Bozbulut Rukiye, Döğer Esra, Çamurdan Mahmut Orhun, Bideci Aysun
Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Türkiye
J Clin Res Pediatr Endocrinol. 2025 Mar 19;17(1):58-67. doi: 10.4274/jcrpe.galenos.2024.2024-3-9. Epub 2024 Sep 23.
Mild metabolic acidosis may adversely affect cardiovascular risk factors, and diet-dependent acid-base load may impair mental health and sleep quality. The aim of this study was to investigate the effects of dietary acid load (DAL) on cardiometabolic risk factors, psychological resilience, and sleep quality in adolescents with obesity.
Obese adolescents participated in the study. Biochemical parameters, anthropometric measurements and blood pressures were measured. Three-day retrospective food intake records were collected from the adolescents, and potential renal acid load (PRAL), net endogenous acid production (NEAP), and DAL were derived from food intake records. Psychological resilience was assessed by the Child and Youth Resilience Measure (CYRM-12) and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI).
A total of 205 adolescents with obesity (105 males, 100 females) aged 13-18 years participated. Body mass index, fat mass, fat percentage, fasting insulin, triglyceride, systolic blood pressure, homeostasis model assessment for insulin resistance (HOMA-IR) and PSQI scores were significantly higher and psychological resilience levels were significantly lower in high tertiles of DAL (p<0.05). Adolescents in the lowest tertile of DAL scores had higher consumption of whole grains, vegetables, dairy, legumes, and higher intakes of potassium and calcium than adolescents in the highest tertile of the DAL scores (p<0.05). Red meat, and white meat consumption and sodium intake were higher in adolescents in the high tertiles (p<0.05). Energy intakes were found to be significantly lower in the first tertile of PRAL and DAL scores compared to the other tertiles (p<0.05). A linear regression model ahowed an increase in NEAP, PRAL and DAL scores led to a decrease in psychological resilience score and an increase in PSQI and HOMA-IR scores (p<0.05).
High DAL was associated with high cardiometabolic risk, insulin resistance, and low psychological resilience and poor sleep quality.
轻度代谢性酸中毒可能会对心血管危险因素产生不利影响，而饮食相关的酸碱负荷可能会损害心理健康和睡眠质量。本研究旨在探讨饮食酸负荷（DAL）对肥胖青少年心血管代谢危险因素、心理韧性和睡眠质量的影响。
肥胖青少年参与了本研究。测量了生化参数、人体测量指标和血压。收集了青少年三天的回顾性食物摄入记录，并根据食物摄入记录得出潜在肾酸负荷（PRAL）、净内源性酸产生（NEAP）和DAL。通过儿童和青少年韧性量表（CYRM-12）评估心理韧性，通过匹兹堡睡眠质量指数（PSQI）评估睡眠质量。
共有205名年龄在13至18岁之间的肥胖青少年（105名男性，100名女性）参与。在DAL三分位数较高的青少年中，体重指数、脂肪量、脂肪百分比、空腹胰岛素、甘油三酯、收缩压、胰岛素抵抗稳态模型评估（HOMA-IR）和PSQI得分显著更高，而心理韧性水平显著更低（p<0.05）。与DAL得分三分位数最高的青少年相比，DAL得分三分位数最低的青少年全谷物、蔬菜、乳制品、豆类的摄入量更高，钾和钙的摄入量也更高（p<0.05）。三分位数较高的青少年红肉、白肉消费量和钠摄入量更高（p<0.）。与其他三分位数相比，PRAL和DAL得分三分位数最低的青少年能量摄入量显著更低（p<0.05）。线性回归模型显示，NEAP、PRAL和DAL得分升高导致心理韧性得分降低，PSQI和HOMA-IR得分升高（p<0.05）。
高DAL与高心血管代谢风险、胰岛素抵抗、低心理韧性和差睡眠质量相关。
