海口市高血压高危人群基于手机APP的膳食情况及24 h尿钠与血压相关性分析

Analysis of the relationship between 24⁃hour sodium and blood pressure and the dietary status based on mobile phone APP in the high⁃risk population of hypertension in Haikou

目的:了解海口市高血压高危人群的膳食摄入情况,分析膳食与血压之间的关联性,尤其是钠盐摄入与血压之间的关系,为减盐提供科学依据。方法:于2021年7月~12月采用多阶段整群抽样的方法,从海口市4个片区中,每个片区抽取3~4家社区服务中心,共抽取15家社区服务中心,以15家社区服务中心为整群,每个社区抽取20名符合条件的研究对象,最终入组295名55~74岁常住居民。对研究对象进行一般体格检查、实验室检测、使用自主研发的安卓手机APP软件“营养助手”(软著登记号:2021SR1547832)进行膳食调查等方法。采用SPSS21.0进行t检验、χ2检验、多重线性回归分析。结果:海口市高血压高危人群膳食摄入不均衡,有69.4%的调查对象能量摄入量高于能量需要量,有44.8%的调查对象脂肪摄入量高于宏量营养素可接受范围。在不同血压水平分组下(正常血压组与正常高值组)仅能量、碳水化合物、维生素B6和钠摄入量中有差异(t值分别为−2.174、−1.990、2.333、−5.442,P值分别为0.031、0.048、0.021、<0.001)。不同尿钠组间BMI、慢性病家族史、收缩压和舒张压的差异有统计学意义(F值或χ2值分别为4.260、19.045、139.916、36.864,P值分别为0.015、<0.001、<0.001、<0.001)。多重线性回归分析结果显示,24 h尿钠排泄量与收缩压和舒张压具有显著相关性(t值为12.964,P<0.001),24 h尿钠排泄量每增加1 mmol,收缩压和舒张压分别增加0.135 mmHg和0.068 mmHg。结论:海口市社区中老年人高血压高危人群膳食摄入量不均衡,其中钠盐的摄入量与血压表现出较强的相关性,需持续将减盐宣传作为预防控制高血压的关键途径之一。

Objective:To understand the dietary intake of high-risk population with hypertension in Haikou,and to analyze the relationship between dietary intake and blood pressure,especially the relationship between sodium intake and blood pressure,so as to provide a scientific basis for salt reduction.Methods:A multi-stage cluster sampling was used from July to December 2021 to collect 3-4 community service centers from each of the four districts in Haikou.A total of 15 community service centers were collected,and 295 permanent residents aged 55-74 were recruited from 15 community service centers,with 20 eligible subjects from each community.The subjects underwent general physical examination and laboratory tests,and a dietary survey was conducted using the self-developed Android phone APP“Nutrition Assistant”(registration number:2021SR1547832).SPSS 21.0 was used for t test,χ2 test and multiple regression analysis.Results:In Haikou,69.4%of the subjects had energy intake above energy requirement,and 44.8%had fat intake above the acceptable range of macronutrients.There were only differences in energy,carbohydrate,vitamin B 6 and sodium intake(t=−2.174,−1.990,2.333,−5.442,P=0.031,0.048,0.021,<0.001,respectively).There were significant differences in BMI,family history of chronic diseases,systolic blood pressure and diastolic blood pressure(F value orχ2 value=4.260,19.045,139.916,36.864,P value=0.015,<0.001,<0.001,<0.001,respectively).Multiple regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure(t=12.964,P<0.001),and for every 1 mmol increase in sodium excretion,systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg,respectively.Conclusion:The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced,and the intake of sodium salt was strongly correlated with blood pressure,so it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension.