Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nutr Health. 2023 Dec;29(4):637-644. doi: 10.1177/02601060221088383. Epub 2022 Mar 21.
Data on the association between dietary acid load and non-alcoholic fatty liver disease (NAFLD) are scarce and controversial. This study aimed to assess the association between dietary acid-base loads and odds of NAFLD. In the current study, 196 cases of NAFLD (proven by a gastroenterologist using Fibroscan) and 803 age-matched controls were enrolled from the same clinic. Dietary intakes of patients with NAFLD and controls without hepatic steatosis were evaluated using a validated food frequency questionnaire. Dietary acid load was estimated using the validated potential renal acid load (PRAL) algorithm. Multivariable logistic regression model was used to estimate the odds of NAFLD across quintiles of PRAL. The mean ± SD age of the study population (43% male) was 43.28 ± 14.02 years. The mean ± SD of PRAL was -1.90 ± 7.12 for all participants. After adjustment for all known confounders, subjects in the third quintile of PRAL (nearly with neutral PRAL) had a 54% lower odds of NAFLD compared with those in the lowest quintiles of the PRAL [(OR: 0.46; 95%CI: 0.24-0.89), (P = 0.021)]. However, the odds of NAFLD in the highest quintiles of PRAL was not different in comparison to the lowest quintiles (OR: 0.90; 95%CI: 0.41-1.57). In conclusion, our results have shown a modest U shaped relationship between PRAL and NAFLD. Further studies with acid-base biomarkers are needed to confirm the role of dietary acid load in the development of NAFLD and its potential mechanisms.
关于饮食酸负荷与非酒精性脂肪性肝病（NAFLD）之间关联的数据稀缺且存在争议。本研究旨在评估饮食酸碱负荷与 NAFLD 发生几率之间的关系。在目前的研究中，从同一家诊所纳入了 196 例 NAFLD 患者（经胃肠病学家使用 Fibroscan 确诊）和 803 例年龄匹配的对照者。使用经过验证的食物频率问卷评估了 NAFLD 患者和无肝脂肪变性对照者的饮食摄入情况。使用经过验证的潜在肾酸负荷（PRAL）算法来评估饮食酸负荷。采用多变量逻辑回归模型来估计 PRAL 五分位数范围内的 NAFLD 发生几率。研究人群的平均年龄（43%为男性）为 43.28±14.02 岁。所有参与者的平均 PRAL±标准差为-1.90±7.12。在调整了所有已知混杂因素后，PRAL 处于第三五分位数（接近中性 PRAL）的受试者发生 NAFLD 的几率比 PRAL 处于最低五分位数的受试者低 54%[比值比（OR）：0.46；95%可信区间（CI）：0.24-0.89），（P=0.021)]。然而，PRAL 处于最高五分位数的受试者发生 NAFLD 的几率与最低五分位数的受试者无差异（OR：0.90；95%CI：0.41-1.57）。总之，我们的结果表明 PRAL 与 NAFLD 之间存在适度的 U 型关系。需要进行酸碱生物标志物的进一步研究来证实饮食酸负荷在 NAFLD 发生及其潜在机制中的作用。
