Fallah Maryam, Azad Banafsheh Jafari, Najafi Anahita, Esmaeily Zahra, Balighi Kamran, Daneshpazhooh Maryam, Ebrahimpour-Koujan Soraiya
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No: 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, PO Box: 14155-6117, Tehran, Iran.
Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2024 Dec 4;14(1):30257. doi: 10.1038/s41598-024-78709-4.
No previous study has examined the association of an acid-base imbalanced diet to autoimmune bullous disease. The present study aimed to investigate the association between dietary acid load (DAL) as either potential renal acid load (PRAL) and net endogenous acid production (NEAP) intake on the odds of high-severity Pemphigus Vulgaris (PV) disease in adult Iranian patients to fill this gap. A cross-sectional study was conducted on 138 patients, aged 18-65 years with confirmed diagnoses of PV in a referral university center for autoimmune bullous diseases. The dietary intakes of all patients during the last year before enrollment in the study were assessed using a 168-item semi-quantitative food frequency questionnaire. Dietary acid load was calculated based on the PRAL and NEAP scores. To assess PV severity, the pemphigus disease area index (PDAI) score was used. Logistic regression was used to evaluate the association between DAL and PDAI. A positive association was observed between PRAL and PDAI score in the crude (adjusted R = 0.088, B = 6.88, P < 0.0001) and all other adjusted models, as well as the crude model for NEAP (adjusted R = 0.037, B = 4.72, P = 0.013). In terms of adherence to NEAP and PRAL, those in the top tertile of PRAL and NEAP had a higher vulnerability for severe PV in unadjusted (OR = 5.18, 95% (CI) 2.19-12.25) and (OR = 2.48, 95% (CI) 1.08-5.68) respectively. In the present study, we found a significant direct association between DAL and severity of disease in PV patients. Further studies are required to confirm these findings.
此前尚无研究探讨酸碱失衡饮食与自身免疫性大疱性疾病之间的关联。本研究旨在填补这一空白，调查成年伊朗患者饮食酸负荷（DAL），即潜在肾酸负荷（PRAL）和净内源性酸生成（NEAP）摄入量与重度寻常型天疱疮（PV）疾病发生几率之间的关联。在一所转诊大学中心的自身免疫性大疱性疾病专科，对138例年龄在18至65岁、确诊为PV的患者进行了一项横断面研究。使用一份包含168个条目的半定量食物频率问卷评估所有患者在入组研究前一年的饮食摄入量。根据PRAL和NEAP评分计算饮食酸负荷。为评估PV严重程度，采用了天疱疮疾病面积指数（PDAI）评分。使用逻辑回归评估DAL与PDAI之间的关联。在粗模型（调整R = 0.088，B = 6.88，P < 0.0001）以及所有其他调整模型中，观察到PRAL与PDAI评分之间存在正相关，在NEAP的粗模型中也是如此（调整R = 0.037，B = 4.72，P = 0.013）。就对NEAP和PRAL的依从性而言，PRAL和NEAP处于最高三分位数的患者在未调整时分别有更高的重度PV易感性（OR = 5.18，95%（CI）2.19 - 12.25）和（OR = 2.48，95%（CI）1.08 - 5.68）。在本研究中，我们发现PV患者的DAL与疾病严重程度之间存在显著的直接关联。需要进一步研究来证实这些发现。
