中国人群中感知盐摄入量与卒中风险的纵向变化。
Longitudinal Change of Perceived Salt Intake and Stroke Risk in a Chinese Population.
机构信息
From the Department of Preventive Medicine, School of Public Health, North China University of Science and Technology, Tangshan (Y. Li).
Departments of Cardiology (Z.H., C.J., A.X., S.W.).
出版信息
Stroke. 2018 Jun;49(6):1332-1339. doi: 10.1161/STROKEAHA.117.020277. Epub 2018 May 8.
BACKGROUND AND PURPOSE
Data for a relationship between salt intake and stroke have been inconsistent. This inconstancy could be because of the majority of studies evaluated salt intake at a single time point, which may be insufficient to accurately characterize salt intake throughout the observation period.
METHODS
Included were 77 605 participants from the Kailuan study. We assessed perceived salt intake via questionnaire in 2006, 2008, and 2010. Salt intake trajectories from 2006 to 2010 were identified using latent mixture models. Incident stroke cases were identified from 2010 to 2015 and confirmed by review of medical records. Cox proportional hazards model was used to examine the association between salt intake trajectories and stroke risk after adjusting for possible confounders, including age, sex, lifestyle, social economic status, body mass index, use of medicines, blood pressure, and lipoprotein profiles.
RESULTS
Identified were 5 distinct salt intake trajectories: moderate-stable (n=59 241), moderate-decreasing (n=9268), moderate-increasing (n=2975), low-increasing (n=2879), and high-decreasing (n=3242). During the 5-year follow-up period, there were 1564 incident strokes cases. Compared with individuals with the moderate-stable salt intake trajectory, individuals with moderate-decreasing salt intake trajectory had significantly lower cerebral infarction stroke risk (adjusted hazard ratio, 0.76; 95% confidence interval, 0.63-0.92) but not intracerebral hemorrhage risk (adjusted hazard ratio, 0.84; 95% confidence interval, 0.55-1.29). Further adjustment for 2006 or 2010 perceived salt intakes generated similar results. When baseline perceived salt intake only was used as the exposure, a significant dose-response relationship between higher perceived salt intake and higher stroke risk was observed ( trend=0.006).
CONCLUSIONS
Change in salt intake was associated with the stroke risk. These data support the dietary recommendation to the reduction of salt intake.
背景与目的
盐摄入量与中风之间的关系数据一直不一致。这种不一致性可能是由于大多数研究仅在一个时间点评估盐摄入量，这可能不足以准确描述整个观察期间的盐摄入量。
方法
该研究纳入了来自开滦研究的 77605 名参与者。我们于 2006 年、2008 年和 2010 年通过问卷评估了感知盐摄入量。使用潜在混合模型确定 2006 年至 2010 年的盐摄入量轨迹。从 2010 年到 2015 年确定了中风事件，并通过审查病历进行了确认。使用 Cox 比例风险模型，在校正了年龄、性别、生活方式、社会经济状况、体重指数、药物使用、血压和脂蛋白谱等可能的混杂因素后，研究了盐摄入量轨迹与中风风险之间的关联。
结果
共确定了 5 种不同的盐摄入量轨迹：中稳定（n=59241）、中减少（n=9268）、中增加（n=2975）、低增加（n=2879）和高减少（n=3242）。在 5 年的随访期间，共发生 1564 例中风事件。与中稳定盐摄入量轨迹的个体相比，中减少盐摄入量轨迹的个体发生脑梗死的风险显著降低（调整后的危险比，0.76；95%置信区间，0.63-0.92），但脑出血风险无显著差异（调整后的危险比，0.84；95%置信区间，0.55-1.29）。进一步调整 2006 年或 2010 年的感知盐摄入量，结果相似。当仅使用基线感知盐摄入量作为暴露因素时，观察到较高的感知盐摄入量与较高的中风风险之间存在显著的剂量反应关系（趋势=0.006）。
结论
盐摄入量的变化与中风风险相关。这些数据支持减少盐摄入量的饮食建议。
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