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Metabolic status is not related to dietary acid load in polycystic ovary syndrome

Year 2022, Volume: 55 Issue: 2, 111 - 115, 31.08.2022
https://doi.org/10.20492/aeahtd.1069778

Abstract

Aim:Women with polycystic ovary syndrome (PCOS) are at high risk for obesity-related disorders, insulin resistance (IR), and metabolic syndrome (MS). Adopting potent approaches to diet enhances cardiometabolic risk profile and reproductive function. Different types of diets have provided conflicting results so far. We aimed to investigate whether dietary acid load (DAL) contributed to the metabolic process in PCOS.
Material and Method: This study included 46 newly diagnosed PCOS patients and 46 healthy individuals with matched age, sex, and BMI. Clinical, anthropometric, and biochemical measurements were obtained. We extracted net endogenous acid production (NEAP) and potential renal acid load (PRAL) scores from 24-hour dietary data recorded on a nutrient database program for three days (BeBiS software program).
Results:We concluded no statistically significant difference between the groups by NEAP (p=0.569) and PRAL (p=0.969).Patients with PCOS had higher fasting insulin levels and HOMA-IR (p<0.001 and p<0.001 respectively.); however, fasting serum glucose and HbA1c levels were similar (p=0.077 and p=0.859, respectively). Both NEAP and PRAL presented positive correlations with waist circumference (WC) (r=.236, p=0.023 and r=.290, p=0.005), hip circumference (HC) (r=.229, p=0.028 and r=.241, p=0.021), respectively. PRAL negatively correlated with total testosterone(r=-.383, p<0.001), while NEAP did not (r=-0.135, p=0.218).
Conclusion: We concluded that the PCOS patients and healthy controls had similar diets in acid load. Both NEAP and PRAL were associated with WC, HC. In addition, there was a positive correlation between PRAL and BMI and negative correlation with total testosterone. The results presented no significant association between DAL and IR.

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Thanks

We thank to E. Borhan to for english editorial. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References

