Sadanaga Tsuneaki, Hirota Shinichi
Seigato Hospital, Kumamoto 8601-5347, Japan.
Department of Cardiology, Kumamoto City Ueki Hospital, Kumamoto 861-0136, Japan.
Exp Ther Med. 2022 Jun;23(6):379. doi: 10.3892/etm.2022.11306. Epub 2022 Apr 8.
Our previous study [Evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients (ESPRIT study)] reported that increased sodium excretion ≥4.0 g/day was associated with composite cardiovascular events in hospitalization for heart failure (HF), acute coronary syndrome, cerebrovascular events and documented cardiovascular-related mortality in Japanese high-risk patients with either stable and compensated HF, coronary artery disease, cerebrovascular disease, chronic kidney disease or atrial fibrillation. However, the method of estimating sodium excretion levels using spot urine is complex, requiring age, body weight, height and multiplier factors for calculation. The aim of the present study was to elucidate whether the sodium to creatinine ratio in spot urine, a key component in estimating daily sodium excretion, was associated with hospitalization for HF. The present study performed a post-hoc analysis of the ESPRIT study (n=520; 60 hospitalizations for HF). Receiver operating curve analysis yielded an optimal sodium to creatinine ratio cut-off value of 24.8 for detecting hospitalization for HF. Kaplan-Meier curve analysis revealed that a high sodium to creatinine ratio in spot urine was associated with an increased hospitalization for HF (P<0.001). Cox regression analysis revealed that a high sodium to creatinine ratio was associated with hospitalization for HF with a hazard ratio (HR) of 2.49 [95% confidence interval (95% CI), 1.47-4.16]. Following adjustment for age, sex and body weight, the HR was as high as 2.74 (95% CI, 1.51-4.71). This association remained following further adjustment for brain natriuretic peptide, estimated glomerular filtration rate, diabetes mellitus or the use of diuretics. Overall, the present study demonstrated that the sodium to creatinine ratio in spot urine is associated with hospitalization for HF in Japanese high-risk patients.
我们之前的研究[评估钠摄入量对日本高危患者心血管事件的预测作用（ESPRIT研究）]报告称，钠排泄增加≥4.0克/天与日本高危患者（患有稳定且代偿性心力衰竭、冠状动脉疾病、脑血管疾病、慢性肾病或心房颤动）因心力衰竭（HF）住院、急性冠状动脉综合征、脑血管事件以及记录在案的心血管相关死亡率等复合心血管事件相关。然而，使用随机尿样估算钠排泄水平的方法很复杂，计算时需要年龄、体重、身高和乘数因子。本研究的目的是阐明随机尿样中钠与肌酐的比值（估算每日钠排泄的关键组成部分）是否与HF住院相关。本研究对ESPRIT研究进行了事后分析（n = 520；60例HF住院患者）。受试者工作特征曲线分析得出检测HF住院的最佳钠与肌酐比值截断值为24.8。Kaplan-Meier曲线分析显示，随机尿样中高钠与肌酐比值与HF住院增加相关（P<0.001）。Cox回归分析显示，高钠与肌酐比值与HF住院相关，风险比（HR）为2.49[95%置信区间（95%CI），1.47 - 4.16]。在对年龄、性别和体重进行调整后，HR高达2.74（95%CI，1.51 - 4.71）。在进一步对脑钠肽、估算肾小球滤过率、糖尿病或利尿剂使用情况进行调整后，这种关联仍然存在。总体而言，本研究表明，随机尿样中钠与肌酐的比值与日本高危患者的HF住院相关。
