DOI QR코드

DOI QR Code

Association between Dietary Acid Load and Insulin Resistance: Tehran Lipid and Glucose Study

  • Received : 2016.03.03
  • Accepted : 2016.04.20
  • Published : 2016.06.30

Abstract

In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.

Keywords

dietary acid-base load;potential renal acid load;insulin resistance

References

  1. Wild S, Roglic G, Green A, Sicree R, King H. 2004. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27: 1047-1053. https://doi.org/10.2337/diacare.27.5.1047
  2. Pathak R, Pathak A. 2012. Study of life style habits on risk of type 2 diabetes. Int J Appl Basic Med Res 2: 92-96. https://doi.org/10.4103/2229-516X.106349
  3. Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML. 2008. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 31: S61-S78. https://doi.org/10.2337/dc08-S061
  4. Akter S, Eguchi M, Kurotani K, Kochi T, Pham NM, Ito R, Kuwahara K, Tsuruoka H, Mizoue T, Kabe I, Nanri A. 2015. High dietary acid load is associated with increased prevalence of hypertension: the Furukawa Nutrition and Health Study. Nutrition 31: 298-303. https://doi.org/10.1016/j.nut.2014.07.007
  5. Souto G, Donapetry C, Calvino J, Adeva MM. 2011. Metabolic acidosis-induced insulin resistance and cardiovascular risk. Metab Syndr Relat Disord 9: 247-253. https://doi.org/10.1089/met.2010.0108
  6. Adeva MM, Souto G. 2011. Diet-induced metabolic acidosis. Clin Nutr 30: 416-421. https://doi.org/10.1016/j.clnu.2011.03.008
  7. Engberink MF, Bakker SJ, Brink EJ, van Baak MA, van Rooij FJ, Hofman A, Witteman JC, Geleijnse JM. 2012. Dietary acid load and risk of hypertension: the Rotterdam Study. Am J Clin Nutr 95: 1438-1444. https://doi.org/10.3945/ajcn.111.022343
  8. Remer T, Dimitriou T, Manz F. 2003. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr 77: 1255-1260. https://doi.org/10.1093/ajcn/77.5.1255
  9. Frassetto LA, Todd KM, Morris RC Jr, Sebastian A. 1998. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr 68: 576-583. https://doi.org/10.1093/ajcn/68.3.576
  10. Maurer M, Riesen W, Muser J, Hulter HN, Krapf R. 2003. Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. Am J Physiol Renal Physiol 284: F32-F40. https://doi.org/10.1152/ajprenal.00212.2002
  11. Rizza RA, Mandarino LJ, Gerich JE. 1982. Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor defect of insulin action. J Clin Endocrinol Metab 54: 131-138. https://doi.org/10.1210/jcem-54-1-131
  12. Xu H, Jia T, Huang X, Riserus U, Cederholm T, Arnlov J, Sjogren P, Lindholm B, Carrero JJ. 2014. Dietary acid load, insulin sensitivity and risk of type 2 diabetes in communitydwelling older men. Diabetologia 57: 1561-1568. https://doi.org/10.1007/s00125-014-3275-z
  13. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, Mehrabi Y, Zahedi-Asl S. 2009. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials 10: 5. https://doi.org/10.1186/1745-6215-10-5
  14. Delshad M, Ghanbarian A, Ghaleh NR, Amirshekari G, Askari S, Azizi F. 2015. Reliability and validity of the modifiable activity questionnaire for an Iranian urban adolescent population. Int J Prev Med 6: 3. https://doi.org/10.4103/2008-7802.151433
  15. Friedewald WT, Levy RI, Fredrickson DS. 1972. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18: 499-502.
  16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. 1985. Homeostasis model assessment: insulin resistance and ${\beta}$-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412-419. https://doi.org/10.1007/BF00280883
  17. Enzevaei A, Salehpour S, Tohidi M, Saharkhiz N. 2014. Subclinical hypothyroidism and insulin resistance in polycystic ovary syndrome: is there a relationship?. Iran J Reprod Med 12: 481-486.
  18. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. 2010. Reliability and relative validity of an FFQ for nutrients in the Tehran Lipid and Glucose Study. Public Health Nutr 13: 654-662. https://doi.org/10.1017/S1368980009991698