  • 1. Yildiz BO, Bozdag G, Yapici Z, et al. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012;27:3067-3073.
  • 2. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41-47.
  • 3. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223-1236.
  • 4. Barber TM, Franks S. Adipocyte biology in polycystic ovary syndrome. Mol Cell Endocrinol. 2013;373:68-76.
  • 5. Randeva HS, Tan BK, Weickert MO, et al. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev. 2012;33:812-841.
  • 6. Barber TM, McCarthy MI, Wass JA, et al. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf.) 2006;65:137-145.
  • 7. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057.
  • 8. Stepto NK, Cassar S, Joham AE, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod. 2013;28:777-784.
  • 9. Wild RA. Dyslipidemia in PCOS. Steroids. 2012;77:295-299.
  • 10. Teede HJ, Joham AE, Paul E, et al. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity (Silver Spring). 2013;21:1526-1532.
  • 11. Akter S, Eguchi M, Kuwahara K, et al. High dietary acid load is associated with insulin resistance: The Furukawa Nutrition and Health Study. Clin Nutr. 2016;35:453-459.
  • 12. Remer T. Influence of nutrition on acid-base balance--metabolic aspects. Eur J Nutr. 2001;40:214-220.
  • 13. Han E, Kim G, Hong N, et al. Association between dietary acid load and the risk of cardiovascular disease: nationwide surveys (KNHANES 2008-2011). Cardiovasc Diabetol. 2016;15:122.
  • 14. 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;77:1255-1260.
  • 15. Abbasalizad Farhangi M, Nikniaz L, Nikniaz Z. Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis. PLoS One. 2019;14:e0216547.
  • 16. Akter S, Eguchi M, Kurotani K, et al. High dietary acid load is associated with increased prevalence of hypertension: the Furukawa Nutrition and Health Study. Nutrition. 2015;31:298-303.
  • 17. Kiefte-de Jong JC, Li Y, Chen M, et al. Diet-dependent acid load and type 2 diabetes: pooled results from three prospective cohort studies. Diabetologia. 2017;60:270-279.
  • 18. Murakami K, Sasaki S, Takahashi Y, et al. Association between dietary acid-base load and cardiometabolic risk factors in young Japanese women. Br J Nutr. 2008;100:642-651.
  • 19. Alferink LJM, Kiefte-de Jong JC, Erler NS, et al. Diet-Dependent Acid Load-The Missing Link Between an Animal Protein-Rich Diet and Nonalcoholic Fatty Liver Disease? J Clin Endocrinol Metab. 2019;104:6325-6337.
  • 20. Rebholz CM, Coresh J, Grams ME, et al. Dietary Acid Load and Incident Chronic Kidney Disease: Results from the ARIC Study. Am J Nephrol. 2015;42:427-435.
  • 21. Mozaffari H, Namazi N, Larijani B, et al. Association of dietary acid load with cardiovascular risk factors and the prevalence of metabolic syndrome in Iranian women: A cross-sectional study. Nutrition. 2019;67-68:110570.
  • 22. Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol. 1981;140:815-830.
  • 23. Matthews DR, Hosker JP, Rudenski AS,et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-419.
  • 24. Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356-1361.
  • 25. Frassetto LA, Todd KM, Morris RC Jr,et al. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr. 1998;68:576-583.
  • 26. Krupp D, Shi L, Remer T. Longitudinal relationships between diet-dependent renal acid load and blood pressure development in healthy children. Kidney Int. 2014;85:204-210.
  • 27. Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618-637.
  • 28. Consensus Development Conference on Insulin Resistance. 5-6 November 1997. American Diabetes Association. Diabetes Care. 1998;21:310-314.
  • 29. Möhlig M, Jürgens A, Spranger J, et al. The androgen receptor CAG repeat modifies the impact of testosterone on insulin resistance in women with polycystic ovary syndrome. Eur J Endocrinol. 2006;155:127-130.
  • 30. Toulis KA, Goulis DG, Farmakiotis D, et al. Adiponectin levels in women with polycystic ovary syndrome: a systematic review and a meta-analysis. Hum Reprod Update. 2009;15:297-307.
  • 31. Kucharska AM, Szostak-Węgierek DE, Waśkiewicz A, et al. Dietary acid load and cardiometabolic risk in the Polish adult population. Adv Clin Exp Med. 2018;27:1347-1354.
  • 32. Bahadoran Z, Mirmiran P, Khosravi H, et al. Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study. Endocrinol Metab (Seoul). 2015;30:201-207.
  • 33. Haghighatdoost F, Najafabadi MM, Bellissimo N, et al. Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy. Nutrition. 2015;31:697-702.
  • 34. Daneshzad E, Haghighatdoost F, Azadbakht L. Dietary acid load and cardiometabolic risk factors: a systematic review and meta-analysis of observational studies. Public Health Nutr. 2019;22:2823-2834.
  • 35. Faure AM, Fischer K, Dawson-Hughes B, et al. Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporos Int. 2017;28:3451-3462.
  • 36. Welch AA, MacGregor AJ, Skinner J, et al. A higher alkaline dietary load is associated with greater indexes of skeletal muscle mass in women. Osteoporos Int. 2013;24:1899-1908.
  • 37. Hossain N, Stepanova M, Afendy A, et al. Non-alcoholic steatohepatitis (NASH) in patients with polycystic ovarian syndrome (PCOS). Scand J Gastroenterol. 2011;46:479-484.
  • 38. Lim SS, Kakoly NS, Tan JWJ, et al. Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Obes Rev. 2019;20:339-352.
  • 39. Wild RA, Rizzo M, Clifton S, et al. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011;95:1073-1079.e1071-1011.
  • 40. Allemand MC, Irving BA, Asmann YW, et al. Effect of testosterone on insulin stimulated IRS1 Ser phosphorylation in primary rat myotubes--a potential model for PCOS-related insulin resistance. PLoS One. 2009;4:e4274.
  • 41. Pedersen AJT, Stage TB, Glintborg D, et al. The Pharmacogenetics of Metformin in Women with Polycystic Ovary Syndrome: A Randomized Trial. Basic Clin Pharmacol Toxicol. 2018;122:239-244.
  • 42. Morley LC, Tang T, Yasmin E, et al. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2017;11:Cd003053.
  • 43. Pinola P, Puukka K, Piltonen TT, et al. Normo- and hyperandrogenic women with polycystic ovary syndrome exhibit an adverse metabolic profile through life. Fertil Steril. 2017;107:788-795.e782.

