Moludi Jalal, Rahimi Akram, Qaisar Shaimaa A, Hamedi-Shahraki Soudabeh, Amirkhizi Farshad
Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran.
Sci Rep. 2025 Jan 26;15(1):3313. doi: 10.1038/s41598-025-87012-9.
Knee osteoarthritis (KOA) is a prevalent chronic condition characterized by inflammation and oxidative stress, particularly in individuals over 40. Dietary factors, specifically dietary acid load (DAL), may influence these pathological processes. However, the relationship between DAL and inflammatory markers, oxidative stress, and clinical features in patients with KOA remains unexplored. This cross-sectional study involved 147 participants aged 40 and above diagnosed with moderate to severe bilateral primary KOA. Dietary intake was assessed using a validated food frequency questionnaire, and DAL was quantified using Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) indices. Clinical symptoms were evaluated using the WOMAC Index. Biochemical markers of oxidative stress and inflammation were measured from serum samples. Higher PRAL and NEAP scores were associated with increased levels of thiobarbituric acid reactive substances (TBARS) and total oxidant status (TOS), indicating elevated oxidative stress. Additionally, serum levels of inflammatory markers, including TNF-α and hs-CRP, positively correlated with higher DAL scores. Clinical assessments revealed that increased PRAL scores were related to greater severity of symptoms as measured by the WOMAC Index. This study demonstrates a significant association between dietary acid load and markers of inflammation and oxidative stress in KOA patients. These findings suggest that dietary modifications aimed at reducing acid load may serve as a beneficial adjunctive strategy in managing KOA and improving patient outcomes.
膝骨关节炎（KOA）是一种常见的慢性疾病，其特征为炎症和氧化应激，在40岁以上人群中尤为常见。饮食因素，特别是饮食酸负荷（DAL），可能会影响这些病理过程。然而，KOA患者中DAL与炎症标志物、氧化应激及临床特征之间的关系仍未得到探索。这项横断面研究纳入了147名40岁及以上被诊断为中度至重度双侧原发性KOA的参与者。通过一份经过验证的食物频率问卷评估饮食摄入量，并使用潜在肾酸负荷（PRAL）和净内源性酸产生（NEAP）指数对DAL进行量化。使用WOMAC指数评估临床症状。从血清样本中测量氧化应激和炎症的生化标志物。较高的PRAL和NEAP评分与硫代巴比妥酸反应性物质（TBARS）水平和总氧化剂状态（TOS）升高相关，表明氧化应激增强。此外，包括TNF-α和hs-CRP在内的炎症标志物血清水平与较高的DAL评分呈正相关。临床评估显示，PRAL评分升高与WOMAC指数所衡量的症状严重程度增加有关。这项研究表明，饮食酸负荷与KOA患者的炎症和氧化应激标志物之间存在显著关联。这些发现表明，旨在降低酸负荷的饮食调整可能作为管理KOA和改善患者预后的有益辅助策略。
