Asupan makan, sindrom metabolik, dan status keseimbangan asam-basa pada lansia

https://doi.org/10.22146/ijcn.18366

Nurmasari Widyastuti(1*), Muhammad Sulchan(2), Andrew Johan(3)

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

Abstract


Background: Metabolic syndrome prevalence increases with age and obesity. The metabolic syndrome is associated with alterations in renal function. Low urine pH has been described as a renal manifestation of the metabolic syndrome. Urine pH is a simple and inexpensive method for determining acid-base status. Recent studies suggest that acid-base status is associated with dietary intake.

Objective: To examine relationship between dietary intake, components of metabolic syndrome and urine pH among the elderly.

Method: Subjects of this cross-sectional study consist of 49 elderly that were collected consecutively. Height, weight, waist circumference (WC), dietary intake, blood pressure (BP), fasting blood glucose and urine were obtained. Rank Spearman correlation test was used to examine the correlation of components of metabolic syndrome and dietary intake with urine pH. Mann-Whitney test was used to compare the urine pH of the metabolic syndrome group and the normal group. Chi-Square/fisher test was used to calculate prevalence ratio (PR) of metabolic syndrome components to low urine pH. Multivariate analysis was done by multiple linear regression.

Results: The mean urine pH of the metabolic syndrome group was 6,06 and significantly lower than the normal group (6,50). WC was the only component of metabolic syndrome that related to urine pH (r=-0,325; p=0,023). Abdominal obesity significantly increases the risk of low urine pH (RP=1,6; p=0,023; CI=1,005-2,442). Urine pH was negatively associated with protein intake and proportion of protein on diet. In multivariate analysis, WC is the most significant factor that predicted urinary pH.

Conclusion: Urine acidification is a characteristic of abdominal obesity and the metabolic syndrome. Protein intake and proportion of protein on diet contribute to urine pH.


Keywords


metabolic syndrome; abdominal obesity; low urine pH; protein intake

Full Text:

PDF


References

Fatmah. Gizi usia lanjut. Jakarta: Penerbit Erlangga; 2010.

Boedhi-Darmojo. Buku ajar geriatri (ilmu kesehatan usia lanjut). Jakarta: Balai Penerbit FKUI; 2006.

Lechleitner M. Obesity and the metabolic syndrome in the elderly – a mini-review. Gerontology 2008;54(5):253-9.

Abete I, Astrup A, Martinez JA, Thorsdottir I, Zule MA. Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutr Rev 2010;68(4):214-31.

Newman AM. Obesity in older adults. OJIN 2009: 14(1).doi: 10.3912/OJIN.Vol14No1Man03.

Arisman. Gizi dalam daur kehidupan. Jakarta: EGC; 2010.

Kementerian Kesehatan RI. Laporan riset kesehatan dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2010.

Ervin BR. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. Natl Health Stat Report 2009;13:1-7.

Djokomoeljanto. Metabolic syndrome and nutrition. Proceeding Seminar dan Pra Konggres Persatuan Dokter Gizi Medik Indonesia (PDGMI); 2009; Semarang.

Miranda PJ, DeFronzo RA, Califf RM, Guyton JR. Metabolic syndrome: definition, pathophysiology, and mechanisms. Am Heart J 2005;149(1):33-45.

Fan AZ. Etiology of the metabolic syndrome. Curr Cardiol Rev 2007;3:232-9.

Kamso S. Body mass index, total cholesterol, and ratio total to HDL cholesterol were determinants of metabolic syndrome in the Indonesian elderly. Med J Indones 2007;16(3):196-200.

Sidartawan S, Reno G. Sindrom metabolik. Dalam: Ilmu penyakit dalam jilid III. Jakarta: Balai Penerbit Fakultas Kedokteran Universitas Indonesia; 2006.

Maalouf NM, Cameron MA, Moe OW, Adams B-Huet, Sakhaee K. Low urine pH: a novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2007;2(5):883-8.

Raimundo M, Lopes JA. Metabolic syndrome, chronic kidney disease, and cardiovascular disease: a dynamic and life-threatening triad. Cardiol Res Pract 2011:1-16.doi:10.4061/2011/747861.

Ayu P, Kandarini Y, Widiana GR, Sudhana W, Loekman JS, Suwitra. Prevalensi dan hubungan sindrom metabolik dengan penyakit ginjal kronik pada populasi Desa Legian, Kuta Bali. J Peny Dalam 2011;12(2):103-8.

Maalouf NM, Cameron MA, Moe OW, Sakhaee K. Metabolic basis for low urine pH in type 2 diabetes. Clin J Am Soc Nephrol 2010;5(7):1277-81.

Sakhaee K. Urinary pH as a risk factor for stone type. Paper presented at: 1” Annual International Urolithiasis Research Symposium; 2006 Nov 2-3; Indianapolis, Indiana.

Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urine composition in type 2 diabetes: predisposition to uric acid nephrolithiasis. J Am Soc Nephrol 2006;17(5):1422-8.

Welch AA. Dipstick measurements of urinary pH have potential for monitoring individual and population dietary behaviors. Open Nutr J 2008;2:63-7.

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.

Corwin EJ. Patofisiologi. Nike Budhi (Alih bahasa). Jakarta: EGC; 2009.

Sudigdo S, Sofyan S. Dasar-dasar metodologi penelitian klinis: perkiraan besar sampel. Jakarta: Sagung Seto; 2002.

Gill TP. Cardiovascular risk in the Asia–Pacific region from a nutrition and metabolic point of view: abdominal obesity. Asia Pacific J Clin Nutr 2001;10(2):8-9.

Alexander CM. The coming of age of the metabolic syndrome. Diabetes Care 2003;26(11):3180-1.

Goldstein SR. Estrogen deficiency during menopause: its role in the metabolic syndrome. OBG Management May 2005; S1-S12.

Otsuki M, Kitamura T, Goya K, Saito H, Mukai M, Kasayama S, Shimomura I, Koga M. Association of urine acidification with visceral obesity and the metabolic syndrome. Endocr J 2011;58(5):363-7.

Sakhaee K. Recent advances in the pathophysiology of nephrolithiasis: pathophysiology of low urine pH in idiopathic uric acid nephrolithiasis. Kidney Int 2009;75(6):585-95.

Dewi IGASK, Pramantara IDP, Pangastuti R. Pola makan berhubungan dengan sindrom metabolik pada lansia di Poliklinik Geriatri RSUP Sanglah Denpasar. Jurnal Gizi Klinik Indonesia 2010;6(3):105-13.

Reddy ST, Ciang-Wang J, Sakhaee K, Brinkley L, Charles. Effect low carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kid Dis 2002;40(2):265-74.

McCarty M. Acid-base balance may influence risk for insulin resistance syndrome by modulating cortisol output. Med Hypotheses 2005;64(2):380-4.



DOI: https://doi.org/10.22146/ijcn.18366

Article Metrics

Abstract views : 1451 | views : 8902

Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 Jurnal Gizi Klinik Indonesia (The Indonesian Journal of Clinical Nutrition)

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Gizi Klinik Indonesia (JGKI) Indexed by:
 
 Crossref   Google Scholar Indonesian Scientific Journal Database (ISJD) Indonesia OneSearch (IOS)  CORE   

  Creative Commons License

JGKI is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

free
web stats View My Stats