Dietary Acid, Age, and Serum Bicarbonate Levels among Adults in the United States
Dietary Acid, Age, and Serum Bicarbonate Levels among Adults in the United States
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DOI：
10.2215/cjn.03600413
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发表时间：
2013-12-06
影响因子：
9.8
通讯作者：
Abramowitz, Matthew K.
中科院分区：
文献类型：
--
作者：
Amodu, Afolarin;Abramowitz, Matthew K.
背景和目的：在CKD患者中，较高的膳食酸与较低的血清碳酸氢盐水平相关。这种关联是否会延伸到一般人群，是否会因年龄而改变，目前尚不清楚。设计、环境、参与者和测量本研究考察了1999-2004年全国健康与营养调查中成人参与者的膳食酸负荷（通过内源性净酸产量估计）与血清碳酸氢盐水平的关系。结果平均血清碳酸氢盐为24.9 mEq/L (SEM=0.1)，平均估计净内源性酸产量为57.4 mEq/d （SEM=0.4）。血清碳酸氢盐与年龄呈线性相关，因此年龄最大的参与者血清碳酸氢盐水平最高。经过多变量调整后，净内源性酸产量最高四分位数的参与者血清碳酸氢盐含量降低0.40 mEq/L(95%可信区间，-0.55至-0.26)，酸中毒的可能性比最低四分位数的参与者高33%（95%可信区间，3至72）。净内源性酸产量与血清碳酸氢盐之间存在显著的年龄交互作用（P=0.005）。在20-39岁、40-59岁和60岁的参与者中，与最低四分位数的参与者相比，净内源性酸产量最高四分位数的参与者血清碳酸氢盐分别降低0.26（95%置信区间，-0.49至-0.03）、0.60（95%置信区间，-0.92至-0.29）和0.49(95%置信区间，-0.84至-0.14)mEq/L。结论在美国一般人群中，较高的膳食酸与较低的血清碳酸氢盐相关，且这种关联在中老年人中比在年轻人中更大。
Background and objectivesGreater dietary acid has been associated with lower serum bicarbonate levels in patients with CKD. Whether this association extends to the general population and if it is modified by age are unknown.Design, setting, participants, & measurementsThis study examined the association of the dietary acid load, estimated by net endogenous acid production, with serum bicarbonate levels in adult participants in the National Health and Nutrition Examination Survey 1999-2004.ResultsThe mean serum bicarbonate was 24.9 mEq/L (SEM=0.1), and the mean estimated net endogenous acid production was 57.4 mEq/d (SEM=0.4). Serum bicarbonate was linearly associated with age, such that the oldest participants had the highest serum bicarbonate levels. After multivariable adjustment, participants in the highest quartile of net endogenous acid production had 0.40 mEq/L (95% confidence interval, -0.55 to -0.26) lower serum bicarbonate and a 33% (95% confidence interval, 3 to 72) higher likelihood of acidosis compared with those participants in the lowest quartile. There was a significant interaction by age of the association of net endogenous acid production with serum bicarbonate (P=0.005). Among participants 20-39, 40-59, and 60 years old, those participants in the highest net endogenous acid production quartile had 0.26 (95% confidence interval, -0.49 to -0.03), 0.60 (95% confidence interval, -0.92 to -0.29), and 0.49 (95% confidence interval, -0.84 to -0.14) mEq/L lower serum bicarbonate, respectively, compared with participants in the lowest quartile.ConclusionGreater dietary acid is associated with lower serum bicarbonate in the general US population, and the magnitude of this association is greater among middle-aged and elderly persons than younger adults.