The association between urine pH and abnormal glucose tolerance in adults

Abstract

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 was showed. The aim of this study is to evaluate the U-pH in patients with different glucose tolerance statuses. Material and Method: 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 oral glucose tolerance test (OGTT) results: group 1=normal glucose tolerance (NGT), group 2=prediabetes, group 3=T2DM. Then 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 T2DM (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 T2DM (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 whether different glucose tolerance statuses such as NGT, IFG, IGT, and T2DM are associated with U-pH.