Kiadehi Fatemeh Babaee, Naghshi Niayesh, Farz Fatemeh, Pam Pedram, Tandorost Arash, Ostadrahimi Alireza, Zamiri Reza Eghdam
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faculty of Medical School, Najafabad branch, Islamic Azad University, Isfahan, Iran.
Curr Ther Res Clin Exp. 2025 Apr 3;102:100790. doi: 10.1016/j.curtheres.2025.100790. eCollection 2025.
Colorectal cancer (CRC) is a type of cancer affecting the colon and rectum, primarily originating from intestinal polyps. Recently, increasing attention has been given to the role of dietary acid-base balance in cancer development. This study aimed to investigate the relationship between dietary acid load and the risk of metastatic colorectal cancer (mCRC).
DESIGN/METHODOLOGY/APPROACH: This hospital-based case-control study was conducted on 120 adults with mCRC and 240 non-neoplastic adults in the control group, matched for age and gender. Dietary intake was assessed using a food frequency questionnaire. Net endogenous acid production (NEAP) and potential renal acid load (PRAL) were calculated using predetermined formulas. Odds ratios (ORs) were used to estimate the risk of mCRC across PRAL and NEAP tertiles.
There were no significant differences between the two groups in terms of demographic characteristics, anthropometric measures, smoking, and alcohol consumption. However, energy intake and energy-adjusted carbohydrate, fiber, potassium, magnesium, and calcium intake were significantly higher in the control group compared to the case group ( < 0.05). The mean PRAL in the case group (10.5 ± 1 mEq/day) was significantly higher than in the control group (5.2 ± 0.5 mEq/day) ( < 0.001). However, no significant difference was observed between the groups regarding NEAP (35 ± 7 mEq/day in the control group vs. 36 ± 5.5 mEq/day in the case group, = 0.12). The second and third tertiles of PRAL were associated with an increased risk of mCRC compared to the first tertile (OR = 3.4, 95% CI: 1.6-7; OR = 4.1, 95% CI: 2-8.5, respectively) ( < 0.001).
ORIGINALITY/VALUE: High PRAL levels were associated with an increased risk of mCRC, whereas NEAP scores were not linked to mCRC risk.
结直肠癌（CRC）是一种影响结肠和直肠的癌症，主要起源于肠息肉。最近，饮食酸碱平衡在癌症发展中的作用受到越来越多的关注。本研究旨在探讨饮食酸负荷与转移性结直肠癌（mCRC）风险之间的关系。
设计/方法/途径：本基于医院的病例对照研究对120名患有mCRC的成年人和240名对照组的非肿瘤成年人进行，按年龄和性别匹配。使用食物频率问卷评估饮食摄入量。使用预定公式计算净内源性酸产生量（NEAP）和潜在肾酸负荷（PRAL）。比值比（OR）用于估计跨PRAL和NEAP三分位数的mCRC风险。
两组在人口统计学特征、人体测量指标、吸烟和饮酒方面无显著差异。然而，与病例组相比，对照组的能量摄入量以及能量调整后的碳水化合物、纤维、钾、镁和钙摄入量显著更高（<0.05）。病例组的平均PRAL（10.5±1 mEq/天）显著高于对照组（5.2±0.5 mEq/天）（<0.001）。然而，两组之间在NEAP方面未观察到显著差异（对照组为35±7 mEq/天，病例组为36±5.5 mEq/天，P = 0.12）。与第一三分位数相比，PRAL的第二和第三三分位数与mCRC风险增加相关（OR分别为3.4,95%CI：1.6 - 7；OR为4.1,95%CI：2 - 8.5）（<0.001）。
原创性/价值：高PRAL水平与mCRC风险增加相关，而NEAP评分与mCRC风险无关。
