Abstract：
Background: Data on the association between dietary acid load and non-alcoholic fatty liver disease (NAFLD) are scarce and controversial. Aim: This study aimed to assess the association between dietary acid-base loads and odds of NAFLD. Methods: In the current study, 196 cases of NAFLD (proven by a gastroenterologist using Fibroscan) and 803 age-matched controls were enrolled from the same clinic. Dietary intakes of patients with NAFLD and controls without hepatic steatosis were evaluated using a validated food frequency questionnaire. Dietary acid load was estimated using the validated potential renal acid load (PRAL) algorithm. Multivariable logistic regression model was used to estimate the odds of NAFLD across quintiles of PRAL. Results: The mean ± SD age of the study population (43% male) was 43.28 ± 14.02 years. The mean ± SD of PRAL was -1.90 ± 7.12 for all participants. After adjustment for all known confounders, subjects in the third quintile of PRAL (nearly with neutral PRAL) had a 54% lower odds of NAFLD compared with those in the lowest quintiles of the PRAL [(OR: 0.46; 95%CI: 0.24-0.89), (P = 0.021)]. However, the odds of NAFLD in the highest quintiles of PRAL was not different in comparison to the lowest quintiles (OR: 0.90; 95%CI: 0.41-1.57). Conclusion: In conclusion, our results have shown a modest U shaped relationship between PRAL and NAFLD. Further studies with acid-base biomarkers are needed to confirm the role of dietary acid load in the development of NAFLD and its potential mechanisms.
摘要：
背景：关于膳食酸负荷与非酒精性脂肪性肝病（NAFLD）之间的关联的数据很少且存在争议。目的：本研究旨在评估膳食酸碱负荷与NAFLD几率之间的关联。方法：在目前的研究中，从同一诊所招募了196例NAFLD（由胃肠病学家使用Fibroscan证实）和803例年龄匹配的对照。使用经过验证的食物频率问卷评估NAFLD患者和无肝脏脂肪变性的对照组的饮食摄入量。使用经过验证的潜在肾酸负荷（PRAL）算法估算饮食酸负荷。使用多变量逻辑回归模型来估计跨PRAL五分之一的NAFLD的几率。结果:研究人群(43%为男性)的平均±SD年龄为43.28±14.02岁。所有参与者的PRAL的平均值±SD为-1.90±7.12。在对所有已知的混杂因素进行调整后，与PRAL最低五分之一的受试者相比，PRAL第三五分之一的受试者（接近中性PRAL）的NAFLD几率降低了54％[（OR：0.46;95CI：0.24-0.89），(P=0.021)]。然而,与最低的5倍相比,PRAL最高的5倍中NAFLD的几率没有差异(OR:0.90;95CI:0.41~1.57).结论：总之，我们的结果表明，PRAL和NAFLD之间存在适度的U形关系。需要进一步研究酸碱生物标志物，以确认饮食中酸负荷在NAFLD发展中的作用及其潜在机制。
