2009 - 2012年美国成年人中肥胖在总水摄入量与尿渗透压关系中的作用。
The role of obesity in the relation between total water intake and urine osmolality in US adults, 2009-2012.
作者信息
Rosinger Asher Y, Lawman Hannah G, Akinbami Lara J, Ogden Cynthia L
机构信息
Epidemic Intelligence Service, Atlanta, GA;
Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD; and.
出版信息
Am J Clin Nutr. 2016 Dec;104(6):1554-1561. doi: 10.3945/ajcn.116.137414. Epub 2016 Nov 9.
BACKGROUND
Adequate water intake is critical to physiologic and cognitive functioning. Although water requirements increase with body size, it remains unclear whether weight status modifies the relation between water intake and hydration status.
OBJECTIVE
We examined how the association between water intake and urine osmolality, which is a hydration biomarker, varied by weight status.
DESIGN
NHANES cross-sectional data (2009-2012) were analyzed in 9601 nonpregnant adults aged ≥20 y who did not have kidney failure. Weight status was categorized with the use of body mass index on the basis of measured height and weight (underweight or normal weight, overweight, and obesity). Urine osmolality was determined with the use of freezing-point depression osmometry. Hypohydration was classified according to the following age-dependent formula: ≥831 mOsm/kg - [3.4 × (age - 20 y)]. Total water intake was determined with the use of a 24-h dietary recall and was dichotomized as adequate or low on the basis of the Institute of Medicine's adequate intake recommendations for men and women (men: ≥3.7 or <3.7 L; nonlactating women: ≥2.7 or <2.7 L; lactating women: ≥3.8 or <3.8 L for adequate or low intakes, respectively). We tested interactions and conducted linear and log-binomial regressions.
RESULTS
Total water intake (P = 0.002), urine osmolality (P < 0.001), and hypohydration prevalence (P < 0.001) all increased with higher weight status. Interactions between weight status and water intake status were significant in linear (P = 0.005) and log-binomial (P = 0.015) models, which were then stratified. The prevalence ratio of hypohydration between subjects with adequate water intake and those with low water intake was 0.56 (95% CI: 0.43, 0.73) in adults who were underweight or normal weight, 0.67 (95% CI: 0.57, 0.79) in adults who were overweight, and 0.78 (95% CI: 0.70, 0.88) in adults who were obese.
CONCLUSION
On a population level, obesity modifies the association between water intake and hydration status.
背景
充足的水分摄入对生理和认知功能至关重要。尽管水分需求随体型增加，但体重状况是否会改变水分摄入与水合状态之间的关系仍不清楚。
目的
我们研究了水分摄入与作为水合生物标志物的尿渗透压之间的关联如何因体重状况而异。
设计
分析了2009 - 2012年美国国家健康与营养检查调查（NHANES）的横断面数据，研究对象为9601名年龄≥20岁且无肾衰竭的非妊娠成年人。根据测量的身高和体重，使用体重指数对体重状况进行分类（体重过轻或正常体重、超重和肥胖）。使用冰点降低渗透压法测定尿渗透压。根据以下与年龄相关的公式对水合不足进行分类：≥831 mOsm/kg - [3.4×（年龄 - 20岁）]。使用24小时饮食回顾法确定总水分摄入量，并根据医学研究所针对男性和女性的充足摄入量建议将其分为充足或低摄入量（男性：≥3.7或<3.7 L；非哺乳期女性：≥2.7或<2.7 L；哺乳期女性：≥3.8或<3.8 L分别为充足或低摄入量）。我们测试了交互作用，并进行了线性回归和对数二项式回归。
结果
随着体重状况增加，总水分摄入量（P = 0.002）、尿渗透压（P < 0.001）和水合不足患病率（P < 0.001）均升高。在进行分层的线性模型（P = 0.005）和对数二项式模型（P = 0.015）中，体重状况与水分摄入状况之间的交互作用显著。体重过轻或正常体重的成年人中，水分摄入充足者与水分摄入低者之间水合不足的患病率比值为0.56（95% CI：0.43，0.73），超重成年人中为0.67（95% CI：0.57，0.79），肥胖成年人中为0.78（95% CI：0.70，0.88）。
结论
在人群层面上，肥胖会改变水分摄入与水合状态之间的关联。
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