Keseimbangan asam-basa tubuh dan kejadian sindrom metabolik pada remaja obesitas

https://doi.org/10.22146/ijcn.24811

Firdananda Fikri Jauharany(1*), Nurmasari Widyastuti(2)

(1) Program Studi S1 Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(2) Program Studi S1 Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(*) Corresponding Author

Abstract


Background: The prevalence of metabolic syndrome increased in young population, indicated by the rise in obesity among children and adolescent. The Western dietary pattern was one of the causes. A Western diet rich in animal protein can produce acid during the metabolic process and may cause an acid-excess in the body (dietary acid load). This process was contributed to acid-base balance through the metabolism of sulfur-containing amino acids (cysteine and methionine) which produce H+ ions as well as lowering the pH.

Objective: To examine the association between acid-base balance and components of metabolic syndrome among obese adolescent.

Method: A cross-sectional study was conducted on 40 obese adolescents in Semarang high school. We measured Potential Renal Acid Load (PRAL) score and pH urine as an acid-base indicator. MetS are defined ≥ 3 following risk factors: waist circumference ≥90th percentile, blood pressure ≥90th percentile, triglycerides ≥110 mg/dl, HDL levels ≤40 mg/dl, and fasting blood glucose levels ≥110 mg/dl. Normality test used the Shapiro-Wilk test (n <50). The bivariate analysis used Pearson test, Rank-Spearman test, and Chi-Square test. The multivariate analysis used Multivariate Linear Regression analysis of Backward.

Results: PRAL score was associated with waist circumference (r=0,347; p=0,028), sistolic blood pressure (r=0,590; p=<0,001), diastolic blood pressure (r=0,668; p=<0,001), and triglyceride levels (r=0,362; p=0,022). pH urin was not associated with any risk factors of MetS.

Conclusion: High dietary acid load may be a risk factor for the development of MetS.


Keywords


adolescent; blood pressure; dietary acid load; obesity; PRAL score; trygliceride; waist circumference

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References

  1. Arisman. Obesitas, diabetes mellitus, dan dislipidemia. Jakarta: Buku Kedokteran; 2008.
  2. The Asia-Pasific perspective: redefining obesity and its treatment. Australia: Health Communications Australia; 2000.
  3. Rachmawati S, Sulchan M. Asupan lemak dan kadar high density lipoprotein (HDL) sebagai faktor risiko peningkatan kadar C-reactive protein (CRP) pada remaja obesitas dengan sindrom metabolik. Journal of Nutrition College 2014;3(3):337–45.
  4. Locatelli F, Pozzoni P, Del Vecchio L. Renal manifestations in the metabolic syndrome. J Am Soc Nephrol 2006;17(Suppl 7):S81–5.
  5. Zhang R, Liao J, Morse S, Donelon S, Reisin E. Kidney disease and the metabolic syndrome. Am J Med Sci 2005;330:319–25.
  6. Chagnac A, Weinstein T, Korzets A, Ramadan E, Hirsch J, Gafter U. Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol 2000;278:F817–22.
  7. Maalouf NM, Cameron MA, Moe OW. Low urine pH: a novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2007;883–8.
  8. Corwin EJ. Patofisiologi. Nike Budhi (Alih bahasa). Jakarta: EGC; 2009.
  9. Welch AA, Mulligan A, Bingham SA, Khaw KT. Urine pH is an indicator of dietary acid–base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Br J Nutr 2008;99(6):1335–43.
  10. Remer T, Dimitriou T, Manz F. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr 2003;77(5):1255–60.
  11. Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc 1995;95:791–7.
  12. Engberink MF, Bakker SJ, Brink EJ, van Baak MA, van Rooij FJ, Geleijnse JM, et al. Dietary acid load and risk o f hypertension: the Rotterdam Study. Am J Clin Nutr 2012;95(6):1438–44.
  13. Welch AA. Dipstick measurement of urinary ph have potential for monitoring individual and population dietary behaviors. The Open Nutrition Journal 2008;2:63­­–6.
  14. Murakami K, Sasaki S, Takahashi Y, Uenishi K. Association between dietary acid-base load and cardiometabolic risk factors in young Japanese women. Br J Nutr 2008;100(3):642–51.
  15. Fahregazzi G, Alice V, Fabrice B, Martin L, Beverley B. Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study. Diabetologia 2014;57(2):313–20.
  16. Adult Treatment Panel III (ATP III). Executive summary of the third report of the national cholesterol education program education program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adult (Adult treatment panel III). JAMA 2001;285(19):2476-97.
  17. Falkner B, Daniels SR, Flynn JT, Gidding S, Green LA, Inelfinger JR, et al. The fourth report of the diagnosis evaluation and treatment of high blood pressure children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555–76.
  18. Badan Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2013. Riset kesehatan dasar (Riskesdas). [series online] 2013 [cited 20 September 2016]. Available from: URL: http://www.depkes.go.id/resources/download/general/Hasil%20Riskesdas%202013.pdf.
  19. Pampang E, Purba MB, Huriyati E. Asupan energi, aktivitas fisik, persepsi orang tua, dan obesitas siswa dan siswi SMP di Kota Yogyakarta. Jurnal Gizi Klinik Indonesia 2009;5(3):108–13.
  20. Bahadoran Z, Mirmiran P, khosravi H, Azizi F. Association between dietary acid-base load and cardiometabolic risk factors in adults: The Tehran Lipid and Glucose Study. Endocrinol Metab 2015;30:201-7.
  21. Remer T, Dimitriou T, Manz F. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr 2003;77(5):1255–60.
  22. Stewart PA. Stewart’s textbook of acid-base. USA: Paul WG Elbers; 2009.
  23. Han E, Kim G, Hong N, Lee Y, Kim DW, Cha BS, et al. Association between dietary acid load and the risk of cardiovascular disease: nationwide surveys (KNHNES 2008-2011). Cardiovasc Diabetol 2016;15(1):122.
  24. Berkemeyer S. Acid-base balance and weight gain: are there crucial links via protein and organic acids in understanding obesity? Med Hypotheses 2009;73(3):347–56.
  25. Maurer M, Riesen W, Muser J, Hulter HN, Krapf R. Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. Am J Physiol Renal Physiol 2003;284(1):F32–40.
  26. Kotchen TA, Kotchen JM. Nutrition, diet, and hypertension. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern nutrition in health and disease. 10th Edition. Philadelpia: Lippincott Williams and Wilkins; 2006.
  27. Taylor EN, Mount DB, Forman JP, Curhan GC. Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors. Am J Kidney Dis 2006;47:780–9.
  28. Rizzo ACB, Goldberg TBL, Silva CC, Kurokawa CS, Nunes HR, Corrente JE. Metabolic syndrome risk factors in overweight, obese, and extremely obese Brazilian adolescents. Nutr J 2013;12:19.
  29. Buse JB, Kenneth SP, Charles FB. Type 2 diabetes mellitus. William Textbook of Endocrinology 2002;1427–51.
  30. Widyastuti N, Sulchan M, Johan A. Asupan makan, sindrom metabolik, dan status keseimbangan asam-basa tubuh pada lansia. Jurnal Gizi Klinik Indonesia 2013;9(4):179–87.



DOI: https://doi.org/10.22146/ijcn.24811

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