Metabolic status is not related to dietary acid load in polycystic ovary syndrome

Year 2022, Volume: 55 Issue: 2, 111 - 115, 31.08.2022
https://doi.org/10.20492/aeahtd.1069778

Abstract

Aim:Women with polycystic ovary syndrome (PCOS) are at high risk for obesity-related disorders, insulin resistance (IR), and metabolic syndrome (MS). Adopting potent approaches to diet enhances cardiometabolic risk profile and reproductive function. Different types of diets have provided conflicting results so far. We aimed to investigate whether dietary acid load (DAL) contributed to the metabolic process in PCOS.
Material and Method: This study included 46 newly diagnosed PCOS patients and 46 healthy individuals with matched age, sex, and BMI. Clinical, anthropometric, and biochemical measurements were obtained. We extracted net endogenous acid production (NEAP) and potential renal acid load (PRAL) scores from 24-hour dietary data recorded on a nutrient database program for three days (BeBiS software program).
Results:We concluded no statistically significant difference between the groups by NEAP (p=0.569) and PRAL (p=0.969).Patients with PCOS had higher fasting insulin levels and HOMA-IR (p<0.001 and p<0.001 respectively.); however, fasting serum glucose and HbA1c levels were similar (p=0.077 and p=0.859, respectively). Both NEAP and PRAL presented positive correlations with waist circumference (WC) (r=.236, p=0.023 and r=.290, p=0.005), hip circumference (HC) (r=.229, p=0.028 and r=.241, p=0.021), respectively. PRAL negatively correlated with total testosterone(r=-.383, p<0.001), while NEAP did not (r=-0.135, p=0.218).
Conclusion: We concluded that the PCOS patients and healthy controls had similar diets in acid load. Both NEAP and PRAL were associated with WC, HC. In addition, there was a positive correlation between PRAL and BMI and negative correlation with total testosterone. The results presented no significant association between DAL and IR.

