Sodium intake and multiple sclerosis activity and progression in BENEFIT.
Sodium intake and multiple sclerosis activity and progression in BENEFIT.
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DOI：
10.1002/ana.24965
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发表时间：
2017-07
影响因子：
11.2
通讯作者：
BENEFIT Study Group
中科院分区：
文献类型：
--
作者：
Fitzgerald KC;Munger KL;Hartung HP;Freedman MS;Montalbán X;Edan G;Wicklein EM;Radue EW;Kappos L;Pohl C;Ascherio A;BENEFIT Study Group
旨在评估通过尿钠浓度测量的高盐饮食是否与从临床孤立综合征 (CIS) 更快转化为多发性硬化症 (MS) 以及 MS 活动和残疾相关。 BENEFIT 是一项随机临床试验，比较了 465 名 CIS 患者的早期和延迟干扰素 β-1b 治疗。在整个 5 年随访期间，每位患者平均提供了 14 个（IQR：13 至 16）个点尿样本。我们使用田中方程估计了每个时间点的 24 小时尿钠排泄水平，并评估了根据重复测量的累积平均值估计的钠水平是否与临床（转换为 MS、EDSS）和磁共振成像 (MRI) 结果相关。 5 年随访期间，平均 24 小时尿钠水平与转化为临床明确的 MS 无关（风险比 [HR]=0.91；95% CI：估计每日钠摄入量每增加 1g，0.67-1.24）；它们也与临床或 MRI 结果无关（6 个月后新的活动性病灶 HR：1.05；95% CI 0.97-1.13；T2 病灶体积相对变化：-0.11；95% CI -0.25-0.04；EDSS 变化：-0.01；95% CI：-0.09-0.08；复发率 HR：0.78； 95% CI：0.56-1.07）。使用五分位数的分类分析结果相似。我们的结果基于 5 年多的尿钠排泄的多重评估以及标准化的临床和 MRI 随访，表明盐摄入量不会影响多发性硬化症的病程或活动。
To assess whether a high-salt diet, as measured by urinary sodium concentration, is associated with faster conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) and MS activity and disability. BENEFIT was a randomized clinical trial comparing early versus delayed interferon beta-1b treatment in 465 patients with a CIS. Each patient provided a median of 14 (IQR: 13 to 16) spot urine samples throughout the 5-year follow-up. We estimated 24-hour urine sodium excretion level at each time point using the Tanaka equations, and assessed whether sodium levels estimated from the cumulative average of the repeated measures were associated with clinical (conversion to MS, EDSS) and magnetic resonance imaging (MRI) outcomes. Average 24-hour urine sodium levels were not associated with conversion to clinically-definite MS over the 5-year follow-up (hazard ratio [HR]=0.91; 95% CI: 0.67-1.24 per 1g increase in estimated daily sodium intake); nor were they associated with clinical or MRI outcomes (new active lesions after 6 months HR: 1.05; 95% CI 0.97-1.13; relative change in T2 lesion volume: -0.11; 95% CI -0.25-0.04; change in EDSS: -0.01; 95% CI: -0.09-0.08; relapse rate HR: 0.78; 95% CI: 0.56-1.07). Results were similar in categorical analyses using quintiles. Our results, based on multiple assessments of urine sodium excretion over 5 years and standardized clinical and MRI follow-up, suggest that salt intake does not influence MS disease course or activity.
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影响因子：
11.2
作者：
POSER, CM;PATY, DW;TOURTELLOTTE, WW
通讯作者：
TOURTELLOTTE, WW
影响因子：
2.8
作者：
Mann, Samuel J.;Gerber, Linda M.
通讯作者：
Gerber, Linda M.
影响因子：
11.2
作者：
McDonald, WI;Compston, A;Wolinsky, JS
通讯作者：
Wolinsky, JS
影响因子：
5
作者：
DYER, AR;SHIPLEY, M;ELLIOTT, P
通讯作者：
ELLIOTT, P
影响因子：
7.7
作者：
Day, NE;McKeown, N;Bingham, S
通讯作者：
Bingham, S