| Objectives: There is no clear summarised report of the association between dietary
acid load components including potential renal acid load (PRAL) and net-endogenous
acid production (NEAP) with cardiometabolic risk factors. In the current meta-analysis,
we aimed to systematically review and summarise the eligible observational studies
evaluating the association between PRAL and NEAP with blood pressure and
hypertension and markers of glucose haemostasis among adults.
Design and Setting: In a systematic search from PubMed, SCOPUS, Web of Sciences
and Cochrane electronic databases up to May 2019, relevant studies were included in
the literature review. Observational studies evaluating the association between PRAL
and NEAP with the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting
blood glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR),
haemoglobin A1C (HbA1C), HOMA-β and quantitative insulin check index (QUICKI) and
also prevalence or odds of hypertension, hyperglycaemia and diabetes were included.
Results: Total number of studies included in the 14 separate meta-analyses were as
follows: Mean (SD) of SBP (PRAL, n = 12; NEAP, n = 6), mean (SD) of DBP (PRAL,
n = 8; NEAP, n = 3), mean (SD) of FBS (PRAL, n = 12; NEAP, n = 5), mean (SD) of HbA1C
(PRAL, n = 6; NEAP, n = 4), mean (SD) of HOMA-IR (PRAL, n = 7), mean (SD) of insulin
(PRAL, n = 7; NEAP, n = 2); OR of type 2 diabetes mellitus (T2DM) (PRAL, n = 8; NEAP;
n = 6), HTN prevalence (PRAL, n = 9; NEAP, n = 9), T2DM prevalence (PRAL, n = 7;
NEAP, n = 6). According to our results, being in the highest PRAL categories was associated
with higher SBP (WMD = 0.98; CI: 0.51, 1.45; P < .001), DBP (WMD = 0.61;
CI: 0.089, 1.135; P = .022), insulin (WMD = −0.235, CI: 0.070, 0.400; P = .005), higher
odds of diabetes (OR = 1.19; CI: 1.092, 1.311; P < .001), higher prevalence of T2DM
(13% and 11% in highest vs lowest category). While, being in the highest category of
NEAP was only associated with higher odds of diabetes (OR = 1.22; CI: 1.14, 1.31,
P < .001). In subgroup analysis for finding the possible source of heterogeneity, the
continent, dietary assessment tool, sample size and gender were the potent sources
of heterogeneity. No association between PRAL and NEAP with HbA1C, HOMA-IR
was reported. |