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References
- Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 1047-53.
- Ninomiya T, Perkovic V, De Galan BE, et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20: 1813-21.
- Fox CS, Coady S, Sorlie PD, et al. Increasing cardiovascular disease burden due to diabetes mellitus: The Framingham Heart Study. Circulation 2007; 115: 1544-50.
- Unwin N, Shaw J, Zimmet P, Alberti KGMM. Impaired glucose tolerance and impaired fasting glycaemia: The current status on definition and intervention. Diabet Med 2002; 19: 708-23.
- Brannick B, Wynn A, Dagogo-Jack S. Prediabetes as a toxic environment for the initiation of microvascular and macrovascular complications. Exp Biol Med (Maywood) 2016; 241: 1323-31.
- Müller-Wieland PD med D, Nauck M, Petersmann A, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes 2019; 127: 1-7.
- Siegelaar SE, Holleman F, Hoekstra JBL, DeVries JH. Glucose variability; does it matter? Endocr Rev 2010; 31: 171-82.
- Poupin N, Calvez J, Lassale C, Chesneau C, Tomé D. Impact of the diet on net endogenous acid production and acid-base balance. Clin Nutr 2012; 31: 313-21.
- Otsuki M, Kitamura T, Goya K, et al. Association of urine acidification with visceral obesity and the metabolic syndrome. Endocr J 2011; 58: 363-7.
- Maalouf NM, Cameron MA, Moe OW, Adams-Huet B, Sakhaee K. Low urine pH: A novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2007; 2: 883-8.
- Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urine composition in type 2 diabetes: Predisposition to uric acid nephrolithiasis. J Am Soc Nephrol 2006; 17: 1422-8.
- Hara S, Tsuji H, Ohmoto Y, et al. High serum uric acid level and low urine pH as predictors of metabolic syndrome: A retrospective cohort study in a Japanese urban population. Metabolism 2012; 61: 281-8.
- Nakanishi N, Fukui M, Tanaka M, et al. Low urine pH is a predictor of chronic kidney disease. Kidney Blood Press Res 2012; 35: 77-81.
- Marunaka Y. Roles of interstitial fluid pH in diabetes mellitus: Glycolysis and mitochondrial function. World J Diabetes 2015; 6: 125-35.
- Aoi W, Hosogi S, Niisato N, et al. Improvement of insulin resistance, blood pressure and interstitial pH in early developmental stage of insulin resistance in OLETF rats by intake of propolis extracts. Biochem Biophys Res Commun 2013; 432: 650-3.
- Zhang L, Curhan GC, Forman JP. Diet-dependent net acid load and risk of incident hypertension in United States women. Hypertension 2009; 54: 751-5.
- Iwase H, Tanaka M, Kobayashi Y, et al. Lower vegetable protein intake and higher dietary acid load associated with lower carbohydrate intake are risk factors for metabolic syndrome in patients with type 2 diabetes: Post-hoc analysis of a cross-sectional study. J Diabetes Investig 2015; 6: 465-72.
- Fagherazzi G, Vilier A, Bonnet F, et al. Dietary acid load and risk of type 2 diabetes: The E3N-EPIC cohort study. Diabetologia 2014; 57: 313-20.
- Akter S, Kurotani K, Kashino I, et al. High dietary acid load score is associated with increased risk of type 2 diabetes in Japanese men: The Japan Public Health Center–based prospective study. J Nutr 2016; 146: 1076-83.
- Hashimoto Y, Hamaguchi M, Nakanishi N, et al. Urinary pH is a predictor of diabetes in men; a population based large scale cohort study. Diabetes Res Clin Pract 2017; 130: 9-14.
- Goel N, Calvert J. Understanding blood gases/acid-base balance. Paediatr. Child Health (Oxford) 2012; 22; 142-8;
- Yucha C. Renal regulation of acid-base balance. Nephrol Nurs J 2004; 31: 201-6.
- Clancy J, McVicar A. Short-term regulation of acid-base homeostasis of body fluids. Br. J. Nurs 2007; 16: 1016–21.
- Adeva MM, Souto G. Diet-induced metabolic acidosis. Clin Nutr 2011; 30: 416-21.
- Souto G, Donapetry C, Calviño J, Adeva MM. Metabolic acidosis-induced insulin resistance and cardiovascular risk. Metab Syndr Relat Disord 2011; 9: 247-53.
