Investigation of Uric Acid and Cystatin C on Low-Carbohydrate Diet (LCD)

Background: As to nutritional therapy, continuous discussions were observed concerning calorie restriction (CR) and low-carbohydrate diet (LCD). Authors and colleagues have applied LCD for lots of diabetic patients and reported the detail relationship with ketone bodies and Morbus (M) value. Methods: Ninety-three patients with type 2 diabetes mellitus (T2DM) were considered as subjects in the study, among which 51 were male and 52 were female, 58.3±13.2 years old on average, 60 years old in median. Methods were as follows: 1) patients were admitted and provided formular diet, which included CR diet (60% carbohydrates, 1400 kcal/day) on day 1-2, and LCD (12% carbohydrate, 1400 kcal/day) on day 3-14; 2) several biomarkers on fasting were measured on day 2, 4 and 14; 3) daily profile of blood glucose were done on day 2 and day 4. Results: According to the M-value, subjects were classified into 4 groups, which were less than 25, 26-100, 101-250, more than 251, and number was 24, 24, 24, 21, respectively. The average HbA1c in 4 groups were 6.6%, 7.4%, 8.5% and 9.5% respectively. The median M-values decreased from day 2 to 4, which were 10.4 to 9.1, 53.5 to 7.7, 150 to 19.1 and 438 to 87, respectively. The average uric acid in each group revealed significant increase from day 2 to day 14. There were significant correlation between uric acid increment and creatinine increment, and among creatinine, creatinine clearance (CCr) and Cystatin C. Conclusion: LCD showed efficacy for glucose variability with significant decrease in glucose and M-value. Renal study showed increase of serum uric acid. In addition to correlations of Cystatin C and biomarkers, current results would be from some dehydrated state and/or relative decrease of total calorie intake. These findings would become the fundamental data of efficacy of LCD and its physiological influences for renal function.