2型糖尿病患者饮食酸负荷与代谢功能障碍相关脂肪性肝病风险之间的关联
Association between dietary acid load and risk of metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes.
作者信息
Bakhshi Hesam, Naghshi Niayesh, Fotros Danial, Pasand Mohammadjavad, Hekmatdoost Azita, Salavatizadeh Marieh, Soltanieh Samira, Poustchi Hossein, Khamseh Mohammad Ebrahim, Yari Zahra
机构信息
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.
Department of Nutrition and Food Science, Wayne State University, Detroit, MI, United States.
出版信息
Front Nutr. 2025 May 29;12:1494617. doi: 10.3389/fnut.2025.1494617. eCollection 2025.
OBJECTIVE
Considering the high prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among patients with type 2 diabetes and its associated complications, this study aimed to investigate the relationship between dietary acid load (DAL) and the risk of MASLD in patients with diabetes.
METHODS
This cross sectional study was conducted on 200 patients aged 18 to 70 with type 2 diabetes. Of whom, 133 participants were diagnosed with MASLD based on transit elastography (Fibroscan). For biochemical evaluation of liver enzymes, lipid profile, and fasting blood sugar, venous blood samples were collected after 10-12 h of fasting. Dietary acid load was determined using a 147-item food frequency questionnaire based on PRAL (potential renal acid load) and NEAP (net endogenous acid production).
RESULTS
A total of 108 women and 92 men with an average age of 52.2 years and an average body mass index of 28.8 kg/m participated in the study. After adjusting for confounders, the risk of MASLD in the third tertile of PRAL was 3.1 times higher than the first tertile (OR = 3.1, 95% CI = 1.2-7.7). After adjusting for all confounding factors, participants in the highest tertile of NEAP had nearly seven times the chance of developing MASLD compared to those in the lowest tertile, which was statistically significant (OR = 7.3, 95% CI = 2.6-20.3). Overall, the data analysis revealed a significant direct relationship between both PRAL (P trend = 0.016) and NEAP (P trend < 0.001) with the risk of MASLD.
CONCLUSION
Our analysis revealed that a higher dietary acid load is associated with an increased risk of MASLD and liver steatosis in patients with type 2 diabetes.
目的
鉴于2型糖尿病患者中代谢功能障碍相关脂肪性肝病（MASLD）的高患病率及其相关并发症，本研究旨在探讨饮食酸负荷（DAL）与糖尿病患者发生MASLD风险之间的关系。
方法
本横断面研究针对200名年龄在18至70岁之间的2型糖尿病患者开展。其中，133名参与者根据瞬时弹性成像（Fibroscan）被诊断为MASLD。为进行肝酶、血脂谱和空腹血糖的生化评估，在禁食10 - 12小时后采集静脉血样本。饮食酸负荷通过基于潜在肾酸负荷（PRAL）和净内源性酸产生（NEAP）的147项食物频率问卷来确定。
结果
共有108名女性和92名男性参与研究，平均年龄为52.2岁，平均体重指数为28.8kg/m²。在调整混杂因素后，PRAL第三分位数组发生MASLD的风险比第一分位数组高3.1倍（OR = 3.1，95%CI = 1.2 - 7.7）。在调整所有混杂因素后，NEAP最高三分位数组的参与者发生MASLD的几率是最低三分位数组的近7倍，具有统计学意义（OR = 7.3，95%CI = 2.6 - 20.3）。总体而言，数据分析显示PRAL（P趋势 = 0.016）和NEAP（P趋势 < 0.001）与MASLD风险均存在显著的直接关系。
结论
我们的分析表明，较高的饮食酸负荷与2型糖尿病患者发生MASLD及肝脂肪变性的风险增加相关。
Zotero 插件