Cappuccio Francesco P, Ji Chen, Donfrancesco Chiara, Palmieri Luigi, Ippolito Renato, Vanuzzo Diego, Giampaoli Simona, Strazzullo Pasquale
University of Warwick, WHO Collaborating Centre for Nutrition, ESH Hypertension Excellence Centre, Warwick Medical School, Coventry, UK.
Istituto Superiore di Sanità, National Center of Epidemiology, Rome, Italy.
BMJ Open. 2015 Sep 10;5(9):e007467. doi: 10.1136/bmjopen-2014-007467.
To assess geographic and socioeconomic gradients in sodium and potassium intake in Italy.
Cross-sectional survey in Italy.
3857 men and women, aged 39-79 years, randomly sampled in 20 regions (as part of a National cardiovascular survey of 8714 men and women).
Participants' dietary sodium and potassium intakes were measured by 24 h urinary sodium and potassium excretions. 2 indicators measured socioeconomic status: education and occupation. Bayesian geoadditive models were used to assess spatial and socioeconomic patterns of sodium and potassium intakes accounting for sociodemographic, anthropometric and behavioural confounders.
There was a significant north-south pattern of sodium excretion in Italy. Participants living in southern Italy (eg, Calabria, Basilicata and Puglia >180 mmol/24 h) had a significantly higher sodium excretion than elsewhere (eg, Val d'Aosta and Trentino-Alto Adige <140 mmol/24 h; p<0.001). There was a linear association between occupation and sodium excretion (p<0.001). When compared with occupation I (top managerial), occupations III and IV had a 6.5% higher sodium excretion (coefficients: 0.054 (90% credible levels 0.014, 0.093) and 0.064 (0.024, 0.104), respectively). A similar relationship was found between educational attainment and sodium excretion (p<0.0001). When compared with those with a university degree, participants with primary and junior school education had a 5.9% higher urinary sodium (coefficients: 0.074 (0.031, 0.116) and 0.038 (0.001, 0.075), respectively). The socioeconomic gradient explained the spatial variation. Potassium excretion was higher in central regions and in some southern regions. Those in occupation V (low-skill workers) showed a 3% lower potassium excretion compared with those in occupation I. However, the socioeconomic gradient only partially explained the spatial variation.
Salt intake in Italy is significantly higher in less advantaged social groups. This gradient is independent of confounders and explains the geographical variation.
评估意大利钠和钾摄入量的地理及社会经济梯度。
意大利的横断面调查。
3857名年龄在39 - 79岁之间的男性和女性，在20个地区随机抽样（作为一项针对8714名男性和女性的全国心血管调查的一部分）。
通过24小时尿钠和钾排泄量来测量参与者的膳食钠和钾摄入量。用教育程度和职业这2个指标衡量社会经济地位。采用贝叶斯地理加性模型评估钠和钾摄入量的空间及社会经济模式，并考虑社会人口学、人体测量学和行为学混杂因素。
意大利钠排泄量存在显著的南北差异模式。生活在意大利南部的参与者（如，卡拉布里亚、巴西利卡塔和普利亚地区>180 mmol/24小时）的钠排泄量显著高于其他地区（如，瓦莱达奥斯塔和特伦蒂诺 - 上阿迪杰地区<140 mmol/24小时；p<0.001）。职业与钠排泄量之间存在线性关联（p<0.001）。与职业I（高层管理人员）相比，职业III和IV的钠排泄量分别高出6.5%（系数分别为：0.054（90%可信区间0.01 – 4, 0.093）和0.064（0.024, 0.104））。在受教育程度与钠排泄量之间也发现了类似的关系（p<0.0001）。与拥有大学学位的参与者相比，小学和初中文化程度的参与者尿钠排泄量分别高出5.9%（系数分别为：0.074（0.031, 0.116）和0.038（0.001, 0.075））。社会经济梯度解释了空间差异。中部地区和一些南部地区的钾排泄量较高。职业V（低技能工人）的钾排泄量比职业I的低3%。然而，社会经济梯度仅部分解释了空间差异。
在意大利，社会经济地位较低的群体盐摄入量显著更高。这种梯度独立于混杂因素，并解释了地理差异。