References

  • 1. Yildiz BO, Bozdag G, Yapici Z, et al. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012;27:3067-3073.
  • 2. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41-47.
  • 3. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223-1236.
  • 4. Barber TM, Franks S. Adipocyte biology in polycystic ovary syndrome. Mol Cell Endocrinol. 2013;373:68-76.
  • 5. Randeva HS, Tan BK, Weickert MO, et al. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev. 2012;33:812-841.
  • 6. Barber TM, McCarthy MI, Wass JA, et al. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf.) 2006;65:137-145.
  • 7. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057.
  • 8. Stepto NK, Cassar S, Joham AE, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod. 2013;28:777-784.
  • 9. Wild RA. Dyslipidemia in PCOS. Steroids. 2012;77:295-299.
  • 10. Teede HJ, Joham AE, Paul E, et al. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity (Silver Spring). 2013;21:1526-1532.
  • 11. Akter S, Eguchi M, Kuwahara K, et al. High dietary acid load is associated with insulin resistance: The Furukawa Nutrition and Health Study. Clin Nutr. 2016;35:453-459.
  • 12. Remer T. Influence of nutrition on acid-base balance--metabolic aspects. Eur J Nutr. 2001;40:214-220.
  • 13. Han E, Kim G, Hong N, et al. Association between dietary acid load and the risk of cardiovascular disease: nationwide surveys (KNHANES 2008-2011). Cardiovasc Diabetol. 2016;15:122.
  • 14. 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;77:1255-1260.
  • 15. Abbasalizad Farhangi M, Nikniaz L, Nikniaz Z. Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis. PLoS One. 2019;14:e0216547.
  • 16. Akter S, Eguchi M, Kurotani K, et al. High dietary acid load is associated with increased prevalence of hypertension: the Furukawa Nutrition and Health Study. Nutrition. 2015;31:298-303.
  • 17. Kiefte-de Jong JC, Li Y, Chen M, et al. Diet-dependent acid load and type 2 diabetes: pooled results from three prospective cohort studies. Diabetologia. 2017;60:270-279.
  • 18. Murakami K, Sasaki S, Takahashi Y, et al. Association between dietary acid-base load and cardiometabolic risk factors in young Japanese women. Br J Nutr. 2008;100:642-651.
  • 19. Alferink LJM, Kiefte-de Jong JC, Erler NS, et al. Diet-Dependent Acid Load-The Missing Link Between an Animal Protein-Rich Diet and Nonalcoholic Fatty Liver Disease? J Clin Endocrinol Metab. 2019;104:6325-6337.
  • 20. Rebholz CM, Coresh J, Grams ME, et al. Dietary Acid Load and Incident Chronic Kidney Disease: Results from the ARIC Study. Am J Nephrol. 2015;42:427-435.
  • 21. Mozaffari H, Namazi N, Larijani B, et al. Association of dietary acid load with cardiovascular risk factors and the prevalence of metabolic syndrome in Iranian women: A cross-sectional study. Nutrition. 2019;67-68:110570.
  • 22. Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol. 1981;140:815-830.
  • 23. Matthews DR, Hosker JP, Rudenski AS,et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-419.
  • 24. Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356-1361.
  • 25. Frassetto LA, Todd KM, Morris RC Jr,et al. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr. 1998;68:576-583.
  • 26. Krupp D, Shi L, Remer T. Longitudinal relationships between diet-dependent renal acid load and blood pressure development in healthy children. Kidney Int. 2014;85:204-210.
  • 27. Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618-637.
  • 28. Consensus Development Conference on Insulin Resistance. 5-6 November 1997. American Diabetes Association. Diabetes Care. 1998;21:310-314.
  • 29. Möhlig M, Jürgens A, Spranger J, et al. The androgen receptor CAG repeat modifies the impact of testosterone on insulin resistance in women with polycystic ovary syndrome. Eur J Endocrinol. 2006;155:127-130.
  • 30. Toulis KA, Goulis DG, Farmakiotis D, et al. Adiponectin levels in women with polycystic ovary syndrome: a systematic review and a meta-analysis. Hum Reprod Update. 2009;15:297-307.
  • 31. Kucharska AM, Szostak-Węgierek DE, Waśkiewicz A, et al. Dietary acid load and cardiometabolic risk in the Polish adult population. Adv Clin Exp Med. 2018;27:1347-1354.
  • 32. Bahadoran Z, Mirmiran P, Khosravi H, et al. Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study. Endocrinol Metab (Seoul). 2015;30:201-207.
  • 33. Haghighatdoost F, Najafabadi MM, Bellissimo N, et al. Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy. Nutrition. 2015;31:697-702.
  • 34. Daneshzad E, Haghighatdoost F, Azadbakht L. Dietary acid load and cardiometabolic risk factors: a systematic review and meta-analysis of observational studies. Public Health Nutr. 2019;22:2823-2834.
  • 35. Faure AM, Fischer K, Dawson-Hughes B, et al. Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporos Int. 2017;28:3451-3462.
  • 36. Welch AA, MacGregor AJ, Skinner J, et al. A higher alkaline dietary load is associated with greater indexes of skeletal muscle mass in women. Osteoporos Int. 2013;24:1899-1908.
  • 37. Hossain N, Stepanova M, Afendy A, et al. Non-alcoholic steatohepatitis (NASH) in patients with polycystic ovarian syndrome (PCOS). Scand J Gastroenterol. 2011;46:479-484.
  • 38. Lim SS, Kakoly NS, Tan JWJ, et al. Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Obes Rev. 2019;20:339-352.
  • 39. Wild RA, Rizzo M, Clifton S, et al. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011;95:1073-1079.e1071-1011.
  • 40. Allemand MC, Irving BA, Asmann YW, et al. Effect of testosterone on insulin stimulated IRS1 Ser phosphorylation in primary rat myotubes--a potential model for PCOS-related insulin resistance. PLoS One. 2009;4:e4274.
  • 41. Pedersen AJT, Stage TB, Glintborg D, et al. The Pharmacogenetics of Metformin in Women with Polycystic Ovary Syndrome: A Randomized Trial. Basic Clin Pharmacol Toxicol. 2018;122:239-244.
  • 42. Morley LC, Tang T, Yasmin E, et al. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2017;11:Cd003053.
  • 43. Pinola P, Puukka K, Piltonen TT, et al. Normo- and hyperandrogenic women with polycystic ovary syndrome exhibit an adverse metabolic profile through life. Fertil Steril. 2017;107:788-795.e782.
There are 43 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original research article
Authors

Tülay Omma 0000-0002-2557-9499

Fatmanur Hümeyra Zengin 0000-0003-1586-5878

Süheyla Aydoğmuş 0000-0003-3441-4597

Cavit Çulha 0000-0002-9275-2538

Publication Date August 31, 2022
Submission Date February 11, 2022
Published in Issue Year 2022 Volume: 55 Issue: 2

Cite

AMA Omma T, Zengin FH, Aydoğmuş S, Çulha C. Metabolic status is not related to dietary acid load in polycystic ovary syndrome. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. August 2022;55(2):111-115. doi:10.20492/aeahtd.1069778