Jia En-zhi, Yang Zhi-jian, Zhu Tie-bing, Wang Lian-sheng, Chen Bo, Cao Ke-jiang, Huang Jun, Ma Wen-zhu
Department of Cardiovascular Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Acta Pharmacol Sin. 2007 Aug;28(8):1136-42. doi: 10.1111/j.1745-7254.2007.00597.x.
To explore the relationship between serum sodium concentration and coronary atherosclerosis.
The study population consisted of 896 consecutive patients (684 males and 212 females) who underwent coronary angiography for suspected or known coronary atherosclerosis. Smoking and drinking were investigated. The anthropometric measurements, including body mass index, systolic blood pressure and diastolic blood pressure, and the serum measurements, including sodium, potassium, chlorine, lipids, blood glucose, urea, creatinine, and uric acid for every patient were conducted. The severity of coronary atherosclerosis was defined by the Gensini score system. The statistical methods, including one-way ANOVA, Kruskal-Wallis test, Spearman correlation analysis, partial correlation analysis, multivariate stepwise linear regression analysis, and multinomial logistic regression analysis were employed to explore the relationship between serum sodium concentration and the Gensini score.
The analysis of the Kruskal-Wallis test indicated that the distribution of the Gensini score (P=0.000) differed among the groups according to serum sodium concentration, quartile values of which were used as cut-off points. The Spearman correlation and partial correlation analysis controlling for gender, smoking status, and drinking status indicated that the Gensini score significantly correlated with the sodium concentration (r=-0.241, P=0.000 for the Spearman correlation, r=-0.114, P=0.000 for the partial correlation). The results from the multivariate stepwise linear regression analysis showed that the left ventricular ejection fraction (beta=-0.228, P=0.000), age (beta=0.137, P=0.010), glucose level (beta=0.129, P=0.000), and sodium level (beta=-0.106, P=0.004) were significantly and independently associated with the Gensini score. The results of the multinomial logistic regression analysis suggested that the hyponatremia was the risk factor for the higher Gensini score.
The serum sodium concentration was significantly and negatively associated with the Gensini score; and the actual mechanism underlying the association needs further study.
探讨血清钠浓度与冠状动脉粥样硬化之间的关系。
研究对象为896例因疑似或已知冠状动脉粥样硬化而接受冠状动脉造影的连续患者（684例男性和212例女性）。调查吸烟和饮酒情况。对每位患者进行人体测量，包括体重指数、收缩压和舒张压，以及血清检测，包括钠、钾、氯、血脂、血糖、尿素、肌酐和尿酸。冠状动脉粥样硬化的严重程度由Gensini评分系统定义。采用单因素方差分析、Kruskal-Wallis检验、Spearman相关分析、偏相关分析、多元逐步线性回归分析和多项logistic回归分析等统计方法，探讨血清钠浓度与Gensini评分之间的关系。
Kruskal-Wallis检验分析表明，根据血清钠浓度分组，Gensini评分的分布（P = 0.000）存在差异，其四分位数用作切点。控制性别、吸烟状态和饮酒状态的Spearman相关分析和偏相关分析表明，Gensini评分与钠浓度显著相关（Spearman相关分析r = -0.241，P = 0.000；偏相关分析r = -0.114，P = 0.000）。多元逐步线性回归分析结果显示，左心室射血分数（β = -0.228，P = 0.000）、年龄（β = 0.137，P = 0.010）、血糖水平（β = 0.129，P = 0.000）和钠水平（β = -0.106，P = 0.004）与Gensini评分显著且独立相关。多项logistic回归分析结果提示，低钠血症是Gensini评分较高的危险因素。
血清钠浓度与Gensini评分显著负相关；两者关联的实际机制有待进一步研究。
