Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-...Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.展开更多
目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性...目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。展开更多
Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot...Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion,possibly due to the circadian rhythm in urinary excretion.This study aimed to explore the circadian rhythm,characteristics,and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.Methods:Eighty-five participants(mean age 32.4 years)completed the 24-h urine ollction by sccessively cllecing each of the single-voided specimens within 24 h.The concentrations of the urinary sodium,potassium,and creatinine for cach voided specimen were measured.Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium,potassium,and creatinine excretion.The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.Results:The metabolism of urinary sodium,potassium,and creatinine showed different patterns of circadian rhythm,although the urinary sodiurm excretion showed non-significant parameters in the cosinor model.A significant circadian rhythm of urinary creatinine excretion was observed,while the circadian rhythm of sodium was less significant than that of potassium.The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent,which had a nocturnal peak and fell to the lowest around noon to afternoon.In contrast,the peak of potassium was observed in the morning and dropped to the lowest point in the evening.The hourly urinary excretion followed a similar circadian rhythm.Conclusion:It is necessary to consider the circadian rhythm of urinary sodium,potassium,and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.展开更多
Importance:Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake.However,their accuracies have been controversial in children.Objective:To validate the ...Importance:Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake.However,their accuracies have been controversial in children.Objective:To validate the performance of three commonly used methods-the Kawasaki,Tanaka,and International Cooperative Study on Salt,Other Factors,and Blood Pressure(INTERSALT)methods.Additionally,this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times.Method:Forty-one adolescents aged 14 to 16 years completed two non-consecutive 24-hour urine collections and their mean values were used as reference data.The second-morning urine was used for assessment with the Kawasaki method;a casual spot urine and spot urine samples taken at four separate times(morning,afternoon,evening,and overnight)were used for assessment with the Tanaka and INTERSALT methods.Results:The mean differences were 1801 mg,542 mg,47 mg,and-31 mg for the Kawasaki,Tanaka,INTERSALT 1(with potassium),and INTERSALT2(without potassium)methods with their required spot urine,respectively.The proportions of relative difference levels within±10%were 4.9%for the Kawasaki method,19.5%for the Tanaka method,36.6%for the INTERSALT 1 method,and 36.6%for the INTERSALT2 method.Interpretation:The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine.However,there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake.The methods assessed in this study were unable to accurately estimate sodium intake at the individual level.展开更多
A simple method to collect 24-hour urine (24U) by sampling 2.5% of the voided urine each time was developed for analyzing the biomarkers of the intakes of salt (NaCl), vegetables and grains (K, Mg), soys (isoflavones)...A simple method to collect 24-hour urine (24U) by sampling 2.5% of the voided urine each time was developed for analyzing the biomarkers of the intakes of salt (NaCl), vegetables and grains (K, Mg), soys (isoflavones), sea-foods (taurine), protein (urea nitrogen) etc. This method was applied to WHO-coordinated CARDIAC (Cardiovascular Diseases and Alimentary Comparison) study covering 61 populations in 25 countries, and revealed significant positive associations of Na or Na/K with blood pressure (BP) and stroke mortality and significant inverse associations of isoflavones or taurine with coronary heart disease (CHD) mortality, indicating the adverse effect of salt intake on BP and stroke and beneficial effect of soy or sea food intakes on CHD. Furthermore, higher urinary taurine and/or Mg excretions were associated with significantly lower risks of metabolic syndromes such as obesity, hypertension and hypercholestelomia. 24U collections were useful to prove nutritional improvement by intervention studies for observing soy intake effect on BP and atherogenic index in Japanese immigrants living in Brazil, and in Australian Aboriginals, for observing taurine effect on BP in Tibetans and for confirming soy and fish effects on the risks of metabolic syndromes in Japanese businessmen. 24U collection was utilized for population strategy to reduce salt and to increase soy intake in 5.6 million people of Hyogo Prefecture. A simple method for 24U collection has enabled us to utilize nutritional biomarkers for hypertension-related disease risk analyses, and to apply objective nutritional intake estimation to intervention studies as well as to population strategy for nutritional improvement, and therefore, the methodology will contribute to hypertension-related disease prevention and global health promotion.展开更多
文摘Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.
