饮食酸碱负荷与2型糖尿病慢性肾病患者之间的相关性
Correlation between dietary acid-base load and chronic kidney disease patients with type 2 diabetes mellitus.
作者信息
Huang Hui, Wang Qian, Zhang Ruimin, Liu Fang, Niu Yue, Luo Yayong, Li Shuang, Li Tao, Tang Zhengchun, Wang Xiaolong, Yang Jian, Wang Yong, Zhang Li, Luo Sha, Zhang Weiguang, Zheng Ying, Deng Weizhu, Cai Guangyan, Chen Xiangmei, Dong Zheyi
机构信息
Chengdu University of Traditional Chinese Medicine, Chengdu, China.
State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Preventionand Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing, China.
出版信息
Front Nutr. 2025 May 22;12:1581009. doi: 10.3389/fnut.2025.1581009. eCollection 2025.
OBJECTIVE
This study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).
DESIGN
A total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed using a 24-h dietary recall, and diet-based acidity was assessed using net endogenous acid production (NEAP), potential renal acid load (PRAL), and dietary acid load (DAL). Multivariable logistic regression models were used to determine the association between diet-based acid load scores and CKD and T2DM.
RESULTS
Within the food category groupings, the DAL score was positively associated with poultry and eggs and negatively associated with fruits and vegetables. Regarding energy and macronutrients, the DAL score was positively correlated with the intake of protein, animal protein, monounsaturated fatty acids, saturated fatty acids, and fat, while it was negatively correlated with the intake of carbohydrates, plant protein, and dietary fiber. In terms of micronutrients, DAL scores were positively associated with phosphorus intake and negatively associated with potassium, magnesium, and copper intake. After adjusting for age, BMI, energy, and eGFR, and stratifying by sex, logistic regression analysis showed that DAL level (OR = 6.47, 95% CI 1.19-35.18, = 0.031) was a related factor for CKD and T2DM in females.
CONCLUSION
DAL score is a related factor for patients with T2DM and CKD.
目的
本研究旨在探讨饮食酸碱负荷对慢性肾脏病（CKD）合并2型糖尿病（T2DM）患者的影响。
设计
共纳入300例CKD患者，根据饮食酸碱负荷三分位数分为三组。采用24小时饮食回顾法评估饮食摄入量，使用净内源性酸产生量（NEAP）、潜在肾酸负荷（PRAL）和饮食酸负荷（DAL）评估饮食酸碱度。采用多变量逻辑回归模型确定饮食酸负荷评分与CKD和T2DM之间的关联。
结果
在食物类别分组中，DAL评分与禽蛋类呈正相关，与水果和蔬菜呈负相关。在能量和宏量营养素方面，DAL评分与蛋白质、动物蛋白、单不饱和脂肪酸、饱和脂肪酸和脂肪的摄入量呈正相关，而与碳水化合物、植物蛋白和膳食纤维的摄入量呈负相关。在微量营养素方面，DAL评分与磷摄入量呈正相关，与钾、镁和铜摄入量呈负相关。在调整年龄、体重指数、能量和估算肾小球滤过率并按性别分层后，逻辑回归分析显示，DAL水平（OR = 6.47，95%CI 1.19 - 35.18，P = 0.031）是女性CKD和T2DM的相关因素。
结论
DAL评分是T2DM和CKD患者的相关因素。
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