Association Between Serum Bicarbonate Levels and Prediabetes and Subclinical Inflammation in Young Healthy Adults: A Cross-sectional Study

Abeer A Omar, Khadija J Radwani, Maryam K Al Thani, Nadin H Abouzeid, Yousef E Qabeel, Manwa Al Shamari, Tawanda Chivese, Susu M Zughaier College of Medicine, QU Health, Qatar University, Doha, QatarCorrespondence: Susu M Zughaier, College of Medicine, QU Health, Qatar University, Tel +974 4403 7859, Email szughaier@qu.edu.qaPurpose: Low bicarbonate, a hallmark of metabolic acidosis is associated with various diseases. This study investigated associations between bicarbonate levels with prediabetes and subclinical inflammation among healthy young adults in Qatar.Patients and Methods: A cross-sectional study was carried out with 825 participants aged 18– 40 years, devoid of any known comorbidities, using data from the Qatar Biobank. For each participant, blood samples were taken for measurements of bicarbonate, prediabetes, and subclinical inflammation biomarkers. Prediabetes was defined using HbA1c between 5.7 and 6.4% and subclinical inflammation was defined using monocyte to high density lipoprotein (HDL) cholesterol ratio (MHR). Associations between bicarbonate levels and the outcomes were analyzed using multivariable linear and logistic regression and then stratified by gender.Results: A total of 825 participants with mean age 29.2 years (5.9) of which 365 (44.2%) were males. After multivariable logistic regression, each unit increase in serum bicarbonate was associated with a 17% decreased risk of prediabetes (OR: 0.83, 95%CI: 0.70– 0.99, p=0.034), in males but no association was observed for females. Similarly, after multivariable linear regression, a unit increase in serum bicarbonate was associated with a 0.18 unit decrease in MHR (beta − 0.18, 95%CI: − 0.29, − 0.07, p=0.002), again with no association observed in females.Conclusion: In a healthy young adult population, higher serum bicarbonate levels were inversely associated with both prediabetes and subclinical inflammation in males, but not in females.Keywords: bicarbonate, prediabetes, subclinical inflammation, males, females, Qatar