Miyagi University of Education Medical Center, Sendai, Japan.
Wakuya National Health Insurance Hospital, Miyagi, Japan.
Eur J Clin Nutr. 2023 Nov;77(11):1044-1050. doi: 10.1038/s41430-023-01327-2. Epub 2023 Aug 16.
BACKGROUND/OBJECTIVES: (Micro)albuminuria (a manifestation of renal microvascular damage) is an independent predictor of mortality risk, even when the urinary albumin/creatinine ratio is ≥ 10 mg/g in the general population. Excessive sodium intake and obesity are strong predictors of cardiovascular disease. However, the effect of obesity on the relationship between sodium intake and albuminuria is not fully understood.
SUBJECTS/METHODS: The purpose of the present study was to investigate the cross-sectional relationships among dietary sodium intake, obesity, and albuminuria in a general population cohort. Subjects were 928 apparently healthy adults. Body mass index was calculated using the height and body weight. Urinary sodium/creatinine and albumin/creatinine ratios were measured in spot urine samples. Estimated 24-h urinary sodium/creatinine ratio (e24UNa/Cr) was assessed using age, height, body weight, and spot urinary sodium/creatinine ratio.
Both the body mass index and e24UNa/Cr positively correlated with the urinary albumin/creatinine ratio (both, P < 0.001), and had a synergistic effect on increasing urinary albumin/creatinine ratio independent of age, sex, mean arterial pressure, and diabetes (interaction P = 0.04). When subjects were divided into 6 groups according to the tertiles of e24UNa/Cr and body mass index < (normal-weight) or ≥ 25 (overweight), the prevalence rate of urinary albumin/creatinine ratio ≥ 10 mg/g increased with rising e24UNa/Cr and being overweight (P < 0.001).
An increase in body mass index increases the positive association between urinary sodium excretion and (micro)albuminuria in the general population. Excess sodium intake may strengthen cardiovascular risk by increasing (micro)albuminuria, particularly in overweight individuals.
背景/目的：（微量）白蛋白尿（肾脏微血管损伤的表现）是死亡风险的独立预测因子，即使在普通人群中尿白蛋白/肌酐比值≥10mg/g 也是如此。过量的钠摄入和肥胖是心血管疾病的强烈预测因素。然而，肥胖对钠摄入与白蛋白尿之间关系的影响尚不完全清楚。
研究对象/方法：本研究的目的是在一般人群队列中调查膳食钠摄入量、肥胖和白蛋白尿之间的横断面关系。研究对象为 928 名看似健康的成年人。使用身高和体重计算体重指数。在随机尿样中测量尿钠/肌酐和白蛋白/肌酐比值。使用年龄、身高、体重和随机尿钠/肌酐比值评估估计的 24 小时尿钠/肌酐比值（e24UNa/Cr）。
体重指数和 e24UNa/Cr 均与尿白蛋白/肌酐比值呈正相关（均 P<0.001），并且在独立于年龄、性别、平均动脉压和糖尿病的情况下，对增加尿白蛋白/肌酐比值具有协同作用（交互 P=0.04）。当根据 e24UNa/Cr 和体重指数<（正常体重）或≥25（超重）的三分位数将受试者分为 6 组时，随着 e24UNa/Cr 的升高和超重，尿白蛋白/肌酐比值≥10mg/g 的患病率增加（P<0.001）。
体重指数的增加增加了普通人群中尿钠排泄与（微量）白蛋白尿之间的正相关关系。过量的钠摄入可能会通过增加（微量）白蛋白尿来增加心血管风险，尤其是在超重人群中。
