Britton J, Pavord I, Richards K, Knox A, Wisniewski A, Weiss S, Tattersfield A
Respiratory Medicine Unit, City Hospital, Nottingham, UK.
Thorax. 1994 Sep;49(9):875-80. doi: 10.1136/thx.49.9.875.
High dietary sodium intake has been identified as a potential cause of asthma and airway hyperreactivity. This study was designed to test the hypothesis that dietary sodium intake is an independent determinant of the risk of hyperreactivity in the general population, and to assess the role of atopy in the association between these factors.
Airway reactivity to methacholine, atopy, 24 hour urinary sodium excretion, and self-reported smoking and symptom history were measured in a random sample of 1702 adults aged 18-70 from an administrative district of Nottingham. Hyperreactivity was defined as a PD20FEV1 of 12.25 mumol or less, and atopy was defined quantitatively as the mean allergen skin weal response to Dermatophagoides pteronyssinus, cat fur, and grass pollen, and categorically as the occurrence of any allergen response 1 mm or greater than the saline control. Multiple logistic regression analysis was used to estimate the independent relative odds of hyperreactivity, atopy, or symptoms in relation to sodium excretion in all 1702 subjects, and multiple linear regression to assess the independent relation between sodium excretion and mean allergen skin weal diameter, and the PD20 value amongst hyperreactive subjects.
There was no relation between the relative odds of hyperreactivity to methacholine and 24 hour urinary sodium excretion, either before or after adjustment for age, smoking, allergen skin weal diameter, and sex, and similarly no relation if the analysis was restricted to men or women only. The relative odds of having at least one allergen skin test response 1 mm greater than the saline control were increased in relation to sodium excretion after adjustment for age, sex, and smoking by a ratio of 2.08 (95% CI 1.04 to 4.15) per log10 unit increase in sodium excretion, but there was no evidence of an association between sodium excretion and the occurrence of self-reported wheeze, hay fever, eczema, or asthma. There was no relation between 24 hour sodium excretion and the magnitude of the mean allergen skin weal response or the PD20 value.
These findings do not support the hypothesis that a high dietary sodium intake is a risk factor for airway hyperreactivity or atopic disease in the general adult population.
高钠饮食摄入已被确认为哮喘和气道高反应性的一个潜在原因。本研究旨在验证以下假设：饮食中钠的摄入量是普通人群中高反应性风险的一个独立决定因素，并评估特应性在这些因素之间关联中的作用。
在来自诺丁汉一个行政区的1702名年龄在18 - 70岁的成年人随机样本中，测量了对乙酰甲胆碱的气道反应性、特应性、24小时尿钠排泄量，以及自我报告的吸烟情况和症状史。高反应性定义为FEV1的激发剂量（PD20）为12.25 μmol或更低，特应性定量定义为对尘螨、猫毛和草花粉的平均变应原皮肤风团反应，分类定义为任何变应原反应出现且比生理盐水对照大1 mm或更大。采用多元逻辑回归分析来估计在所有1702名受试者中，与钠排泄相关的高反应性、特应性或症状的独立相对比值比，并采用多元线性回归来评估钠排泄与平均变应原皮肤风团直径之间的独立关系，以及高反应性受试者中的PD20值。
在调整年龄、吸烟、变应原皮肤风团直径和性别之前或之后，对乙酰甲胆碱的高反应性相对比值比与24小时尿钠排泄量之间均无关联；同样，如果仅对男性或女性进行分析，也无关联。在调整年龄、性别和吸烟后，每增加1个对数单位的钠排泄量，至少有一次变应原皮肤试验反应比生理盐水对照大1 mm的相对比值比增加2.08（95%可信区间1.04至4.15），但没有证据表明钠排泄与自我报告的喘息、花粉症、湿疹或哮喘的发生之间存在关联。24小时钠排泄量与平均变应原皮肤风团反应的大小或PD20值之间无关联。
这些发现不支持高钠饮食摄入是普通成年人群气道高反应性或特应性疾病危险因素这一假设。
