Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Am J Cardiol. 2019 Aug 15;124(4):636-643. doi: 10.1016/j.amjcard.2019.05.014. Epub 2019 May 29.
The associations between dietary sodium intake and markers of subclinical cardiovascular disease (CVD), such as high-sensitivity cardiac troponin T (hs-cTnT) and amino terminal pro b-type natriuretic peptide (NT-proBNP), may provide mechanistic insight into the relation between dietary sodium and cardiovascular events. We studied 6,131 participants of the Multi-Ethnic Study of Atherosclerosis, who were free of clinical CVD at baseline. Food frequency questionnaires were used to assess estimated sodium intake (ESI) at baseline. We tested the associations between 5 quintiles of ESI (quintile 1: 0.2 to 1.3 grams/day, quintile 2: 1.3 to 1.8 grams/day, quintile 3: 1.8 to 2.4 grams/day, quintile 4: 2.4 to 3.2 grams/day, and quintile 5: 3.2 to 9.9 grams/day) with cross-sectional and 5-year longitudinal change in hs-cTnT and NT-proBNP concentrations. Restricted cubic spline plots were utilized to explore the shape of the associations between ESI and biomarker outcomes. A cross-sectional association between baseline sodium intake and hs-cTnT (but not NT-proBNP) was observed, driven predominantly by a strong positive relation at an intake range of 0.2 to 2.4 g/day. Conversely, a longitudinal association between baseline sodium intake and NT-proBNP (but not hs-cTnT) was observed, driven predominantly by a strong positive relation at intake levels ≥2.4 g/day. In conclusion, temporal shifts in the association between increased ESI and markers of subclinical CVD, hs-cTnT in the short term and NT-proBNP in the longer term, point to the complex pathobiology of the association between sodium intake and CVD. There was also no consistent evidence supporting a J-curve (i.e., excess biomarker values at very low ESI).
饮食钠摄入量与亚临床心血管疾病（CVD）标志物之间的关联，如高敏心肌肌钙蛋白 T（hs-cTnT）和氨基末端 pro B 型利钠肽（NT-proBNP），可能为饮食钠与心血管事件之间的关系提供机制上的深入了解。我们研究了动脉粥样硬化多民族研究中的 6131 名参与者，他们在基线时没有临床 CVD。使用食物频率问卷评估基线时的估计钠摄入量（ESI）。我们测试了 ESI 的 5 个五分位数（五分位数 1：0.2 至 1.3 克/天，五分位数 2：1.3 至 1.8 克/天，五分位数 3：1.8 至 2.4 克/天，五分位数 4：2.4 至 3.2 克/天，五分位数 5：3.2 至 9.9 克/天）与 hs-cTnT 和 NT-proBNP 浓度的横断面和 5 年纵向变化之间的关联。限制性立方样条图用于探索 ESI 与生物标志物结果之间的关联形状。基线钠摄入量与 hs-cTnT 之间存在横断面关联（但与 NT-proBNP 无关），主要由 0.2 至 2.4 克/天范围内的强烈正相关驱动。相反，基线钠摄入量与 NT-proBNP 之间存在纵向关联（但与 hs-cTnT 无关），主要由 2.4 克/天以上摄入水平的强烈正相关驱动。总之，随着时间的推移，ESI 增加与亚临床 CVD 标志物（短期的 hs-cTnT 和长期的 NT-proBNP）之间的关联发生变化，这表明钠摄入量与 CVD 之间的关联具有复杂的病理生理学。也没有一致的证据支持 J 型曲线（即非常低的 ESI 时的过量生物标志物值）。