- Hayata H, Miyazaki H, Niisato N, Yokoyama N, Marunaka Y. Lowered extracellular pH is involved in the pathogenesis of skeletal muscle insulin resistance. Biochem Biophys Res Commun 2014; 445: 170-4.
- Klisic J, Hu MC, Nief V, et al. Insulin activates Na (+)/H (+) exchanger 3: biphasic response and glucocorticoid dependence. Am. J. Physiol. Renal Physiol 2002; 283: 532-9.
- Yoshida S, Miyake T, Yamamoto S, et al. Relationship between urine pH and abnormal glucose tolerance in a community-based study. J Diabetes Investig 2018; 9: 769-75.
- Ogawa S, Takiguchi J, Nako K, et al. Elucidation of the etiology and characteristics of pink urine in young healthy subjects. Clin Exp Nephrol 2015; 19: 822-9.
- Ogawa S, Takiguchi J, Shimizu M, et al. The reduction in urinary glutamate excretion is responsible for lowering urinary pH in pink urine syndrome. Tohoku J Exp Med 2016; 239: 103-10.
- Souma T, Abe M, Moriguchi T, et al. Luminal alkalinization attenuates proteinuria-induced oxidative damage in proximal tubular cells. J Am Soc Nephrol 2011; 22: 635-48.
- Sato E, Mori T, Satoh M, et al. Urinary angiotensinogen excretion is associated with blood pressure in obese young adults. Clin Exp Hypertens 2016; 38: 203-8.
- Ogawa S, Nako K, Okamura M, Ito S. Lower urinary pH is useful for predicting renovascular disorder onset in patients with diabetes. BMJ Open Diabetes Res Care 2015; 3: e000097.
- Mandel EI, Curhan GC, Hu FB, Taylor EN. Plasma bicarbonate and risk of type 2 diabetes mellitus. CMAJ 2012; 184: 719-25.
- Higashiura Y, Tanaka M, Furuhashi M, et al. Low urine pH predicts new onset of diabetes mellitus during a 10-year period in men: BOREAS-DM1 study. J Diabetes Investig 2020; 11: 1490-7.
- Tramunt B, Smati S, Grandgeorge N, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia 2020; 63: 453-61.
- Capolongo G, Sakhaee K, Pak CYC, Maalouf NM. Fasting versus 24-h urine pH in the evaluation of nephrolithiasis. Urol Res 2011; 39: 367-72.
- Taylor EN, Curhan GC. Body Size and 24-Hour Urine Composition. Am J Kidney Dis 2006; 48: 905-15.
- Juraschek SP, Shantha GPS, Chu AY, et al. Lactate and risk of incident diabetes in a case-cohort of the atherosclerosis risk in communities (ARIC) study. PLoS One 2013; 8: e55113.
- Kimura T, Hashimoto Y, Tanaka M, et al. Sodium-chloride difference and metabolic syndrome: A population-based large-scale cohort study. Intern Med 2016; 55: 3085-90.
Abstract
Aim: Urine Ph (U-pH) is a clinical indicator of acid excretion in the urine and acid load in the diet. The association between low U-pH and net acid secretion with obesity, metabolic syndrome, diabetes, chronic kidney disease, and uric acid nephrolithiasis were showed. The aim of this study is to evaluate the U-pH in patients with different glucose tolerance status.
Materials and methods: This study was designed as single-center, retrospective, and cross-sectional. A total of 1666 subjects (male/female: 531/1135) were divided into three groups according to their OGTT results: group 1 = normal glucose tolerance (NGT), group 2 = prediabetes, group 3 = T2DM. Than subjects were divided into five groups according to their OGTT results: group 1 = NGT, group 2 = impaired fasting glucose (IFG), group 3 = isolated impaired glucose tolerance (IGT), group 4 = both IFG and IGT, and group 5 = T2DM. Additionally, patients were divided into three groups according to their glycated hemoglobin (HbA1c) results: group 1 = NGT, group 2 = prediabetes, and group 3 = T2DM. U-pH values and other outcomes were compared between groups.
