Department of Epidemiology, University of Pittsburgh, Pennsylvania, USA.
Am J Hypertens. 2011 Jan;24(1):70-6. doi: 10.1038/ajh.2010.113. Epub 2010 May 27.
Increased dietary sodium has been reported to increase cardiovascular disease (CVD) risk, perhaps through blood pressure (BP)-independent vascular remodeling. Carotid intima-media thickness (IMT) is an accepted measure of structural vascular remodeling and a strong predictor of CVD. This study aimed to determine whether urinary sodium is positively associated with carotid IMT in normotensive overweight and obese adults.
We evaluated baseline data from 258 participants in the Slow Adverse Vascular Effects (SAVE) clinical trial. Urinary sodium was measured from one 24-h urine collection from each individual. Carotid IMT was measured using high-resolution B-mode ultrasonography. Participants were categorized into quartiles of urinary sodium.
There was a significant positive trend with greater IMT associated with increasing urinary sodium quartile in univariate linear regression (P = 0.047). This trend was significant when adjusting for age, sex, race, and systolic BP (SBP) (P = 0.03) as well as in a fully adjusted model (P = 0.04). In pairwise comparisons, the highest urinary sodium quartile had a significantly greater mean IMT (0.62 mm) than the lowest urinary sodium quartile (0.59 mm) after adjustment for age, sex, race, and SBP (P = 0.04). This comparison lost significance after the addition of BMI.
In our community-based sample of normotensive overweight and obese adults, we observed a significant positive trend in carotid IMT with increasing quartile of urinary sodium. If the ongoing clinical trial confirms this relationship between sodium and carotid IMT, it would lend support to efforts to decrease sodium intake in overweight and obese individuals.
有研究报道，膳食钠摄入增加与心血管疾病（CVD）风险增加相关，这可能与血压（BP）无关的血管重构有关。颈动脉内膜中层厚度（IMT）是公认的血管重构结构指标，也是 CVD 的强预测因子。本研究旨在确定在血压正常的超重和肥胖成年人中，尿钠是否与颈动脉 IMT 呈正相关。
我们评估了来自 Slow Adverse Vascular Effects（SAVE）临床试验的 258 名参与者的基线数据。对每个个体的一次 24 小时尿液收集进行尿钠测量。使用高分辨率 B 型超声测量颈动脉 IMT。参与者按尿钠四分位进行分类。
在单变量线性回归中，随着尿钠四分位的增加，IMT 显著增加（P=0.047）。在校正年龄、性别、种族和收缩压（SBP）后，这种趋势具有统计学意义（P=0.03），在完全校正模型中也具有统计学意义（P=0.04）。在两两比较中，经过年龄、性别、种族和 SBP 校正后，尿钠最高四分位数的平均 IMT（0.62 毫米）显著大于最低四分位数（0.59 毫米）（P=0.04）。在加入 BMI 后，这种比较失去了统计学意义。
在我们的社区基础超重和肥胖成年人样本中，我们观察到颈动脉 IMT 与尿钠四分位的增加呈显著正相关。如果正在进行的临床试验证实了钠与颈动脉 IMT 之间的这种关系，这将支持减少超重和肥胖人群钠摄入量的努力。
