Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1397
1
1
gregorian
2018
4
1
25
2
online
1
fulltext
fa
بررسی ارتباط باراسیدی رژیم غذایی با شاخص های متابولیسم استخوان در سالمندان تهران
The relationship between dietary acid load and bone metabolism markers in Tehranian elderly
علوم تغذیه
Nutrition Sciences
پژوهشي
Research
<strong><span style="font-family:b mitra;"><span style="font-size:10.0pt;">زمینه و هدف</span></span></strong>: <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مطالعات محدودی ارتباط بار اسیدی رژیم غذایی با افزایش شکستگی و استئوپروز را گزارش کردند که نتایج برخی از مطالعات متناقض میباشد. </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">هدف از مطالعه حاضر، ارزیابی ارتباط بار اسیدی رژیم غذایی بر اساس</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"> PRAL (potential renal acid load) </span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> و امتیاز (</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">net</span></span></span></span> <span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">endogenous acid production</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">)</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"> NEAP </span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">با برخی نشانگرهای سلامت استخوان در سالمندان میباشد.</span></span></span><br>
<strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">روش کار</span></span></span></strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">: 172سالمند (</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">122 زن و 50 مرد) </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در مطالعهی مقطعی حاضر شرکت کردند. در این مطالعه شاخصهای</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"> PRAL </span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">NEAP </span></span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بررسی شدند. پرسشنامهی بسامد مصرف غذایی اعتبارسنجی شده به منظور ارزیابی دریافتهای غذایی استفاده شد. </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">قد و وزن بیماران اندازه گیری شد. اندازه گیری استئوکلسین </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سرم </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX(C-terminal telopeptide of type I collagen)</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> ادرار ، پاراتورمون، </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">hs-CRP</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> (</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">High sensitivity C-reactive protein</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">) و 25هیدروکسی ویتامین</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">D </span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> طبق دستورالعمل کیتهای تجاری انجام شد. از نرمافزار </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">SPSS23</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> برای رگرسیون خطی با حد معناداری 05/0 استفاده شد.</span></span></span><br>
<strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">یافته</span></span></span></strong><strong><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span></strong><strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">ها</span></span></span></strong><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">:</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مطالعه حاضر نشان داد که </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">شاخص باراسیدی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">رژیم غذایی</span></span></span> <span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PRAL</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> ارتباط مثبت و معناداری با دور کمر</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و وزن </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">داشت (</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">34/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">P=</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">). </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در مورد شاخصهای متابولیسم استخوان تنها </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX- I</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> ادرار ارتباط معنا داری را در بین سهکهای شاخص بار اسیدی </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">NEAP</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> نشان داد به نحوی که در بالاترین سهک </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">شاخص بار اسیدی </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">NEAP</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> (غلظت </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX- I</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> ادرار در</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سهک سوم =86/1</span></span></span><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">±</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">13/18) غلظت </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX- I</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> ادرار کاهش مییافت (</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">غلظت </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX- I</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> اداری در </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سهک اول =95/1</span></span></span><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">±</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">63/16 و غلظت </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">CTX- I</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> اداری در</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سهک دوم =95/1</span></span></span><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">±</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">45/26</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">) (001/0=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">). </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span dir="RTL"><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نتیجهگیری</span></span></span></span></strong><span dir="RTL"><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">: به نظر میرسد بار اسیدی بالای رژیم غذایی نمی تواند تهدیدی برای از دست دادن تراکم استخوان و بروز استئوپروز در سالمندان باشد. </span></span></span></span>
<strong>Background</strong>: Few studies have reported the association between dietary acid load with increased fractures and osteoporosis, which results in of these studies are contradictory. The aim of this study was to evaluate the relation of dietary acid load based on PRAL (potential renal acid load) and NEAP (net endogenous acid production) score with bone health markers in the elderly.<br>
<strong>Methods</strong>: 172 elderlies (122 female and 50 male) participated in this cross-sectional study. In this study, PRAL and NEAP scores were investigated. A validated food frequency questionnaire was used to evaluate dietary intake. Height and weight of patients were measured. Measurement of serum osteocalcin and CTX (C-terminal telopeptide of type I collagen) of urine, parathormone, hs-CRP (high-sensitivity C-reactive protein) and 25 hydroxyvitamin D were performed according to commercial kits guidelines. SPSS v. 23 software was used for regression with a significance level of 0.05.<br>
<strong>Results</strong>: The present study showed that the PRAL had a positive and significant correlation with body weight and waist circumference in linear regression (p=0.034). There was no significant statistical relationship between other variables. Among of bone metabolism markers, only CTX-I indicated significant difference between NEAP tertiles. Thus, in the highest tertile of NEAP (tertile3=18.13±1.86) concentration of CTX- I declined (tertile 1=16.63±1.95 and tertile2=26.45±1.95) (p= 0.001).<br>
<strong>Conclusion</strong>: It seems that high dietary acid intake can not be a threat to bone loss and osteoporosis in the elderly.<br>
بار اسیدی رژیم غذایی, استئوکلسین,CTX , سالمندان
Dietary acid load, Osteocalcin, CTX, Elderly
58
68
http://rjms.iums.ac.ir/browse.php?a_code=A-10-3775-1&slc_lang=fa&sid=1
Somaye
Fatahi
سمیه
فتاحی
fatahis70@gmail.com
3900319475328460039609
3900319475328460039609
No
Tehran University of Medical Sciences, Tehran, Iran.
دانشگاه علوم پزشکی تهران، تهران، ایران
Jamal
Rahmani
جمال
رحمانی
mojtaba1717@yahoo.com
3900319475328460039610
3900319475328460039610
No
Tehran University of Medical Sciences, Tehran, Iran.
دانشگاه علوم پزشکی تهران، تهران، ایران
Hamed
Kord Varkaneh
حامد
کرد ورکانه
hkord@razi.tums.ac.ir
3900319475328460039611
3900319475328460039611
Yes
Tehran University of Medical Sciences, Tehran, Iran.
دانشگاه علوم پزشکی تهران، تهران، ایران