title: Higher estimated net endogenous Acid production may be associated with increased prevalence of nonalcoholic Fatty liver disease in chinese adults in Hong Kong.
abstract: Nonalcoholic fatty liver disease (NAFLD) has been associated with reduced growth hormone levels and signaling. Such hormonal changes also occur in metabolic acidosis. Since mild metabolic acidosis can be diet induced, diet-induced acid load may constitute a nutritional factor with possible influence on NAFLD development. This study explored whether a higher diet-induced acid load is associated with an increased likelihood of NAFLD. Apparently healthy Chinese adults (330 male, 463 female) aged 19-72 years were recruited through population screening between 2008 and 2010 in a cross-sectional population-based study in Hong Kong. Estimated net endogenous acid production (NEAP) was calculated using Frassetto's method and potential renal acid load (PRAL) was calculated using Remer's method based on dietary data from a food frequency questionnaire. NAFLD was defined as intrahepatic triglyceride content at >5% by proton-magnetic resonance spectroscopy. Possible advanced fibrosis was defined as liver stiffness at >7.9 kPa by transient elastography. Multivariate logistic regression models were used to examine the association between each measure of dietary acid load and prevalent NAFLD or possible advanced fibrosis with adjustment for potential anthropometric and lifestyle factors. 220 subjects (27.7%) were diagnosed with NAFLD. Estimated NEAP was positively associated with the likelihood of having NAFLD after adjustment for age, sex, body mass index, current drinker status and the presence of metabolic syndrome [OR (95% CI) = 1.25 (1.02-1.52), p = 0.022]. The association was slightly attenuated but remained significant when the model was further adjusted for other dietary variables. No association between PRAL and NAFLD prevalence was observed. Both estimated NEAP and PRAL were not associated with the presence of possible advance fibrosis. Our findings suggest that there may be a modest association between diet-induced acid load and NAFLD. More studies are needed to ascertain the link between diet-induced acid load and NAFLD and to investigate the underlying mechanisms.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Ruth
authors.initials: R
authors.lastname: Chan
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Winnie Chiu-Wing
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Liz Sin
authors.initials: LS
authors.lastname: Li
authors.affiliation: Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jason
authors.initials: J
authors.lastname: Leung
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Angel Mei-Ling
authors.initials: AM
authors.lastname: Chim
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: David Ka-Wai
authors.initials: DK
authors.lastname: Yeung
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Mandy Man-Mei
authors.initials: MM
authors.lastname: Sea
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Francis Ka-Leung
authors.initials: FK
authors.lastname: Chan
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
mesh_terms: D000138:Acidosis / Q000378:metabolism; D000143:Acids / Q000378:metabolism*; D044466:Asian People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology* / Q000378:metabolism*; D015995:Prevalence; D014280:Triglycerides / Q000378:metabolism
chemical_list: D000143:Acids; D014280:Triglycerides