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. 2018 Aug 24;13(8):e0202757.
doi: 10.1371/journal.pone.0202757. eCollection 2018.

Low urine pH affects the development of metabolic syndrome, associative with the increase of dyslipidemia and dysglycemia: Nationwide cross-sectional study (KNHANES 2013-2015) and a single-center retrospective cohort study

Seung Min Chung  1 , Jun Sung Moon  1 , Ji Sung Yoon  1 , Kyu Chang Won  1 , Hyoung Woo Lee  1
Affiliations

Low urine pH affects the development of metabolic syndrome, associative with the increase of dyslipidemia and dysglycemia: Nationwide cross-sectional study (KNHANES 2013-2015) and a single-center retrospective cohort study

Seung Min Chung et al. PLoS One. .

Abstract

Introduction: Low urine pH (UpH) and high serum uric acid are considered evidence of metabolic disorders. The effect of low UpH on the development of metabolic syndrome (MetS) is less clear than that of high serum uric acid. We investigated the association between low UpH on the development of MetS and its components: central obesity, dyslipidemia, hypertension, and dysglycemia.

Methods: Two studies were conducted based on 2 datasets. The cross-sectional study included 14,511 subjects aged 19-80 years, based on the Korea National Health and Nutrition Examination Survey in 2013-2015. The retrospective cohort study included 3,453 subjects aged 19-80 years without MetS at the first checkup, who underwent at least 3 health checkups at a single tertiary hospital between 2011 and 2017. UpH was measured using an automatic urine analyzer in the range of 5.0-9.0 at first visit.

Results: In the cross-sectional study, low UpH (= 5.0) was associated with the prevalence of MetS (odds ratio [OR] = 1.480, 95% confidence interval [CI] 1.334-1.643, p<0.001), particularly central obesity, dyslipidemia, and dysglycemia (OR ranges 1.282-1.422, p<0.001, all). In the retrospective cohort study, compared with the highest UpH subgroup, the lowest UpH subgroup (= 5.0) was associated with higher risk of MetS development (hazard ratio = 1.394, 95% CI 1.096-1.772, p = 0.007). The incident risk of MetS increased from the highest to lowest UpH subgroups (p for trend = 0.020), among which dyslipidemia and dysglycemia increased (p for trend <0.01, all).

Conclusion: Low UpH can be used as a surrogate marker of MetS and affects the development of MetS, associative with the increase of dyslipidemia and dysglycemia in those without MetS. If UpH is ≤5.0, efforts to prevent metabolic disorders are warranted.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Description of study population.
(A) Cross-sectional study based on KNHANES 2013–2015 and (B) retrospective longitudinal cohort study based on YUHPC. †estimated glomerular filtration rate < 30 ml/min/1.73 m2.
Fig 2
Fig 2. Cumulative incidences (%) of metabolic syndrome according to 4 UpH subgroups at first checkup.
The cumulative incidence was calculated based on cox regression analysis adjusted for age, gender, eGFR, and serum uric acid at the first checkup. UpH, urine pH.
See this image and copyright information in PMC

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