Association between sodium intake and change in uric acid, urine albumin excretion, and the risk of developing hypertension.
Association between sodium intake and change in uric acid, urine albumin excretion, and the risk of developing hypertension.
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DOI：
10.1161/circulationaha.112.096115
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发表时间：
2012-06-26
期刊：
影响因子：
37.8
通讯作者：
Gansevoort RT
中科院分区：
文献类型：
--
作者：
Forman JP;Scheven L;de Jong PE;Bakker SJ;Curhan GC;Gansevoort RT
在非高血压个体中，高钠饮食对血压几乎没有急性影响，但由于不清楚的原因，如果长期食用，则与高血压有关。我们假设长期高钠摄入与内皮功能障碍的生物标志物增加相关，特别是血清尿酸（SUA）和尿白蛋白排泄（UAE），高钠摄入与SUA和UAE较高的患者的高血压事件相关。我们前瞻性分析了钠摄入量与PREVEND研究中未服用降压药物的受试者的SUA（N=4062）和UAE（N=4146）变化之间的相关性。我们还研究了非高血压参与者中钠摄入量与高血压发病率的关系（N=5556）。调整混杂因素后，钠摄入量每增加1克，SUA增加1.2μmol/L（p=0.01），UAE增加4.6mg/d（p<0.001）。钠摄入量与高血压发病率之间的关系因SUA和UAE而异。钠摄入量每增加1克，SUA最低三分位数人群发生高血压的校正风险比为0.98（0.89-1.08），SUA最高三分位数人群为1.09（1.02-1.16）。UAE <10 mg/d的受试者相应的风险比为0.99（0.93-1.06），UAE> 15 mg/d的受试者相应的风险比为1.18（1.07-1.29）。随着时间的推移，较高的钠摄入量与SUA和UAE的增加有关。在具有较高SUA和尿UAE的个体中，较高的钠摄入量是发展高血压的独立危险因素。
In non-hypertensive individuals, a high sodium diet has little acute effect on blood pressure but, for unclear reasons, is associated with hypertension if consumed chronically. We hypothesized that a chronically high sodium intake would be associated with increases in biomarkers of endothelial dysfunction, specifically serum uric acid (SUA) and urine albumin excretion (UAE), and that high sodium intake would be associated with incident hypertension among those with higher SUA and UAE. We prospectively analyzed the associations between sodium intake and the change in SUA (N=4062) and UAE (N=4146) among participants of the PREVEND study who were not taking antihypertensive medications. We also examined the association of sodium intake with the incidence of hypertension (N=5556) among non-hypertensive participants. After adjusting for confounders, each 1 gram higher sodium intake was associated with a 1.2µmol/L increase in SUA (p=0.01) and a 4.6mg/d increase in UAE (p<0.001). The relation between sodium intake and incident hypertension varied according to SUA and UAE. For each 1 gram higher sodium intake, the adjusted hazard ratio for developing hypertension was 0.98 (0.89–1.08) among those in the lowest tertile of SUA, and 1.09 (1.02–1.16) among those in the highest. Corresponding hazard ratios were 0.99 (0.93–1.06) among participants whose UAE was <10mg/d, and 1.18 (1.07–1.29) among those whose UAE was >15mg/d. Over time, higher sodium intake is associated with increases in SUA and UAE. Among individuals with higher SUA and urine UAE, a higher sodium intake is an independent risk factor for developing hypertension.