儿童和青少年的钠摄入量与血压：系统评价和荟萃分析方案

Sodium intake and blood pressure in children and adolescents: protocol for a systematic review and meta-analysis.

作者信息

Leyvraz Magali, Taffé Patrick, Chatelan Angeline, Paradis Gilles, Tabin René, Bovet Pascal, Bochud Murielle, Chiolero Arnaud

机构信息

Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada.

出版信息

BMJ Open. 2016 Sep 21;6(9):e012518. doi: 10.1136/bmjopen-2016-012518.

DOI:10.1136/bmjopen-2016-012518

PMID:27655262

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5051513/

Abstract

INTRODUCTION

Hypertension is a major risk factor for cardiovascular diseases. In adults, high sodium intake is associated with elevated blood pressure. In children, experimental studies have shown that reducing sodium intake can reduce blood pressure. However, their external validity is limited, notably because the sodium reduction was substantial and not applicable in a real-life setting. Observational studies, on the other hand, allow assess the association between blood pressure and sodium intake across usual levels of consumption. There is also evidence that the association differs between subgroups of children according to age and body weight. Our objective is to conduct a systematic review and meta-analysis of experimental and observational studies on the association between sodium intake and blood pressure in children and adolescents and to assess whether the association differs according to age and body weight.

METHODS AND ANALYSIS

A systematic search of the MEDLINE, EMBASE, CINAHL and CENTRAL databases will be conducted and supplemented by a manual search of bibliographies and unpublished studies. Experimental and observational studies involving children or adolescents between 0 and 18 years of age will be included. The exposure will be dietary sodium intake, estimated using different methods including urinary sodium excretion. The outcomes will be systolic and diastolic blood pressure, elevated blood pressure and hypertension. If appropriate, meta-analyses will be performed by pooling data across all studies together and separately for experimental and observational studies. Subgroup meta-analyses by age and body weight will be also conducted. Moreover, separate meta-analyses for different sodium intake levels will be conducted to investigate the dose-response relationship.

ETHICS AND DISSEMINATION

This systematic review and meta-analysis will be published in a peer-reviewed journal. A report will be prepared for national authorities and other stakeholders in the domains of nutrition, public health, and child health in Switzerland.

TRIAL REGISTRATION NUMBER

CRD42016038245.

摘要

引言

高血压是心血管疾病的主要危险因素。在成年人中，高钠摄入与血压升高有关。在儿童中，实验研究表明减少钠摄入可降低血压。然而，这些研究的外部有效性有限，特别是因为钠减少量很大，不适用于现实生活环境。另一方面，观察性研究能够评估在通常摄入水平下血压与钠摄入之间的关联。也有证据表明，根据年龄和体重，儿童亚组之间的这种关联有所不同。我们的目标是对关于儿童和青少年钠摄入与血压之间关联的实验性和观察性研究进行系统综述和荟萃分析，并评估这种关联是否因年龄和体重而异。

方法与分析

将对MEDLINE、EMBASE、CINAHL和CENTRAL数据库进行系统检索，并通过人工检索参考文献和未发表的研究进行补充。将纳入涉及0至18岁儿童或青少年的实验性和观察性研究。暴露因素为膳食钠摄入，使用包括尿钠排泄在内的不同方法进行估计。结局指标将为收缩压和舒张压、血压升高和高血压。如果合适，将通过汇总所有研究的数据以及分别汇总实验性和观察性研究的数据进行荟萃分析。还将按年龄和体重进行亚组荟萃分析。此外，将针对不同的钠摄入水平进行单独的荟萃分析，以研究剂量反应关系。