Tokioka Sayuri, Nakaya Naoki, Hatanaka Rieko, Nakaya Kumi, Kogure Mana, Chiba Ippei, Takase Masato, Nochioka Kotaro, Susukita Kai, Metoki Hirohito, Nakamura Tomohiro, Ishikuro Mami, Obara Taku, Hamanaka Yohei, Orui Masatsugu, Kobayashi Tomoko, Uruno Akira, Kodama Eiichi N, Nagaie Satoshi, Ogishima Soichi, Izumi Yoko, Fuse Nobuo, Kuriyama Shinichi, Yasuda Satoshi, Hozawa Atsushi
Tohoku University Graduate School of Medicine.
Tohoku Medical Megabank Organization, Tohoku University.
Circ J. 2025 May 23;89(6):757-764. doi: 10.1253/circj.CJ-24-0780. Epub 2025 Jan 11.
The primary prevention of atrial fibrillation (AF), which increases mortality through complications including stroke and heart failure, is important. Excessive salt intake and low potassium intake are risk factors for cardiovascular disease; however, their association with AF remains inconclusive. This study investigated the association between sodium- and potassium-related urinary markers and AF prevalence.
Data from the Tohoku Medical Megabank Project Community-based Cohort Study were used in this cross-sectional study. The urinary sodium-to-potassium (Na/K) ratio and estimated 24-h sodium and potassium excretion were calculated using spot urine samples and categorized into quartiles (Q1-Q4). The prevalence of AF was the primary outcome. Of the 26,506 participants (mean age 64.8 years; 33.2% males) included in this study, 630 (2.4%) had AF. Using Q1 as the reference group, the odds ratios for AF prevalence in Q4 were 1.35 (95% confidence interval [CI] 1.07-1.73) and 1.59 (95% CI 1.20-2.12) for 24-h estimated urinary Na/K ratio and estimated 24-h sodium excretion, respectively. Estimated 24-h potassium excretion was not associated with AF prevalence.
AF prevalence was positively associated with the urinary Na/K ratio and estimated 24-h urinary sodium excretion, but not with estimated 24-h urinary potassium excretion. Although further prospective studies are warranted, the findings of this study suggest that salt intake may be a modifiable risk factor for AF.
心房颤动（AF）的一级预防很重要，因为它会通过包括中风和心力衰竭在内的并发症增加死亡率。过量的盐摄入和低钾摄入是心血管疾病的危险因素；然而，它们与AF之间的关联仍不明确。本研究调查了与钠和钾相关的尿标志物与AF患病率之间的关联。
本横断面研究使用了来自东北医学大数据库项目社区队列研究的数据。使用随机尿样计算尿钠钾比（Na/K）以及估计的24小时钠和钾排泄量，并将其分为四分位数（Q1-Q4）。AF患病率是主要结局。本研究纳入的26506名参与者（平均年龄64.8岁；33.2%为男性）中，630人（2.4%）患有AF。以Q1作为参照组，对于估计的24小时尿Na/K比和估计的24小时钠排泄量，Q4中AF患病率的比值比分别为1.35（95%置信区间[CI]1.07-1.73）和1.59（95%CI 1.20-2.12）。估计的24小时钾排泄量与AF患病率无关。
AF患病率与尿Na/K比和估计的24小时尿钠排泄量呈正相关，但与估计的24小时尿钾排泄量无关。尽管需要进一步的前瞻性研究，但本研究结果表明盐摄入可能是AF的一个可改变的危险因素。
