Miyake Teruki, Yoshida Sakiko, Yamamoto Shin, Furukawa Shinya, Yoshida Osamu, Kanzaki Sayaka, Senba Hidenori, Ishihara Toru, Koizumi Mitsuhito, Tokumoto Yoshio, Hirooka Masashi, Kumagi Teru, Abe Masanori, Kitai Kohichiro, Matsuura Bunzo, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Japan.
Intern Med. 2018 Oct 1;57(19):2799-2805. doi: 10.2169/internalmedicine.0167-17. Epub 2018 May 18.
Objective Low urine pH is associated with several metabolic diseases, such as dyslipidemia, diabetes, and metabolic syndrome. However, the association between low urine pH and non-alcoholic fatty liver disease (NAFLD) remains unknown. Therefore, we conducted a community-based cross-sectional study to investigate this association. Methods Between April 2013 and March 2014, the records of 4,945 Japanese subjects who had undergone annual health checkups were reviewed to identify subjects who met the diagnostic criteria for NAFLD. Patients Based on urine pH, the participants were classified into four groups; a low urine pH was defined as ≤5.5. Of the 3,411 subjects who qualified for enrollment, 1,028 met the diagnostic criteria for NAFLD. Results The prevalence of NAFLD was significantly increased with decreasing urine pH in both men and women (p<0.01 and p=0.02, respectively). A multivariate analysis, including adjustments for age, metabolic markers, and the renal function, showed a significant association between low urine pH and NAFLD in men and women (odds ratio, 1.37; 95% confidence interval, 1.01-1.85, p=0.04 and odds ratio, 1.73; 95% confidence interval, 1.15-2.62, p<0.01, respectively). Conclusion Our study indicates that NAFLD is associated with a low urine pH in both sexes, findings that might help clinicians identify patients at high risk for NAFLD.
目的 低尿pH值与多种代谢性疾病相关，如血脂异常、糖尿病和代谢综合征。然而，低尿pH值与非酒精性脂肪性肝病（NAFLD）之间的关联尚不清楚。因此，我们开展了一项基于社区的横断面研究来调查这种关联。方法 在2013年4月至2014年3月期间，回顾了4945名接受年度健康检查的日本受试者的记录，以确定符合NAFLD诊断标准的受试者。根据尿pH值，将参与者分为四组；低尿pH值定义为≤5.5。在符合纳入条件的3411名受试者中，1028名符合NAFLD诊断标准。结果 男性和女性中，NAFLD的患病率均随尿pH值降低而显著增加（分别为p<0.01和p=0.02）。多因素分析，包括对年龄、代谢指标和肾功能进行校正后，显示男性和女性中低尿pH值与NAFLD之间存在显著关联（优势比分别为1.37；95%置信区间为1.01-1.85，p=0.04；优势比为1.73；95%置信区间为(1.15-2.62，p<0.01)）。结论 我们的研究表明，NAFLD与两性的低尿pH值相关，这些发现可能有助于临床医生识别NAFLD高危患者。
