{"title":"Correlation between dietary acid-base load and chronic kidney disease patients with type 2 diabetes mellitus.","authors":"Hui Huang, Qian Wang, Ruimin Zhang, Fang Liu, Yue Niu, Yayong Luo, Shuang Li, Tao Li, Zhengchun Tang, Xiaolong Wang, Jian Yang, Yong Wang, Li Zhang, Sha Luo, Weiguang Zhang, Ying Zheng, Weizhu Deng, Guangyan Cai, Xiangmei Chen, Zheyi Dong","doi":"10.3389/fnut.2025.1581009","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).</p><p><strong>Design: </strong>A total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed using a 24-h dietary recall, and diet-based acidity was assessed using net endogenous acid production (NEAP), potential renal acid load (PRAL), and dietary acid load (DAL). Multivariable logistic regression models were used to determine the association between diet-based acid load scores and CKD and T2DM.</p><p><strong>Results: </strong>Within the food category groupings, the DAL score was positively associated with poultry and eggs and negatively associated with fruits and vegetables. Regarding energy and macronutrients, the DAL score was positively correlated with the intake of protein, animal protein, monounsaturated fatty acids, saturated fatty acids, and fat, while it was negatively correlated with the intake of carbohydrates, plant protein, and dietary fiber. In terms of micronutrients, DAL scores were positively associated with phosphorus intake and negatively associated with potassium, magnesium, and copper intake. After adjusting for age, BMI, energy, and eGFR, and stratifying by sex, logistic regression analysis showed that DAL level (OR = 6.47, 95% CI 1.19-35.18, <i>p</i> = 0.031) was a related factor for CKD and T2DM in females.</p><p><strong>Conclusion: </strong>DAL score is a related factor for patients with T2DM and CKD.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"12 ","pages":"1581009"},"PeriodicalIF":4.0000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137085/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Nutrition","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.3389/fnut.2025.1581009","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to investigate the effect of dietary acid-base load on patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).
Design: A total of 300 patients with CKD were enrolled and divided into three groups according to DAL tertiles. Dietary intake was assessed using a 24-h dietary recall, and diet-based acidity was assessed using net endogenous acid production (NEAP), potential renal acid load (PRAL), and dietary acid load (DAL). Multivariable logistic regression models were used to determine the association between diet-based acid load scores and CKD and T2DM.
Results: Within the food category groupings, the DAL score was positively associated with poultry and eggs and negatively associated with fruits and vegetables. Regarding energy and macronutrients, the DAL score was positively correlated with the intake of protein, animal protein, monounsaturated fatty acids, saturated fatty acids, and fat, while it was negatively correlated with the intake of carbohydrates, plant protein, and dietary fiber. In terms of micronutrients, DAL scores were positively associated with phosphorus intake and negatively associated with potassium, magnesium, and copper intake. After adjusting for age, BMI, energy, and eGFR, and stratifying by sex, logistic regression analysis showed that DAL level (OR = 6.47, 95% CI 1.19-35.18, p = 0.031) was a related factor for CKD and T2DM in females.
Conclusion: DAL score is a related factor for patients with T2DM and CKD.
目的：探讨饮食酸碱负荷对慢性肾脏疾病（CKD）合并2型糖尿病（T2DM）患者的影响。设计：共纳入300例CKD患者，根据DAL分值分为三组。采用24小时饮食回忆法评估膳食摄入量，采用净内源性产酸（NEAP）、潜在肾酸负荷（PRAL）和膳食酸负荷（DAL）评估膳食酸性。使用多变量logistic回归模型来确定基于饮食的酸负荷评分与CKD和T2DM之间的关系。结果：在食物类别分组中，DAL得分与家禽和蛋类呈正相关，与水果和蔬菜负相关。在能量和常量营养素方面，DAL评分与蛋白质、动物蛋白、单不饱和脂肪酸、饱和脂肪酸、脂肪的摄入量呈正相关，与碳水化合物、植物蛋白、膳食纤维的摄入量呈负相关。在微量营养素方面，DAL评分与磷摄入量呈正相关，与钾、镁和铜摄入量负相关。在调整年龄、BMI、能量和eGFR并按性别分层后，logistic回归分析显示DAL水平（OR = 6.47,95% CI 1.19-35.18, p = 0.031）是女性CKD和T2DM的相关因素。结论：DAL评分是T2DM合并CKD患者的一个相关因素。
期刊介绍：
No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health.
Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.
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