Effects of d-alanine Intake on Amino Acid Metabolism and Kidney Function in Healthy Adults: A Multicenter, Randomized Pilot Study

IF 3.8 Q2 NUTRITION & DIETETICS
Megumi Oshima , Tadashi Toyama , Tatsuhiko Toyama , Yusuke Nakade , Toshiaki Tokumaru , Keisuke Sako , Sho Kajikawa , Daiki Hayashi , Hajime Sanada , Takahiro Yuasa , Akihiko Koshino , Keisuke Horikoshi , Taichiro Minami , Shunsuke Tsuge , Akira Tamai , Shiori Nakagawa , Ryo Nishioka , Takeshi Zoshima , Kiyoaki Ito , Shinji Kitajima , Takashi Wada
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Abstract

Background

d-alanine administration prevented kidney damage in a murine acute kidney injury model. Further data are needed on the influence of d-alanine on kidney function in humans.

Objective

This study investigated the effects of d-alanine intake on amino acid metabolism and kidney function in healthy volunteers.

Methods

This multicenter pilot study randomly assigned individuals from the general Japanese population to receive 3 g or 6 g of d-alanine intake per day for 7 d in a 1:1 ratio. The primary endpoint was the mean change in plasma and urine d-alanine levels from baseline to 7 d after intake. The secondary endpoints were mean changes in kidney function and other clinical factors. Safety was assessed by evaluating adverse events and clinical parameters.

Results

We randomly assigned 24 participants to the 3-g (n = 12) and 6-g d-alanine (n = 12) groups. The mean baseline estimated glomerular filtration rate (eGFR) was 73 mL/min/1.73 m2. The mean plasma d-alanine concentration increased from baseline by 77.5 ± 34.3 and 192.1 ± 80.9 nmol/mL in the 3-g and 6-g d-alanine groups (both p < 0.0001), respectively, in a dose-dependent manner (between-group difference: 114.6 nmol/mL; 95% CI: 62.1–167.2; P = 0.0002). A similar increase was observed for the urine d-alanine to creatinine ratio. The mean eGFR was elevated by 5.7 ± 8.8 mL/min/1.73 m2 in the 6-g d-alanine group (P = 0.045) but did not significantly change in the 3-g d-alanine group. Nonserious adverse events were reported in 11 participants.

Conclusions

d-alanine intake increased plasma and urine d-alanine levels and was well tolerated in participants with normal kidney function. These results will be useful in future trials investigating the effects of d-alanine intake on kidney disease progression in patients with chronic kidney disease.

This trial was registered at the UMIN Clinical Trials Registry as UMIN000051466.

摄入 d- 丙氨酸对健康成年人氨基酸代谢和肾功能的影响:一项多中心随机试验研究
背景 d-丙氨酸能预防小鼠急性肾损伤模型中的肾损伤。本研究调查了摄入 d-alanine 对健康志愿者体内氨基酸代谢和肾功能的影响。方法这项多中心试验性研究从日本普通人群中随机分配,以 1:1 的比例每天摄入 3 克或 6 克 d-alanine,持续 7 天。主要终点是血浆和尿液中 d-丙氨酸水平从基线到摄入 7 天后的平均变化。次要终点是肾功能和其他临床因素的平均变化。通过评估不良事件和临床参数来评估安全性。结果我们将 24 名参与者随机分配到 3 克 d-丙氨酸组(12 人)和 6 克 d-丙氨酸组(12 人)。平均基线肾小球滤过率(eGFR)为 73 mL/min/1.73 m2。3 g 和 6 g d-alanine 组的平均血浆 d-alanine 浓度较基线分别增加了 77.5 ± 34.3 和 192.1 ± 80.9 nmol/mL(P 均为 0.0001),且呈剂量依赖性(组间差异:114.6 nmol/mL;95% CI:62.1-167.2;P = 0.0002)。尿液中 d-丙氨酸与肌酐的比值也出现了类似的升高。6 克 d-alanine 组的平均 eGFR 升高了 5.7 ± 8.8 mL/min/1.73 m2(P = 0.045),但 3 克 d-alanine 组的 eGFR 变化不大。结论 d-丙氨酸摄入可提高血浆和尿液中 d-丙氨酸的水平,肾功能正常的参与者对其耐受性良好。这些结果将有助于今后研究摄入 d-alanine 对慢性肾病患者肾病进展影响的试验。该试验在 UMIN 临床试验登记处登记为 UMIN000051466。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Developments in Nutrition
Current Developments in Nutrition NUTRITION & DIETETICS-
CiteScore
5.30
自引率
4.20%
发文量
1327
审稿时长
8 weeks
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