Results: Age, male gender, hemoglobin, creatinine, triglycerides, and OGTT groups showed significant association with low U-pH through univariate logistic regression analyses. In model 1 (with OGTT 3 groups), it was found that creatinine (OR: 3.471; % 95 CI: 1.377-8.749; p=0.008) and triglycerides (OR: 1.001; %95 CI: 1-1.003; p = 0.013) were positively associated with low U-pH. Patients with DM (OR:1.437; %95 CI: 1.015-2.035; p=0.041) had higher risk for low U-pH compared to patients with NGT. In Model 2 (with OGTT 5 groups), creatinine (OR:3.423; %95 CI: 1.354-8.654; p = 0.009) and triglycerides (OR:1.001; %95 CI: 1-1.003; p = 0.014) were identified as independent predictive factors associated with low U-pH. Patients with IFG+IGT (OR:1.522; %95 CI: 1.083-2.138; p=0.015) and DM (OR:1.447; %95 CI: 1.022-2.049; p=0.037) had higher risk for low U-pH compared to patients with NGT.
Conclusion: In this study, the frequency of diabetes was found to be increased in patients with low U-pH. More detailed clinical studies are needed to evaluate the relationship between total acid load in the body and U-pH and glucose tolerance disorders.
Keywords
References
- Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 1047-53.
- Ninomiya T, Perkovic V, De Galan BE, et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20: 1813-21.
- Fox CS, Coady S, Sorlie PD, et al. Increasing cardiovascular disease burden due to diabetes mellitus: The Framingham Heart Study. Circulation 2007; 115: 1544-50.
- Unwin N, Shaw J, Zimmet P, Alberti KGMM. Impaired glucose tolerance and impaired fasting glycaemia: The current status on definition and intervention. Diabet Med 2002; 19: 708-23.
- Brannick B, Wynn A, Dagogo-Jack S. Prediabetes as a toxic environment for the initiation of microvascular and macrovascular complications. Exp Biol Med (Maywood) 2016; 241: 1323-31.
- Müller-Wieland PD med D, Nauck M, Petersmann A, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes 2019; 127: 1-7.
- Siegelaar SE, Holleman F, Hoekstra JBL, DeVries JH. Glucose variability; does it matter? Endocr Rev 2010; 31: 171-82.
- Poupin N, Calvez J, Lassale C, Chesneau C, Tomé D. Impact of the diet on net endogenous acid production and acid-base balance. Clin Nutr 2012; 31: 313-21.
- Otsuki M, Kitamura T, Goya K, et al. Association of urine acidification with visceral obesity and the metabolic syndrome. Endocr J 2011; 58: 363-7.
- Maalouf NM, Cameron MA, Moe OW, Adams-Huet B, Sakhaee K. Low urine pH: A novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2007; 2: 883-8.
- Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urine composition in type 2 diabetes: Predisposition to uric acid nephrolithiasis. J Am Soc Nephrol 2006; 17: 1422-8.
- Hara S, Tsuji H, Ohmoto Y, et al. High serum uric acid level and low urine pH as predictors of metabolic syndrome: A retrospective cohort study in a Japanese urban population. Metabolism 2012; 61: 281-8.
- Nakanishi N, Fukui M, Tanaka M, et al. Low urine pH is a predictor of chronic kidney disease. Kidney Blood Press Res 2012; 35: 77-81.
- Marunaka Y. Roles of interstitial fluid pH in diabetes mellitus: Glycolysis and mitochondrial function. World J Diabetes 2015; 6: 125-35.
- Aoi W, Hosogi S, Niisato N, et al. Improvement of insulin resistance, blood pressure and interstitial pH in early developmental stage of insulin resistance in OLETF rats by intake of propolis extracts. Biochem Biophys Res Commun 2013; 432: 650-3.
- Zhang L, Curhan GC, Forman JP. Diet-dependent net acid load and risk of incident hypertension in United States women. Hypertension 2009; 54: 751-5.
- Iwase H, Tanaka M, Kobayashi Y, et al. Lower vegetable protein intake and higher dietary acid load associated with lower carbohydrate intake are risk factors for metabolic syndrome in patients with type 2 diabetes: Post-hoc analysis of a cross-sectional study. J Diabetes Investig 2015; 6: 465-72.
- Fagherazzi G, Vilier A, Bonnet F, et al. Dietary acid load and risk of type 2 diabetes: The E3N-EPIC cohort study. Diabetologia 2014; 57: 313-20.