文摘目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。
基金This study was supported by the Laboratory Examination Technology Special Fund from International Scientific Exchange Foundation of China(No.Z2019L BJ001)the Beiing Municipal Administration of Hospital Clinical Medicine Development Special Project(No.ZYLX201840).
文摘Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion,possibly due to the circadian rhythm in urinary excretion.This study aimed to explore the circadian rhythm,characteristics,and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.Methods:Eighty-five participants(mean age 32.4 years)completed the 24-h urine ollction by sccessively cllecing each of the single-voided specimens within 24 h.The concentrations of the urinary sodium,potassium,and creatinine for cach voided specimen were measured.Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium,potassium,and creatinine excretion.The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.Results:The metabolism of urinary sodium,potassium,and creatinine showed different patterns of circadian rhythm,although the urinary sodiurm excretion showed non-significant parameters in the cosinor model.A significant circadian rhythm of urinary creatinine excretion was observed,while the circadian rhythm of sodium was less significant than that of potassium.The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent,which had a nocturnal peak and fell to the lowest around noon to afternoon.In contrast,the peak of potassium was observed in the morning and dropped to the lowest point in the evening.The hourly urinary excretion followed a similar circadian rhythm.Conclusion:It is necessary to consider the circadian rhythm of urinary sodium,potassium,and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.
基金National Key Research and Development Program of China(2016 YFC1300101)。
文摘Importance:Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake.However,their accuracies have been controversial in children.Objective:To validate the performance of three commonly used methods-the Kawasaki,Tanaka,and International Cooperative Study on Salt,Other Factors,and Blood Pressure(INTERSALT)methods.Additionally,this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times.Method:Forty-one adolescents aged 14 to 16 years completed two non-consecutive 24-hour urine collections and their mean values were used as reference data.The second-morning urine was used for assessment with the Kawasaki method;a casual spot urine and spot urine samples taken at four separate times(morning,afternoon,evening,and overnight)were used for assessment with the Tanaka and INTERSALT methods.Results:The mean differences were 1801 mg,542 mg,47 mg,and-31 mg for the Kawasaki,Tanaka,INTERSALT 1(with potassium),and INTERSALT2(without potassium)methods with their required spot urine,respectively.The proportions of relative difference levels within±10%were 4.9%for the Kawasaki method,19.5%for the Tanaka method,36.6%for the INTERSALT 1 method,and 36.6%for the INTERSALT2 method.Interpretation:The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine.However,there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake.The methods assessed in this study were unable to accurately estimate sodium intake at the individual level.
文摘A simple method to collect 24-hour urine (24U) by sampling 2.5% of the voided urine each time was developed for analyzing the biomarkers of the intakes of salt (NaCl), vegetables and grains (K, Mg), soys (isoflavones), sea-foods (taurine), protein (urea nitrogen) etc. This method was applied to WHO-coordinated CARDIAC (Cardiovascular Diseases and Alimentary Comparison) study covering 61 populations in 25 countries, and revealed significant positive associations of Na or Na/K with blood pressure (BP) and stroke mortality and significant inverse associations of isoflavones or taurine with coronary heart disease (CHD) mortality, indicating the adverse effect of salt intake on BP and stroke and beneficial effect of soy or sea food intakes on CHD. Furthermore, higher urinary taurine and/or Mg excretions were associated with significantly lower risks of metabolic syndromes such as obesity, hypertension and hypercholestelomia. 24U collections were useful to prove nutritional improvement by intervention studies for observing soy intake effect on BP and atherogenic index in Japanese immigrants living in Brazil, and in Australian Aboriginals, for observing taurine effect on BP in Tibetans and for confirming soy and fish effects on the risks of metabolic syndromes in Japanese businessmen. 24U collection was utilized for population strategy to reduce salt and to increase soy intake in 5.6 million people of Hyogo Prefecture. A simple method for 24U collection has enabled us to utilize nutritional biomarkers for hypertension-related disease risk analyses, and to apply objective nutritional intake estimation to intervention studies as well as to population strategy for nutritional improvement, and therefore, the methodology will contribute to hypertension-related disease prevention and global health promotion.
