U-Shaped Association between Dietary Acid Load and Risk of Osteoporotic Fractures in 2 Populations at High Cardiovascular Risk
Por:
García-Gavilán JF, Martínez A, Konieczna J, Mico-Perez R, García-Arellano A, Basora J, Barrubés L, Goday A, Canudas S, Salas-Salvadó J and Bulló M
Publicada:
1 ene 2021
Ahead of Print:
9 dic 2020
Resumen:
Background: Bone contributes to maintaining the acid-base balance as a buffering system for blood pH. Diet composition also affects acid-base balance. Several studies have linked an imbalance in the acid-base system to changes in the density and structure of bone mass, although some prospective studies and meta-analyses suggest that acid load has no deleterious effect on bone.
Objective: The aim of this study was to examine the associations between potential renal acid load (PRAL) and net endogenous acid production (NEAP) and the risk of osteoporotic fractures and bone mineral density (BMD) in 2 middle-aged and elderly Mediterranean populations.
Methods: We conducted a longitudinal analysis including 870 participants from the PREvencion con DIeta MEDiterranea (PREDIMED) Study and a cross-sectional analysis including 1134 participants from the PREDIMED-Plus study. Participants were adults, aged 55-80 y, either at high cardiovascular risk (PREDIMED) or overweight/obese with metabolic syndrome (PREDIMED-Plus), as defined by the International Diabetes Federation, the American Heart Association, and the National Heart Association. PRAL and NEAP were calculated from validated food-frequency questionnaires. BMD was measured using DXA scans. Fracture information was obtained from medical records. The association between mean PRAL and NEAP and fracture risk was assessed using multivariable-adjusted Cox models. BMD differences between tertiles of baseline PRAL and NEAP were evaluated by means of ANCOVA.
Results: A total 114 new fracture events were documented in the PREDIMED study after a mean of 5.2 y of intervention and 8.9 y of total follow-up. Participants in the first and third PRAL and NEAP tertiles had a higher risk of osteoporotic fracture compared with the second tertile, showing a characteristically U-shaped association [HR (95% CI): 1.73 (1.03, 2.91) in tertile 1 and 1.91 (1.14, 3.19) in tertile 3 for PRAL, and 1.83 (1.08, 3.09) in tertile 1 and 1.87 (1.10, 3.17) in tertile 3 for NEAP]. Compared with the participants in tertile 1, the participants in the top PRAL and NEAP tertiles had lower BMD [PRAL: mean total femur BMD: 1.029 +/- 0.007 and 1.007 +/- 0.007 g/cm(2); P = 0.006 (tertiles 1 and 3); NEAP: mean total femur BMD: 1.032 +/- 0.007 and 1.009 +/- 0.007 g/cm(2); P = 0.017 (tertiles 1 and 3)].
Conclusions: The results of our study suggest that both high and low dietary acid are associated with a higher risk of osteoporotic fractures, although only high dietary acid was found to have a negative relation to BMD in senior adults with existing chronic health conditions. This trial was registered at http://www.isrctn.com/ as ISRCTN3573963 (PREDIMED) and ISRCTN89898870 (PREDIMED-Plus).
Filiaciones:
García-Gavilán JF:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Martínez A:
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
Konieczna J:
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
:
Health Office Fontanars dels Alforins, Primary Care Ontinyent, Valencia, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
García-Arellano A:
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Emergency Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Spain
Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain
Basora J:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain
Barrubés L:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Goday A:
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Unidad de Riesgo Cardiovascular y Nutrición, Institut Hospital del Mar d'Investigacions Mèdiques Municipal (IMIM), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
Canudas S:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Salas-Salvadó J:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Bulló M:
Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Reus, Spain
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
Bronze
|