The association between urine pH and abnormal glucose tolerance in adults

Aim: Urine Ph (U-pH) is a clinical indicator of acid excretion in the urine and acid load in the diet. The association between low U-pH and net acid secretion with obesity, metabolic syndrome, diabetes, chronic kidney disease, and uric acid nephrolithiasis were showed. The aim of this study is to evaluate the U-pH in patients with different glucose tolerance status. Materials and methods: This study was designed as single-center, retrospective, and cross-sectional. A total of 1666 subjects (male/female: 531/1135) were divided into three groups according to their OGTT results: group 1 = normal glucose tolerance (NGT), group 2 = prediabetes, group 3 = T2DM. Than subjects were divided into five groups according to their OGTT results: group 1 = NGT, group 2 = impaired fasting glucose (IFG), group 3 = isolated impaired glucose tolerance (IGT), group 4 = both IFG and IGT, and group 5 = T2DM. Additionally, patients were divided into three groups according to their glycated hemoglobin (HbA1c) results: group 1 = NGT, group 2 = prediabetes, and group 3 = T2DM. U-pH values and other outcomes were compared between groups. Results: Age, male gender, hemoglobin, creatinine, triglycerides, and OGTT groups showed significant association with low U-pH through univariate logistic regression analyses. In model 1 (with OGTT 3 groups), it was found that creatinine (OR: 3.471; % 95 CI: 1.377-8.749; p=0.008) and triglycerides (OR: 1.001; %95 CI: 1-1.003; p = 0.013) were positively associated with low U-pH. Patients with DM (OR:1.437; %95 CI: 1.015-2.035; p=0.041) had higher risk for low U-pH compared to patients with NGT. In Model 2 (with OGTT 5 groups), creatinine (OR:3.423; %95 CI: 1.354-8.654; p = 0.009) and triglycerides (OR:1.001; %95 CI: 1-1.003; p = 0.014) were identified as independent predictive factors associated with low U-pH. Patients with IFG+IGT (OR:1.522; %95 CI: 1.083-2.138; p=0.015) and DM (OR:1.447; %95 CI: 1.022-2.049; p=0.037) had higher risk for low U-pH compared to patients with NGT. Conclusion: In this study, the frequency of diabetes was found to be increased in patients with low U-pH. More detailed clinical studies are needed to evaluate the relationship between total acid load in the body and U-pH and glucose tolerance disorders.

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