中国六省18~75岁人群24小时尿钠尿钾水平及其与血压相关性分析

24 hours urinary sodium and potassium excretion and association with blood pressure among people aged 18-75 years old in six Chinese provinces

目的分析中国六省18~75岁人群尿钠和尿钾水平及其与血压的关系。方法2018年10至12月,采用整群随机抽样的方法在河北、湖南、四川、江西、青海和黑龙江六省选取18~75岁居民。通过问卷调查的方式收集研究对象人口学特征和生活方式信息,并对其进行体格测量和24 h尿液收集。结果共纳入研究对象2636名,其24 h尿钠为(4438.4±1822.8)mg/d,尿钾为(1566.2±646.3)mg/d,尿钠钾比为5.2±2.2。按照世界卫生组织钠和钾推荐摄入量,94.5%的研究对象钠摄入过量,98.7%的研究对象钾摄入不足。调整相关因素后,尿钠每增加1000 mg收缩压升高1.65 mmHg(95%CI:1.07,2.22),舒张压升高0.53 mmHg(95%CI:0.21,0.84);尿钾每增加1000 mg收缩压降低3.02 mmHg(95%CI:-4.25,-1.80),舒张压降低1.27 mmHg(95%CI:-2.05,-0.48)。结论我国六省18~75岁人群存在钠摄入过量和钾摄入不足的情况,尿钠和尿钾与血压之间存在相关关系,应在相应人群中开展减盐补钾干预。

Objective To analyze the level of sodium and potassium intake and their association with blood pressure among people aged 18 to 75 years old in six provinces.Methods From October to December 2018,participants aged 18 to 75 years were selected from Hebei,Hunan,Sichuan,Jiangxi,Qinghai and Heilongjiang provinces by using cluster random sampling method.Demographic characteristics and lifestyle information were collected by using questionnaire survey.Physical measurement and 24-hour urine collection were also conducted.Results A total of 2636 subjects were finally included in the analysis.The average urine sodium,potassium and sodium-to-potassium molar ratio were(4438.4±1822.8)mg/d,(1566.2±646.3)mg/d,and 5.2±2.2,respectively.According to World Health Organization standards,94.5%and 98.7%of the respondents had excessive sodium intake and insufficient potassium intake.After adjusting for related factors,each 1000 mg increase in sodium excretion was associated with increased systolic blood pressure(1.65 mmHg,95%CI:1.07,2.22)and diastolic blood pressure(0.53 mmHg,95%CI:0.21,0.84),and each 1000 mg increase in potassium excretion was associated with decreased systolic blood pressure(3.02 mmHg,95%CI:-4.25,-1.80)and diastolic blood pressure(1.27 mmHg,95%CI:-2.05,-0.48).Conclusion The sodium intake in Chinese population remains excessive and potassium intake is insufficient.Sodium and potassium could be associated with blood pressure and the intervention of reducing sodium and supplementing potassium should be conducted in the corresponding population.