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[通过两份24小时尿液样本对284名中小学生膳食盐和钾摄入量的评估]

[The evaluation of dietary salt and potassium intake assessed by two 24-hour urine specimens among 284 primary and secondary school students].

作者信息

Dong J, Fan H, Zhao X Y, Chang S Y, Mi J

机构信息

Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.

Department of Preventive Medicine, North Sichuan Medical College, Nanchong 637100, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Feb 6;53(2):185-190. doi: 10.3760/cma.j.issn.0253-9624.2019.02.012.

Abstract

To estimate the dietary salt and potassium intake by two 24 hour urine salt and potassium excretion in primary and secondary school students. The boarders from Grade 5 to 6 in a rural primary school and Grade 1 to 3 in a rural middle school in Changde City, Hunan Province were recruited from October to December in 2017. Subjects who had 2 and more urinary incontinence episodes or a history of kidney disease or diarrhea and girls in menstruation were excluded. The final analysis included 284 subjects. Questionnaires on basic demographic information were collected, and height and weight were examined. Two inconsecutive 24-hour urine specimens were collected in weekdays. The differences and consistency between two 24-hour urine were tested and dietary salt and potassium intake were assessed by the average of two 24-hour urine collections. A Total of 284 participants was (12.1±1.5) years old, of which 148 (52.1%) were boys and 36 (12.7%) were overweight. In the first 24-hour urine, the volume [(50) ((25), (75))=670 (513, 868) ml], potassium concentration [(50) ((25), (75))=29 (21, 39) mmol/L] and potassium excretion [(50) ((25), (75))=0.7 (0.6, 1.0) g] were similar to those in the second 24-hour urine [(5)0 ((25), (75)) values were 660 (490, 916) ml, 30 (21,40) mmol/L, and 0.8 (0.6, 1.0) g, respectively]. But the sodium and creatinine concentrations, salt excretion in the first 24-hour urine [(50) ((25), (75)) values were 175 (123, 219) mmol/L, 7.20 (5.15, 10.86) mmol/L and 6.6 (5.0, 8.7) g, respectively] were lower than those in the second 24-hour urine [(50) ((25), (75)) values were 188 (133, 248) mmol/L, 8.66 (5.99, 12.47) mmol/L and 7.3 (5.2, 9.2) g, respectively] (all values<0.05). The intraclass correlation coefficients between salt and potassium excretions in the two 24-hour urine were 0.534 (95: 0.412-0.631) and 0.478 (95: 0.341-0.587) (0.001), respectively. The mean± of salt consumed was (7.3±2.5) g (range: 2.3 to 18.8 g) per day by all participants. Overweight children consumed more salt [(8.2±2.6) g/d] than those non-overweight [(7.2±2.4) g/d] (0.05). The mean± of potassium consumed was (1.1±0.3) g (range: 0.4 to 2.3 g) per day. Boys consumed more potassium [(1.1±0.3) g/d] than girls [(1.0±0.3) g/d] (0.05), and overweight children had higher potassium intake [(1.2±0.3) g/d] than those non-overweight [(1.0±0.3) g/d] (0.05). A total of 212 participants (74.6%) consumed more salt than the recommended level and all participants had inadequate potassium intake. The problem of excessive salt intake and insufficient potassium intake of rural primary and middle school students was serious.

摘要

通过两次24小时尿盐和钾排泄量估算中小学生的膳食盐和钾摄入量。2017年10月至12月,招募了湖南省常德市一所农村小学五年级至六年级的寄宿生以及一所农村初中一年级至三年级的寄宿生。排除有2次及以上尿失禁发作史、肾病或腹泻病史的受试者以及处于月经期的女生。最终分析纳入284名受试者。收集基本人口统计学信息问卷,并测量身高和体重。在工作日收集两份非连续的24小时尿液样本。对两次24小时尿液之间的差异和一致性进行检验,并通过两次24小时尿液收集量的平均值评估膳食盐和钾摄入量。共有284名参与者,年龄为(12.1±1.5)岁,其中148名(52.1%)为男生,36名(12.7%)超重。在第一次24小时尿液中,尿量[(50)((25),(75))=670(513,868)ml]、钾浓度[(50)((25),(75))=29(21,39)mmol/L]和钾排泄量[(50)((25),(75))=0.7(0.6,1.0)g]与第二次24小时尿液中的相似[(50)((25),(75))值分别为660(490,916)ml、30(21,40)mmol/L和0.8(0.6,1.0)g]。但第一次24小时尿液中的钠和肌酐浓度、盐排泄量[(50)((25),(75))值分别为175(123,219)mmol/L、7.20(5.15,10.86)mmol/L和6.6(5.0,8.7)g]低于第二次24小时尿液中的[(50)((25),(75))值分别为188(133,248)mmol/L、8.66(5.99,12.47)mmol/L和7.3(5.2,9.2)g](所有P值<0.05)。两次24小时尿液中盐和钾排泄量的组内相关系数分别为0.534(95%CI:0.412 - 0.631)和0.478(95%CI:0.341 - 0.587)(P<0.001)。所有参与者每天摄入盐的平均值±标准差为(7.3±2.5)g(范围:2.3至18.8 g)。超重儿童摄入的盐[(8.2±2.6)g/天]比非超重儿童[(7.2±2.4)g/天]多(P<0.05)。每天摄入钾的平均值±标准差为(1.1±0.3)g(范围:0.4至2.3 g)。男生摄入的钾[(1.1±0.3)g/天]比女生[(1.0±0.3)g/天]多(P<0.05),超重儿童的钾摄入量[(1.2±0.3)g/天]高于非超重儿童[(1.0±0.3)g/天](P<0.05)。共有212名参与者(占74.6%)摄入的盐超过推荐水平,且所有参与者的钾摄入量均不足。农村中小学生盐摄入过量和钾摄入不足的问题严重。

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