Abstract
OBJECTIVE: Low urine pH (LUP) is not only affected by environmental factors, but is also a feature of metabolic syndrome (MS), which is characterized by insulin resistance, abdominal obesity, dyslipidaemia and hypertension. However, it is unclear which factors contribute most to urine acidity. This study investigated factors influencing LUP and the link between LUP and metabolic traits in South Korea. METHODS: Participants were middle-aged subjects (age, 52.2 ± 8.9 years; average body mass index, 24.6 ± 3.2 kg/m(2)), of whom 4,626 had urine pH of 5.0 and were assigned to the LUP group and 4,185 had urine pH > 5.0 and were assigned to the control group. The association between LUP and various phenotypes, including environmental and metabolic traits, was analysed. RESULTS: LUP was significantly associated with MS diagnostic components and with environmental exposures such as smoking, alcohol intake and low-fibre diet. Multivariate analysis showed that the waist-to-hip ratio was the best predictor for LUP compared with other MS components (OR: 2.439). CONCLUSIONS: LUP is an indicator of MS and is mainly related to the MS diagnostic criterion of abdominal obesity, even after adjusting for environmental influences on urine acidity.