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  • Original Article
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Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

European Journal of Clinical Nutrition volume 61, pages 605–609 (2007)Cite this article

Abstract

Objective:

In patients with nephrolithiasis, an inverse relationship between 24-h urinary pH (24h-UpH) and body weight has been reported. Whether body composition indices and 24h-UpH are similarly associated in healthy subjects needs investigation.

Design:

Cross-sectional, retrospective analysis.

Setting:

Dortmund, Germany and Gothenburg, Sweden.

Subjects:

Healthy young adults (18–23 years; n=117) and elderly (55–75years; n=85) having a mean body mass index (BMI) of 22.80±3.4 and 25.3±3.9 kg/m2, respectively.

Methods:

Anthropometric data, 24h-UpH, and 24-h urinary excretion rates of net acid (NAE), creatinine, and urea were determined. After adjusting for urea (reflecting protein intake), renal creatinine output was used as a biochemical marker for muscularity. The BMI served as a marker of adiposity.

Results:

NAE, body weight, and BMI were significantly (P<0.05) higher, and height and creatinine significantly lower in the elderly, whereas body-surface area (BSA) was not different. Step-wise multiple regression analysis using BSA-corrected urinary variables revealed NAE as the primary predictor of 24h-UpH (with R2 values of 0.64 and 0.68 in young adults and elderly, respectively, P<0.0001), followed by urea (P<0.0001), creatinine (P<0.05), and BMI (P<0.05 for the young adults and P=0.12 for the elderly). These associations were negative for NAE and BMI, and positive for urea and creatinine.

Conclusions:

Muscularity (i.e. creatinine adjusted for urea) and particularly in the group of young adults, adiposity (i.e. BMI) proved to be modest, but significant predictors of 24h-UpH. Future research should focus on more obese subjects in whom insulin resistance and particular kidney functions should also be examined to further substantiate the role of obesity in low-urine pH-associated conditions, for example, nephrolithiasis.

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Acknowledgements

This study has been supported by the Ministry of Science and Research North Rhine-Westphalia, Germany and funded by a research grant from Protina Pharm GmbH to TR.

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Authors and Affiliations

  1. Research Institute of Child Nutrition, Dortmund, Germany

    T Remer & S Berkemeyer

  2. Biofact Environmental Health Research Center, Lerum, Sweden

    R Rylander

  3. Institute for Prevention and Nutrition, Ismaning/Munich, Germany

    J Vormann

Authors
  1. T Remer
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  2. S Berkemeyer
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  3. R Rylander
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  4. J Vormann
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Corresponding author

Correspondence to T Remer.

Additional information

Contributions: TR and SB were basically involved in the development of study design, did basic interpretation of results, and prepared the manuscript. SB was responsible for the analysis of the urine samples to a great extent. JV and RR initiated the study and coordinated parts of the assembly of data and analysis. All authors contributed to the preparation of the manuscript.

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Remer, T., Berkemeyer, S., Rylander, R. et al. Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly. Eur J Clin Nutr 61, 605–609 (2007). https://doi.org/10.1038/sj.ejcn.1602560

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