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中国人群中尿钠、钾排泄及其比值与蛋白尿的基于人群的关联。

Population-based association between urinary excretion of sodium, potassium and its ratio with albuminuria in Chinese.

作者信息

Yan Liuxia, Guo Xiaolei, Wang Huicheng, Zhang Jiyu, Tang Junli, Lu Zilong, Cai Xiaoning, Liu Longjian, Gracely Edward J, Ma Jixiang

机构信息

Department of Cardiovascular Disease Prevention and Control, National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC, Beijing, China.

Institute of Chronic and Noncommunicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.

出版信息

Asia Pac J Clin Nutr. 2016 Dec;25(4):785-797. doi: 10.6133/apjcn.092015.33.

Abstract

BACKGROUND AND OBJECTIVES

Albuminuria is a risk factor for cardiovascular and renal disease. However, little is known about the association of 24 h urinary sodium and potassium excretion with albuminuria in China. The aim of this study was to examine this association by analyzing the data from 1,975 Chinese adults living in north China.

METHODS AND STUDY DESIGN

Excretion of urinary sodium, potassium and albumin was assessed in a single 24-h urine sample for each participant. Height, weight, waist circumference and blood pressure were measured and body mass index was determined as weight divided by square height. Fasting blood sample was collected and fasting glucose was measured.

RESULTS

The average 24-h urinary sodium and potassium excretion were 232 mmol and 40.8 mmol, resulting a mean sodium to potassium ratio of 6.7. The median (Q1-Q3) 24-h urinary albuminuria excretion was 6.1 mg (4.5-8.7 mg). Overall, urinary sodium excretion was positively associated with albumin excretion (β=0.029, p<0.001). This association was independent of major cardiovascular risk factors including age, gender, systolic blood pressure, body mass index, fasting glucose, waist circumference, hypertensive drug treatment, and smoking. Moreover, the relation of sodium and albumin was similar in the subgroups stratified by gender, adiposity and diabetic status. No significant associations of potassium excretion or sodium to potassium ratio with urinary albumin excretion were observed.

CONCLUSIONS

In cross-sectional analyses, high sodium intake was shown to be associated with increased urinary albuminuria in the general Chinese adult population, supporting salt restriction for renal and cardiovascular health benefit.

摘要

背景与目的

蛋白尿是心血管疾病和肾脏疾病的危险因素。然而,在中国,关于24小时尿钠和钾排泄与蛋白尿之间的关联知之甚少。本研究的目的是通过分析1975名居住在中国北方的成年人的数据来研究这种关联。

方法与研究设计

对每位参与者采集一次24小时尿液样本,评估尿钠、钾和白蛋白的排泄情况。测量身高、体重、腰围和血压,并计算体重指数(体重除以身高的平方)。采集空腹血样并测量空腹血糖。

结果

24小时尿钠和钾的平均排泄量分别为232 mmol和40.8 mmol,钠钾比平均为6.7。24小时尿白蛋白排泄量的中位数(四分位数间距)为6.1 mg(4.5 - 8.7 mg)。总体而言,尿钠排泄与白蛋白排泄呈正相关(β = 0.029,p < 0.001)。这种关联独立于包括年龄、性别、收缩压、体重指数、空腹血糖、腰围、高血压药物治疗和吸烟在内的主要心血管危险因素。此外,在按性别、肥胖程度和糖尿病状态分层的亚组中,钠与白蛋白的关系相似。未观察到钾排泄或钠钾比对尿白蛋白排泄有显著关联。

结论

在横断面分析中,高钠摄入与中国普通成年人群尿白蛋白尿增加有关,支持限制盐摄入对肾脏和心血管健康有益。

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