Higher Estimated Net Endogenous Acid Production May Be Associated with Increased Prevalence of Nonalcoholic Fatty Liver Disease in Chinese Adults in Hong Kong
Higher Estimated Net Endogenous Acid Production May Be Associated with Increased Prevalence of Nonalcoholic Fatty Liver Disease in Chinese Adults in Hong Kong
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DOI：
10.1371/journal.pone.0122406
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发表时间：
2015-04-23
期刊：
影响因子：
3.7
通讯作者：
Chan, Henry Lik-Yuen
中科院分区：
文献类型：
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作者：
Chan, Ruth;Wong, Vincent Wai-Sun;Chan, Henry Lik-Yuen
非酒精性脂肪性肝病（NAFLD）与生长激素水平和信号传导降低有关。代谢性酸中毒也会出现这种激素变化。由于轻度代谢性酸中毒可由饮食诱导，因此饮食诱导的酸负荷可能构成可能影响NAFLD发展的营养因素。这项研究探讨了较高的饮食诱导的酸负荷是否与NAFLD的可能性增加有关。在2008年至2010年期间，在香港进行的一项基于横断面人群的研究中，通过人群筛查招募了19-72岁的表面健康的中国成年人（330名男性，463名女性）。估计的净内源性产酸量（NEAP）采用Frassetto方法计算，潜在的肾脏酸负荷（PRAL）采用雷默方法计算，基于食物频率问卷的饮食数据。NAFLD被定义为通过质子磁共振波谱分析肝内甘油三酯含量>5%。可能的晚期纤维化被定义为通过瞬时弹性成像在>7.9 kPa下的肝硬度。多变量逻辑回归模型用于检查饮食酸负荷的每个测量值与流行NAFLD或可能的晚期纤维化之间的关联，并调整潜在的人体测量和生活方式因素。220例受试者（27.7%）被诊断为NAFLD。在校正年龄、性别、体重指数、当前饮酒状态和代谢综合征后，估计的NEAP与NAFLD的可能性呈正相关[OR（95%CI）= 1.25（1.02-1.52），p = 0.022]。这种关联略有减弱，但当模型进一步调整其他饮食变量时仍然显着。未观察到PRAL与NAFLD患病率之间的相关性。估计的NEAP和PRAL与可能的晚期纤维化的存在无关。我们的研究结果表明，饮食诱导的酸负荷和NAFLD之间可能存在适度的关联。需要更多的研究来确定饮食诱导的酸负荷和NAFLD之间的联系，并调查潜在的机制。
Nonalcoholic fatty liver disease (NAFLD) has been associated with reduced growth hormone levels and signaling. Such hormonal changes also occur in metabolic acidosis. Since mild metabolic acidosis can be diet induced, diet-induced acid load may constitute a nutritional factor with possible influence on NAFLD development. This study explored whether a higher diet-induced acid load is associated with an increased likelihood of NAFLD. Apparently healthy Chinese adults (330 male, 463 female) aged 19-72 years were recruited through population screening between 2008 and 2010 in a cross-sectional population-based study in Hong Kong. Estimated net endogenous acid production (NEAP) was calculated using Frassetto's method and potential renal acid load (PRAL) was calculated using Remer's method based on dietary data from a food frequency questionnaire. NAFLD was defined as intrahepatic triglyceride content at >5% by proton-magnetic resonance spectroscopy. Possible advanced fibrosis was defined as liver stiffness at >7.9 kPa by transient elastography. Multivariate logistic regression models were used to examine the association between each measure of dietary acid load and prevalent NAFLD or possible advanced fibrosis with adjustment for potential anthropometric and lifestyle factors. 220 subjects (27.7%) were diagnosed with NAFLD. Estimated NEAP was positively associated with the likelihood of having NAFLD after adjustment for age, sex, body mass index, current drinker status and the presence of metabolic syndrome [OR (95% CI) = 1.25 (1.02-1.52), p = 0.022]. The association was slightly attenuated but remained significant when the model was further adjusted for other dietary variables. No association between PRAL and NAFLD prevalence was observed. Both estimated NEAP and PRAL were not associated with the presence of possible advance fibrosis. Our findings suggest that there may be a modest association between diet-induced acid load and NAFLD. More studies are needed to ascertain the link between diet-induced acid load and NAFLD and to investigate the underlying mechanisms.