The George Institute for Global Health, The University of New South Wales, Sydney, 2052, Australia.
Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases, Fiji National University, Nasinu, Fiji.
Nutr J. 2019 Sep 10;18(1):55. doi: 10.1186/s12937-019-0484-9.
There is an increasing interest in finding less costly and burdensome alternatives to measuring population-level salt intake than 24-h urine collection, such as spot urine samples. However, little is known about their usefulness in developing countries like Fiji and Samoa. The purpose of this study was to evaluate the capacity of spot urine samples to estimate mean population salt intake in Fiji and Samoa.
The study involved secondary analyses of urine data from cross-sectional surveys conducted in Fiji and Samoa between 2012 and 2016. Mean salt intake was estimated from spot urine samples using six equations, and compared with the measured salt intake from 24-h urine samples. Differences and agreement between the two methods were examined through paired samples t-test, intraclass correlation coefficient analysis, and Bland-Altman plots and analyses.
A total of 414 participants from Fiji and 725 participants from Samoa were included. Unweighted mean salt intake based on 24-h urine collection was 10.58 g/day (95% CI 9.95 to 11.22) in Fiji and 7.09 g/day (95% CI 6.83 to 7.36) in Samoa. In both samples, the INTERSALT equation with potassium produced the closest salt intake estimate to the 24-h urine (difference of - 0.92 g/day, 95% CI - 1.67 to - 0.18 in the Fiji sample and + 1.53 g/day, 95% CI 1.28 to 1.77 in the Samoa sample). The presence of proportional bias was evident for all equations except for the Kawasaki equation.
These data suggest that additional studies where both 24-h urine and spot urine samples are collected are needed to further assess whether methods based on spot urine samples can be confidently used to estimate mean population salt intake in Fiji and Samoa.
相较于 24 小时尿液收集，寻找成本更低、负担更小的替代方法来测量人群盐摄入量的方法正日益受到关注，例如随机尿样。然而，关于这些方法在斐济和萨摩亚等发展中国家的实用性，人们知之甚少。本研究旨在评估随机尿样估算斐济和萨摩亚人群平均盐摄入量的能力。
本研究涉及 2012 年至 2016 年在斐济和萨摩亚进行的横断面调查中尿液数据的二次分析。使用六种方程从随机尿样估算平均盐摄入量，并将其与 24 小时尿液样本的实际盐摄入量进行比较。通过配对样本 t 检验、组内相关系数分析以及 Bland-Altman 图和分析，检查两种方法之间的差异和一致性。
共纳入来自斐济的 414 名参与者和来自萨摩亚的 725 名参与者。基于 24 小时尿液收集的未加权平均盐摄入量在斐济为 10.58g/天（95%CI 9.95 至 11.22），在萨摩亚为 7.09g/天（95%CI 6.83 至 7.36）。在这两个样本中，INTERSALT 方程与钾生成的盐摄入量估计值最接近 24 小时尿液（斐济样本的差值为-0.92g/天，95%CI-1.67 至-0.18；萨摩亚样本的差值为+1.53g/天，95%CI 1.28 至 1.77）。除了川崎方程外，所有方程都存在比例偏差。
这些数据表明，需要进一步开展同时收集 24 小时尿液和随机尿样的研究，以进一步评估基于随机尿样的方法是否可以可靠地用于估算斐济和萨摩亚的人群平均盐摄入量。
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