Dietary sodium chloride intake independently predicts the degree of hyperchloremic metabolic acidosis in healthy humans consuming a net acid-producing diet
Dietary sodium chloride intake independently predicts the degree of hyperchloremic metabolic acidosis in healthy humans consuming a net acid-producing diet
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DOI：
10.1152/ajprenal.00048.2007
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发表时间：
2007-08-01
影响因子：
4.2
通讯作者：
Sebastian, Anthony
中科院分区：
文献类型：
--
作者：
Frassetto, Lynda A.;Morris, R. Curtis, Jr.;Sebastian, Anthony
我们以前证明，典型的美国净产酸饮食预测严重程度与饮食净酸负荷成比例的低度代谢性酸中毒，如稳态肾净酸排泄率（NAE）所示。我们现在研究含氯化钠（Na）（Cl）的饮食是否同样与严重程度与饮食中氯化钠含量成比例的低级代谢性酸中毒相关，如通过稳态Na和Cl排泄率所指示的。在我们先前报道的包括77名健康受试者的研究的稳态干预前阶段，我们对每名受试者的血液氢离子浓度（[ H]B）、血浆碳酸氢盐浓度（[ H]b）和血浆碳酸氢盐浓度（[B] b）的三至六个值进行平均。（[HCO 3-]p）、二氧化碳分压（P-CO2）、Na、Cl、NAE的尿排泄率和通过肌酐清除率（CrCl）测定的肾功能，并进行了多变量分析。膳食氯与膳食钠密切正相关（P < 0.001），在调整膳食净酸负荷、P-CO2和CrCl后，膳食氯是[HCO 3-]p的独立负预测因子，在调整膳食酸负荷和P-CO2后，膳食氯分别是[ H] B和[HCO 3-]p的正预测因子和负预测因子。这些数据提供了第一个证据，即在健康人体中，NaCl和净酸的饮食负荷独立地预测全身酸碱状态，随着负荷的增加，轻度高血糖代谢性酸中毒的程度也增加。假设存在因果关系，在其各自的变化范围内，NaCl对饮食净酸负荷产生的酸中毒效应相似于50 - 100%。
We previously demonstrated that typical American net acid- producing diets predict a low- grade metabolic acidosis of severity proportional to the diet net acid load as indexed by the steady- state renal net acid excretion rate ( NAE). We now investigate whether a sodium ( Na) chloride ( Cl) containing diet likewise associates with a low- grade metabolic acidosis of severity proportional to the sodium chloride content of the diet as indexed by the steady- state Na and Cl excretion rates. In the steady- state preintervention periods of our previously reported studies comprising 77 healthy subjects, we averaged in each subject three to six values of blood hydrogen ion concentration ([ H]b), plasma bicarbonate concentration ([ HCO3-]p), the partial pressure of carbon dioxide ( P-CO2), the urinary excretion rates of Na, Cl, NAE, and renal function as measured by creatinine clearance ( CrCl), and performed multivariate analyses. Dietary Cl strongly correlated positively with dietary Na ( P < 0.001) and was an independent negative predictor of [ HCO3-]p after adjustment for diet net acid load, P-CO2 and CrCl, and positive and negative predictors, respectively, of [ H] b and [ HCO3-]p after adjustment for diet acid load and P-CO2. These data provide the first evidence that, in healthy humans, the diet loads of NaCl and net acid independently predict systemic acid- base status, with increasing degrees of low- grade hyperchloremic metabolic acidosis as the loads increase. Assuming a causal relationship, over their respective ranges of variation, NaCl has similar to 50 - 100% of the acidosisproducing effect of the diet net acid load.