(P04-074-20) Association of Dietary Acid Load with the Risk of Insulin Resistance in Middle-Aged and Older Korean Adults

Objectives: Prospective studies on the relationship between diet-induced acid-base imbalance and insulin resistance among Asian populations have been limited. Thus, we investigated weather diet-induced metabolic acidosis was prospectively associated with insulin resistance risk in middle-aged and older Korean adults.

Methods: A total of 5,663 participants from the Korean Genome and Epidemiology Study without type 2 diabetes, insulin resistance, or cancer at baseline were included in this study. To estimate diet-induced metabolic acidosis, we used potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. They were calculated from the usual dietary intake assessed by a validated 103-item food frequency questionnaire at baseline. Multivariable Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the future risk of insulin resistance after adjusting for covariates.

Results: During a mean of 7.4-year of follow-up, we documented 3,623 insulin resistance cases. In the fully adjusted model, the future risks of insulin resistance were significantly higher among participants in the highest quartiles of PRAL (HR: 1.28, 95% CI: 1.12-1.46, Ptrend = 0.0002) and NEAP (HR: 1.28, 95% CI: 1.12-1.46, Ptrend = 0.0013) compared with those in the lowest. Associations were slightly strengthened among men, adults aged < 50 years, those having obesity or low levels of physical activity.

Conclusions: Diet-induced metabolic acidosis is associated with an increased risk of insulin resistance, irrespective of other type 2 diabetes risk factors. Moreover, we observed effect modifiers of associations between dietary acid load scores and insulin resistance, suggesting stronger effects among men, those aged < 50 years, obese individuals, or individuals with low levels of physical activity.

Funding Sources: None