- Akter S, Kurotani K, Kashino I, et al. High dietary acid load score is associated with increased risk of type 2 diabetes in Japanese men: The Japan Public Health Center–based prospective study. J Nutr 2016; 146: 1076-83.
- Hashimoto Y, Hamaguchi M, Nakanishi N, et al. Urinary pH is a predictor of diabetes in men; a population based large scale cohort study. Diabetes Res Clin Pract 2017; 130: 9-14.
- Goel N, Calvert J. Understanding blood gases/acid-base balance. Paediatr. Child Health (Oxford) 2012; 22; 142-8;
- Yucha C. Renal regulation of acid-base balance. Nephrol Nurs J 2004; 31: 201-6.
- Clancy J, McVicar A. Short-term regulation of acid-base homeostasis of body fluids. Br. J. Nurs 2007; 16: 1016–21.
- Adeva MM, Souto G. Diet-induced metabolic acidosis. Clin Nutr 2011; 30: 416-21.
- Souto G, Donapetry C, Calviño J, Adeva MM. Metabolic acidosis-induced insulin resistance and cardiovascular risk. Metab Syndr Relat Disord 2011; 9: 247-53.
- Hayata H, Miyazaki H, Niisato N, Yokoyama N, Marunaka Y. Lowered extracellular pH is involved in the pathogenesis of skeletal muscle insulin resistance. Biochem Biophys Res Commun 2014; 445: 170-4.
- Klisic J, Hu MC, Nief V, et al. Insulin activates Na (+)/H (+) exchanger 3: biphasic response and glucocorticoid dependence. Am. J. Physiol. Renal Physiol 2002; 283: 532-9.
- Yoshida S, Miyake T, Yamamoto S, et al. Relationship between urine pH and abnormal glucose tolerance in a community-based study. J Diabetes Investig 2018; 9: 769-75.
- Ogawa S, Takiguchi J, Nako K, et al. Elucidation of the etiology and characteristics of pink urine in young healthy subjects. Clin Exp Nephrol 2015; 19: 822-9.
- Ogawa S, Takiguchi J, Shimizu M, et al. The reduction in urinary glutamate excretion is responsible for lowering urinary pH in pink urine syndrome. Tohoku J Exp Med 2016; 239: 103-10.
- Souma T, Abe M, Moriguchi T, et al. Luminal alkalinization attenuates proteinuria-induced oxidative damage in proximal tubular cells. J Am Soc Nephrol 2011; 22: 635-48.
- Sato E, Mori T, Satoh M, et al. Urinary angiotensinogen excretion is associated with blood pressure in obese young adults. Clin Exp Hypertens 2016; 38: 203-8.
- Ogawa S, Nako K, Okamura M, Ito S. Lower urinary pH is useful for predicting renovascular disorder onset in patients with diabetes. BMJ Open Diabetes Res Care 2015; 3: e000097.
- Mandel EI, Curhan GC, Hu FB, Taylor EN. Plasma bicarbonate and risk of type 2 diabetes mellitus. CMAJ 2012; 184: 719-25.
- Higashiura Y, Tanaka M, Furuhashi M, et al. Low urine pH predicts new onset of diabetes mellitus during a 10-year period in men: BOREAS-DM1 study. J Diabetes Investig 2020; 11: 1490-7.
- Tramunt B, Smati S, Grandgeorge N, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia 2020; 63: 453-61.
- Capolongo G, Sakhaee K, Pak CYC, Maalouf NM. Fasting versus 24-h urine pH in the evaluation of nephrolithiasis. Urol Res 2011; 39: 367-72.
- Taylor EN, Curhan GC. Body Size and 24-Hour Urine Composition. Am J Kidney Dis 2006; 48: 905-15.
- Juraschek SP, Shantha GPS, Chu AY, et al. Lactate and risk of incident diabetes in a case-cohort of the atherosclerosis risk in communities (ARIC) study. PLoS One 2013; 8: e55113.
- Kimura T, Hashimoto Y, Tanaka M, et al. Sodium-chloride difference and metabolic syndrome: A population-based large-scale cohort study. Intern Med 2016; 55: 3085-90.
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| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Publication Date | September 5, 2021 |
| Published in Issue | Year 2021 Volume: 4 Issue: 5 |
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