an LPD and the underlying molecular mechanism in a rat model of type 2 diabetes and obesity. METHODS: Diabetic male Wistar fatty (fa/fa) rats (WFRs) were treated with a standard diet (23.84% protein) or an LPD (5.77% protein) for 20 weeks from 24 weeks of age. We investigated the effect of the LPD on renal function, fibrosis, tubular cell damage, inflammation, mitochondrial morphology of proximal tubular cells (PTCs), apoptosis, autophagy and activation of mammalian target of rapamycin complex 1 (mTORC1). RESULTS: Kidney weight, albuminuria, excretion of urinary liver-type fatty acid binding protein, levels of plasma cystatin C and changes in renal histology, including fibrosis, tubular cell damage and inflammation, were aggravated in WFRs compared with non-diabetic Wistar lean rats (WLRs). Fragmented and swelling mitochondria accumulated in PTCs and apoptosis were enhanced in the kidney of WFRs. Immunohistochemical staining of p62 and p-S6 ribosomal protein (p-S6RP) in the tubular lesions of WFRs was increased compared with WLRs. The LPD intervention clearly ameliorated damage as shown by the assessment of renal function and histology, particularly tubulointerstitial damage in diabetic kidneys. Additionally, the 5.77% LPD, but not the 11.46% LPD, significantly suppressed p-S6RP levels and increased microtubule-associated protein light chain 3-II levels in the renal cortex. The LPD intervention partially decreased HbA1c levels in WFRs, and no differences in mean BP were observed among any of the groups. CONCLUSIONS/INTERPRETATION: A very-low-protein diet improved advanced diabetic renal injuries, including tubulointerstitial damage, by restoring autophagy through the suppression of the mTORC1 pathway.

Medical Subject Headings (MeSH)
AnimalsAutophagyDiabetes Mellitus, Type 2Diabetic NephropathiesDiet, Protein-RestrictedDisease Models, AnimalImmunohistochemistryMaleMechanistic Target of Rapamycin Complex 1Microscopy, Electron, TransmissionMultiprotein ComplexesObesityRatsRats, WistarReal-Time Polymerase Chain ReactionTOR Serine-Threonine Kinases
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality78/10
Citation Metrics
Total Citations70
Citations/Year7.8
Relative Citation Ratio2.57
NIH Percentile81.4%
Research Impact Scores
APT Score0.75
Weight Score1.00
Normalized Score0.70
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