Sausenthaler Stefanie, Kompauer Iris, Brasche Sabine, Linseisen Jakob, Heinrich Joachim
GSF-National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
Respir Med. 2005 Jul;99(7):864-70. doi: 10.1016/j.rmed.2004.11.019.
Several investigations suggested a relationship between sodium intake and asthma and bronchial hyperresponsiveness (BHR), respectively. However, clinical and epidemiological studies did not show consistent finding.
We analysed the association between dietary sodium intake and BHR to methacholine among 613 adults aged 20-65 years as one of the two German centres of the European Community Respiratory Health Survey (ECRHS).
Dietary sodium intake was estimated from a 3-day weighed record of food intake. We applied multiple logistic regression models contrasting the three higher quartiles of sodium intake versus the lowest to assess the risk of BHR and mild BHR estimated by PD20 and PD10, respectively, controlling for potential confounders and stratified for sex. In addition, we analysed PD20 (dose of methacholine causing a fall of 20% in forced expiratory volume in 1s) as continuous variable expressed as transformed dose-response slope (tDRS) in the linear model.
Women were as expected more likely to be bronchial hyperresponsive (PD20: 26.1%; PD10: 52.2%) than men (PD20:15.8%; PD10: 34.8%) and had a lower mean daily sodium intake (2.36 g) compared with men (3.15 g). Logistic regression did not show any significant relationship between sodium intake and BHR in terms of PD20 after adjustment for age group, education, smoking status, body mass index and height in men or women. However, mild BHR assessed as PD10 was statistically significant positively related to the third (OR: 2.35; CI: 1.11-5.00) and highest quartile of sodium intake (OR: 2.28; CI: 1.06-4.88) in women, but not in men for third quartile (OR: 1.29; CI: 0.68-2.44) and for fourth quartile (OR: 1.07; CI: 0.56-2.07), respectively.
Sodium intake by several food items does not alter BHR assessed as PD20 to methacholine but may increase mild BHR assessed as PD10. We conclude that, in addition, PD10 has to be considered when the effect of sodium intake on BHR is studied.
多项调查分别提示钠摄入与哮喘及支气管高反应性（BHR）之间存在关联。然而，临床和流行病学研究并未得出一致的结果。
作为欧洲共同体呼吸健康调查（ECRHS）在德国的两个中心之一，我们分析了613名20至65岁成年人的饮食钠摄入量与对乙酰甲胆碱的BHR之间的关联。
通过3天食物摄入量称重记录估算饮食钠摄入量。我们应用多元逻辑回归模型，对比钠摄入量的三个较高四分位数与最低四分位数，以评估分别由PD20和PD10估算的BHR和轻度BHR的风险，同时控制潜在混杂因素并按性别分层。此外，我们在线性模型中分析了PD20（使1秒用力呼气量下降20%的乙酰甲胆碱剂量）作为以转换剂量反应斜率（tDRS）表示的连续变量。
正如预期，女性比男性更易出现支气管高反应性（PD20：26.1%；PD10：52.2%），而男性为（PD20：15.8%；PD10：34.8%），且女性的平均每日钠摄入量（2.36克）低于男性（3.15克）。在对男性或女性的年龄组、教育程度、吸烟状况、体重指数和身高进行调整后，逻辑回归未显示钠摄入量与以PD20评估的BHR之间存在任何显著关系。然而，以PD10评估的轻度BHR在女性中与钠摄入量的第三个四分位数（比值比：2.35；可信区间：1.11 - 5.00）和最高四分位数（比值比：2.28；可信区间：1.06 - 4.88）呈统计学显著正相关，但在男性中，第三个四分位数（比值比：1.29；可信区间：0.68 - 2.44）和第四个四分位数（比值比：1.07；可信区间：0.56 - 2.07）均无此关联。
通过多种食物摄入的钠不会改变以PD20评估的对乙酰甲胆碱的BHR，但可能会增加以PD10评估的轻度BHR。我们得出结论，此外，在研究钠摄入量对BHR的影响时，还必须考虑PD10。
