Takachi Ribeka, Yamagishi Marina, Goto Atsushi, Inoue Manami, Yamaji Taiki, Iwasaki Motoki, Yamagishi Kazumasa, Iso Hiroyasu, Tsugane Shoichiro, Sawada Norie
Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Kitauoya-higashimachi Nara, Japan.
Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Kitauoya-higashimachi Nara, Japan.
J Nutr. 2025 Mar;155(3):945-956. doi: 10.1016/j.tjnut.2024.12.020. Epub 2024 Dec 27.
Reducing premature noncommunicable disease (NCD) mortality is a global challenge. Sodium is thought to increase risk of NCDs via an effect of salt per se or high-salt foods on hypertension-induced cardiovascular disease (CVD) and gastrointestinal cancer. Further, relative risk of CVD is reportedly more closely associated with sodium-to-potassium ratio than that with sodium alone. However, few studies have investigated the effect of consumption of sodium or its ratio to consumption of potassium on risk of premature NCD death.
We examined associations between intake of sodium and sodium-to-potassium ratio and risk of all-cause and cause-specific death, including premature NCD, in a Japanese prospective cohort study.
During 1995-1998, a validated food frequency questionnaire was administered in 11 areas to 83,048 men and women aged 45-74 y. During 1,587,901 person-years of follow-up until the end of 2018, 17,727 all-cause deaths and 3555 premature NCD deaths were identified.
Higher sodium intake was significantly associated with increased risk of all-cause and premature NCD mortality, but not all NCD mortality, among men: multivariate hazards ratios for the highest compared with lowest quintiles (HR) were 1.11 (95% CI: 1.03, 1.20; P-trend < 0.01) for all-cause and 1.25 (95% CI: 1.06, 1.47; P-trend < 0.01) for premature NCD mortality. When intakes were expressed as ratio to potassium intake, these associations (HR of all-cause: 1.19, 95% CI: 1.11-1.27; P-trend < 0.01; HR of premature NCD: 1.27, 95% CI: 1.10, 1.46; P-trend < 0.01), including associations with cancers (HR: 1.18, 95% CI: 1.07, 1.31; P-trend = 0.02), were strengthened in men.
This prospective cohort study showed that both sodium intake and sodium-to-potassium ratio are associated with increased risk of all-cause and early NCD mortality in middle-aged men.
降低过早发生的非传染性疾病（NCD）死亡率是一项全球性挑战。钠被认为会通过盐本身或高盐食物对高血压诱发的心血管疾病（CVD）和胃肠道癌症的影响来增加非传染性疾病的风险。此外，据报道，心血管疾病的相对风险与钠钾比的关系比与单独的钠的关系更为密切。然而，很少有研究调查钠的摄入量或其与钾摄入量的比例对过早发生的非传染性疾病死亡风险的影响。
在一项日本前瞻性队列研究中，我们研究了钠摄入量和钠钾比与全因死亡及特定原因死亡风险（包括过早发生的非传染性疾病）之间的关联。
1995 - 1998年期间，在11个地区对83,048名年龄在45 - 74岁的男性和女性进行了经过验证的食物频率问卷调查。在截至2018年底的1,587,901人年的随访期间，确定了17,727例全因死亡和3555例过早发生的非传染性疾病死亡。
在男性中，较高的钠摄入量与全因死亡和过早发生的非传染性疾病死亡率增加显著相关，但与所有非传染性疾病死亡率无关：最高五分位数与最低五分位数相比的多变量风险比（HR），全因死亡为1.11（95%CI：1.03，1.20；P趋势<0.01），过早发生的非传染性疾病死亡率为1.25（95%CI：1.06，1.47；P趋势<0.01）。当摄入量以与钾摄入量的比值表示时，这些关联（全因死亡的HR：1.19，95%CI：1.11 - 1.27；P趋势<0.01；过早发生的非传染性疾病的HR：1.27，95%CI：1.10，1.46；P趋势<0.01），包括与癌症的关联（HR：1.18，95%CI：1.07，1.31；P趋势 = 0.02），在男性中得到加强。
这项前瞻性队列研究表明，钠摄入量和钠钾比均与中年男性全因死亡和早期非传染性疾病死亡率增加的风险相关。
