NEUROHUMORAL AND METABOLIC EFFECTS OF SHORT-TERM DIETARY NACL RESTRICTION IN MEN - RELATIONSHIP TO SALT-SENSITIVITY STATUS
NEUROHUMORAL AND METABOLIC EFFECTS OF SHORT-TERM DIETARY NACL RESTRICTION IN MEN - RELATIONSHIP TO SALT-SENSITIVITY STATUS
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DOI：
10.1093/ajh/4.5.416
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发表时间：
1991-05-01
影响因子：
3.2
通讯作者：
HOFFMAN, RG
中科院分区：
文献类型：
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作者：
EGAN, BM;WEDER, AB;HOFFMAN, RG
已发表的观察表明，并不是每个人都能从严格的饮食盐限制中受益，因为血压反应似乎是异质性的，可能会发生不利的代谢影响。我们研究了27名男性每天摄入20~200mEq的食盐7天对心血管、神经体液和代谢的影响。12名受试者为盐敏感(SS)受试者，其定义为高盐时的平均动脉内压(MAP)大于或等于低盐时的MAP大于或等于5%。11个受试者为耐盐(SR)，定义为低盐阶段的MAP大于或等于高盐阶段的MAP。根据血浆去甲肾上腺素(NE，P=.12)和血浆肾素活性(PRA，P<；.001)在低盐饮食和高盐饮食中平均值的变化，SR亚群有更强的神经体液活性的趋势。在SR受试者中，低盐和高盐饮食也提高了肌酐(P=.03)、尿酸(P=.001)和低密度胆固醇(L DL-C，P=.03)的平均值，但没有提高空腹胰岛素(P=.15)。在SS受试者中，低v高盐饮食并未使NE升高(P=.35)，但PRA较大(P=.002)。在SS受试者中，尿酸(P=0.005)和胰岛素(P=0.02)的平均值在低v高氯化钠阶段较高，而肌酸(P=.15)和低密度脂蛋白(P=.67)的平均值没有差别。数据表明，严重的、短期的氯化钠限制可能是不可取的，特别是在SR受试者，因为潜在的不利的神经体液和代谢变化不能被较低MAP的好处所抵消。
Published observations suggest that not everyone benefits from severe dietary NaCl restriction, since blood pressure responses appear heterogeneous and adverse metabolic effects may occur. We studied the cardiovascular, neurohumoral, and metabolic effects of 7 day periods of 20 v 200 mEq/day NaCl diets in 27 men.Twelve subjects were salt sensitive (SS), defined as mean intraarterial pressure (MAP, mm Hg) during high NaCl greater-than-or-equal-to 5% above MAP on low NaCl. Eleven subjects were salt resistant (SR), defined as MAP during the low NaCl phase greater-than-or-equal-to MAP during the high NaCl phase. The SR subset had a tendency to greater neurohumoral activity, assessed by changes in mean values for plasma norepinephrine (NE, P = .12) and plasma renin activity (PRA, P < .001) on the low v high NaCl diet. In SR subjects the low v high NaCl diet also raised mean values for creatinin (P = .03), uric acid (P = .001), and low density cholesterol (LDL-C, P = .03), but not fasting insulin (P = .15). In SS subjects, the low v high NaCl diet did not raise NE (P = .35), although the PRA was greater (P = .002). Among SS subjects, mean values for uric acid (P = .005) and insulin (P = .02) were greater during the low v high NaCl phase, while creatining (P = .15) and LDL-C (P = .67) were not different.The data sugges that severe, short-term NaCl restriction can be undesirable, especially in SR subjects, since potentially adverse neurohumoral and metabolic changes are not counterbalanced by the benefits of a lower MAP.