中国成年人尿钠排泄量与代谢综合征关系的探索研究

发布时间：2018-11-21 12:32

【摘要】：背景和目的:研究表明,代谢综合征(Metabolic syndrome,MS)与心血管疾病疾病的发生有很大关联性。代谢异常组分越多,心血管疾病的发病、死亡风险越高。尽管已有证据表明高钠盐摄入与心血管事件存在关联,但目前关于盐摄入量与MS相关性的大规模研究较少。尤其是我国居民盐摄入量偏高,测量盐摄入量与MS及其各组分之间的关系,具有重要的公共卫生意义。本研究拟分析钠盐摄入量和代谢综合征及其各组分的关系,评估钠盐摄入量和其他因素对MS的影响。方法:本研究以前瞻性城乡流行病学研究(Prospective Urban Rural Epidemiology,PURE)的中国人群基线数据为基础。以NCEP-ATPⅢ为MS诊断标准,利用Kawasaki公式估算24小时尿钠排泄量(24-hour urinary sodium excretion,24-h USE)。计算不同人群MS及其各组分的患病率,使用多元Logistic回归模型探索钠盐与MS之间的关联,以24-h USE四分位数最低组为参照,计算钠摄入量各组的比值比(Odds ratio,OR)和 95%置信区间(Confidence interval,CI),并按年龄、性别等进行分层分析。结果:研究纳入年龄在35-70岁之间,共40,139名研究对象。总人群MS患病率为32.2%,年龄标化后患病率为30.8%,女性患病率高于男性(36.4%和27.4%,P0.001)。估算24小时尿钠排泄量为5673.3±1704.9mg/d(约为盐14.4克/天),男性显著高于女性(6122.2 mg/d和5358.8 mg/d)。以尿钠排泄最低组为参照,各组 MS 患病风险比值比分别为1.18(1.10-1.27)、1.39(1.29-1.49)、1.48(1.38-1.60),且存在线性趋势(P0.001)。进行多因素调整后,24 h尿钠排泄与MS及其组分中心肥胖、血压升高、高甘油三酯患病呈正相关,趋势检验均为P0.001。而低高密度脂蛋白、糖代谢异常与24小时尿钠排泄线性趋势无统计学意义(P0.05)。根据血压分层,血压正常的MS患者,不同尿钠水平各组OR值为1.13(0.97-1.32)、1.28(1.10-1.49)、0.99(0.84-1.18),趋势检验P=0.287;而含有血压升高组分的MS患者,各组 OR 值为 1.19(1.11-1.29)、1.41(1.31-1.52)、1.59(1.47-1.72),趋势检验 P0.001。结论:随着24小时尿钠排泄量升高,代谢综合征患病风险呈上升趋势。适当降低盐摄入量,尤其是血压升高及中心肥胖的MS患者,可以有效降低代谢综合征的发生风险,进而降低心脑血管疾病的发生风险。
[Abstract]:Background and objective: metabolic syndrome (Metabolic syndrome,MS) is associated with cardiovascular disease. The more components of abnormal metabolism, the higher the risk of death caused by cardiovascular disease. Although there has been evidence that high sodium intake is associated with cardiovascular events, there are few large-scale studies on the correlation between salt intake and MS. Especially, the salt intake of Chinese residents is relatively high. It is of great public health significance to measure the relationship between salt intake and MS and its components. The purpose of this study was to analyze the relationship between sodium intake and metabolic syndrome and its components, and to evaluate the effects of sodium intake and other factors on MS. Methods: this study was based on baseline data of Chinese population in a prospective urban and rural epidemiological study (Prospective Urban Rural Epidemiology,PURE). Using NCEP-ATP 鈪，

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