  19. Hosseini-Esfahani F, Jessri M, Mirmiran P, Bastan S, Azizi F. 2010. Adherence to dietary recommendations and risk of metabolic syndrome: Tehran Lipid and Glucose Study. Metabolism 59: 1833-1842. https://doi.org/10.1016/j.metabol.2010.06.013
  20. Willett W, Stampfer MJ. 1986. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124: 17-27. https://doi.org/10.1093/oxfordjournals.aje.a114366
  21. Bahadoran Z, Mirmiran P, Khosravi H, Azizi F. 2015. Associations between dietary acid-base load and cardiometabolic risk factors in adults: the Tehran Lipid and Glucose Study. Endocrinol Metab 30: 201-207. https://doi.org/10.3803/EnM.2015.30.2.201
  22. Fagherazzi G, Vilier A, Bonnet F, Lajous M, Balkau B, Boutron-Rualt MC, Clavel-Chapelon F. 2014. Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study. Diabetologia 57: 313-320. https://doi.org/10.1007/s00125-013-3100-0
  23. Zhang L, Curhan GC, Forman JP. 2009. Diet-dependent net acid load and risk of incident hypertension in United States women. Hypertension 54: 751-755. https://doi.org/10.1161/HYPERTENSIONAHA.109.135582
  24. Mangano KM, Walsh SJ, Kenny AM, Insogna KL, Kerstetter JE. 2014. Dietary acid load is associated with lower bone mineral density in men with low intake of dietary calcium. J Bone Miner Res 29: 500-506. https://doi.org/10.1002/jbmr.2053
  25. DeFronzo RA, Beckles AD. 1979. Glucose intolerance following chronic metabolic acidosis in man. Am J Physiol 236: E328-E334.
  26. Farwell WR, Taylor EN. 2008. Serum bicarbonate, anion gap and insulin resistance in the National Health and Nutrition Examination Survey. Diabet Med 25: 798-804. https://doi.org/10.1111/j.1464-5491.2008.02471.x
  27. Workeneh B, Abbasi F, Reaven G. 2010. Fasting urine pH is independent of insulin sensitivity. Am J Clin Nutr 91: 586-588. https://doi.org/10.3945/ajcn.2009.28830
  28. Maalouf NM, Cameron MA, Moe OW, Adams-Huet B, Sakhaee K. 2007. Low urine pH: a novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2: 883-888. https://doi.org/10.2215/CJN.00670207
  29. Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K. 2004. The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65: 386-392. https://doi.org/10.1111/j.1523-1755.2004.00386.x
  30. Haghighatdoost F, Najafabadi MM, Bellissimo N, Azadbakht L. 2015. Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy. Nutrition 31: 697-702. https://doi.org/10.1016/j.nut.2014.11.012
  31. Colditz GA, Manson JE, Stampfer MJ, Rosner B, Willett WC, Speizer FE. 1992. Diet and risk of clinical diabetes in women. Am J Clin Nutr 55: 1018-1023. https://doi.org/10.1093/ajcn/55.5.1018
  32. Humphries S, Kushner H, Falkner B. 1999. Low dietary magnesium is associated with insulin resistance in a sample of young, nondiabetic black Americans. Am J Hypertens 12: 747-756. https://doi.org/10.1016/S0895-7061(99)00041-2
  33. Huerta MG, Roemmich JN, Kington ML, Bovbjerg VE, Weltman AL, Holmes VF, Patrie JT, Rogol AD, Nadler JL. 2005. Magnesium deficiency is associated with insulin resistance in obese children. Diabetes Care 28: 1175-1181. https://doi.org/10.2337/diacare.28.5.1175

Cited by

  1. Role of Acid-Base Homeostasis in Diabetic Kidney Disease vol.17, pp.4, 2017, https://doi.org/10.1007/s11892-017-0855-6
  2. Adherence to the dietary approaches to stop hypertension trial (DASH) diet is inversely associated with incidence of insulin resistance in adults: the Tehran lipid and glucose study vol.61, pp.2, 2017, https://doi.org/10.3164/jcbn.16-95
  3. Examining the Impact of Adherence to a Vegan Diet on Acid-Base Balance in Healthy Adults vol.72, pp.3, 2017, https://doi.org/10.1007/s11130-017-0620-7
  4. Dietary Potential Renal Acid Load Is Positively Associated with Serum Uric Acid and Odds of Hyperuricemia in the German Adult Population vol.148, pp.1, 2018, https://doi.org/10.1093/jn/nxx003
  5. Nutrition and Cardio-Metabolic Risk Factors: 20 Years of the Tehran Lipid and Glucose Study Findings vol.In Press, pp.In Press, 2018, https://doi.org/10.5812/ijem.84772