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血清钾水平与中国老年人膳食钾摄入量的关系:一项多中心、横断面调查。

Association of serum potassium level with dietary potassium intake in Chinese older adults: a multicentre, cross-sectional survey.

机构信息

Peking University Clinical Research Center, Peking University Health Science Center, Beijing, China.

Peking University First Hospital, Beijing, China.

出版信息

BMJ Open. 2023 Nov 24;13(11):e077249. doi: 10.1136/bmjopen-2023-077249.

Abstract

OBJECTIVES

Evidence linking dietary potassium and serum potassium is virtually scarce and inconclusive. The aim of the study was to investigate the association between serum potassium level and potassium intake measured by 24-hour urine. We also explored whether the association differed across health conditions.

DESIGN

A cross-sectional study conducted from September 2017 to March 2018.

SETTING

48 residential elderly care facilities in northern China.

PARTICIPANTS

Participants aged 55 years and older and with both serum potassium and 24-hour urinary potassium measured were classified as having a low (apparently healthy), moderate (with ≥1 health condition but normal renal function) and high (with ≥1 health condition and abnormal renal function) risk of hyperkalaemia.

EXPOSURE

Potassium intake is measured by 24-hour urinary potassium.

OUTCOMES

Serum potassium in association with potassium intake after adjustment for age, sex, region and accounting for the cluster effect.

RESULTS

Of 962 eligible participants (mean age 69.1 years, 86.8% men), 17.3% were at low risk, 48.4% at moderate risk and 34.3% at high risk of hyperkalaemia. Serum potassium was weakly associated with 24-hour urinary potassium among individuals with moderate (adjusted β=0.0040/L; p=0.017) and high (adjusted β=0.0078/L; p=0.003) but not low (adjusted β=0.0018/L; p=0.311) risk of hyperkalaemia.

CONCLUSIONS

A weak association between dietary potassium intake and serum potassium level existed only among individuals with impaired renal function or other health conditions but not among apparently healthy individuals. The results imply that increasing dietary potassium intake may slightly increase the risk of hyperkalaemia but may also decrease the risk of hypokalaemia in unhealthy individuals, both of which have important health concerns.

TRIAL REGISTRATION NUMBER

NCT03290716; Post-results.

摘要

目的

目前有关饮食钾与血清钾之间关联的证据几乎是缺乏且不确定的。本研究旨在调查血清钾水平与 24 小时尿液中钾摄入量之间的关系。我们还探讨了这种关联是否因健康状况而异。

设计

一项于 2017 年 9 月至 2018 年 3 月进行的横断面研究。

地点

中国北方的 48 个住宅养老院。

参与者

年龄在 55 岁及以上且同时检测了血清钾和 24 小时尿钾的参与者被分为低(显然健康)、中(有≥1 种健康状况但肾功能正常)和高(有≥1 种健康状况且肾功能异常)血钾升高风险组。

暴露量

钾摄入量通过 24 小时尿钾来测量。

结局

血清钾与调整年龄、性别、地区以及考虑到聚类效应后的钾摄入量相关。

结果

在 962 名符合条件的参与者中(平均年龄 69.1 岁,86.8%为男性),17.3%为低风险组,48.4%为中风险组,34.3%为高风险组。在肾功能受损或有其他健康状况的个体中,血清钾与 24 小时尿钾之间存在弱相关(中风险调整后β=0.0040/L;p=0.017;高风险调整后β=0.0078/L;p=0.003),但在显然健康的个体中不存在弱相关(调整后β=0.0018/L;p=0.311)。

结论

仅在肾功能受损或有其他健康状况的个体中,饮食钾摄入量与血清钾水平之间存在弱关联,而在显然健康的个体中则不存在这种关联。这些结果表明,增加饮食钾摄入可能会略微增加高钾血症的风险,但也可能降低不健康个体低钾血症的风险,这两者都有重要的健康意义。

试验注册号

NCT03290716;试验后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4aa/10679980/09f36c930e54/bmjopen-2023-077249f01.jpg

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