2 型糖尿病患者的高钠低钾摄入。

High sodium and low potassium intake in patients with Type 2 diabetes.

机构信息

Endocrine Centre, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital, Heidelberg West, Victoria 3081, Australia.

出版信息

Diabet Med. 2010 Dec;27(12):1401-8. doi: 10.1111/j.1464-5491.2010.03111.x.

DOI:10.1111/j.1464-5491.2010.03111.x

PMID:21059093

Abstract

AIMS

To document dietary sodium and potassium intake and adherence to the Australian National Heart Foundation (NHF) guidelines in patients with Type 2 diabetes mellitus attending an Australian tertiary referral and university teaching hospital.

METHODS

In a longitudinal study, 24h urinary sodium (uNa), potassium (uK), creatinine (uCr), urea (uUrea) and glucose (uGlu) excretions, urine volume (uVol) and body mass index were recorded in 122 regular attenders over an 8 year period (2001-2008; mean of 1.9 samples/patient/year). In a cross-sectional study, the same measurements were recorded in patients providing urine samples in the month of June from 2001 to 2009 (782 patients, averaging 87/year).

RESULTS

In the longitudinal study, uNa (mmol/24 h) was 170 ± 53 (mean ± SD) in males and 142 ± 51 in females, whereas uK (mmol/24 h) was 75 ± 22 in males and 62 ± 18 in females. Once adjusted for insensible losses, only 3% of males and 14% of females met the NHF dietary sodium intake guidelines, and 14% of males and 3% of female patients met the NHF dietary potassium guidelines. Body mass index, uUrea, uVol and uGlu were independent predictors of uNa (adjusted r(2) =0.57, P<0.0001). The mean intra-individual coefficient of variation of the corrected uNa was 21 ± 1%. The cross-sectional study confirmed these findings, and no temporal trends were observed. There was no correlation with glycated haemoglobin to suggest natriuresis with hyperglycaemia.

CONCLUSIONS

Most patients with Type 2 diabetes mellitus do not meet NHF sodium or potassium intake guidelines. A diet high in sodium and low in potassium may contribute to the development of hypertension and to resistance to blood-pressure-lowering therapies.

摘要

目的

记录在澳大利亚三级转诊和大学教学医院就诊的 2 型糖尿病患者的饮食钠和钾摄入量以及对澳大利亚国家心脏基金会（NHF）指南的依从性。

方法

在一项纵向研究中，对 122 名经常就诊者进行了 24 小时尿液钠（uNa）、钾（uK）、肌酐（uCr）、尿素（uUrea）和葡萄糖（uGlu）排泄、尿量（uVol）和体重指数的记录，研究时间为 8 年（2001-2008 年；每位患者平均 1.9 个样本/年）。在一项横断面研究中，在 2001 年至 2009 年 6 月提供尿液样本的患者中记录了相同的测量值（782 例患者，平均每年 87 例）。

结果

在纵向研究中，男性 uNa（mmol/24 h）为 170 ± 53（平均值 ± 标准差），女性为 142 ± 51；而男性 uK（mmol/24 h）为 75 ± 22，女性为 62 ± 18。在调整不显性失落后，只有 3%的男性和 14%的女性符合 NHF 饮食钠摄入量指南，14%的男性和 3%的女性患者符合 NHF 饮食钾摄入量指南。体重指数、uUrea、uVol 和 uGlu 是 uNa 的独立预测因素（调整 r(2)=0.57，P<0.0001）。校正后 uNa 的个体内变异系数平均值为 21 ± 1%。横断面研究证实了这些发现，且未观察到时间趋势。与糖化血红蛋白无相关性，提示钠排泄与高血糖有关。