Risk of Cardiovascular Mortality Associated With Serum Sodium and Chloride in the General Population
Risk of Cardiovascular Mortality Associated With Serum Sodium and Chloride in the General Population
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一般人群中与血清钠和氯相关的心血管死亡风险
DOI：
10.1016/j.cjca.2018.03.013
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发表时间：
2018-08-01
影响因子：
6.2
通讯作者：
Dong, Yugang
中科院分区：
文献类型：
--
作者：
He, Xin;Liu, Chen;Dong, Yugang
背景：先前的研究已经证实了血清氯化物对心力衰竭患者的预后价值。然而，血清氯化物和心血管疾病死亡率的风险之间的一般population.Methods：我们包括16,483名参与者在全国健康和营养调查III。考克斯比例风险模型用于评估血清钠和氯与心血管死亡率的相关性。模型中包括潜在的混杂因素。还使用限制性三次样条对血清钠和氯化物水平进行建模，以确定潜在的非线性关联。亚组分析的基础上基线疾病和使用利尿剂。结果：平均年龄为43.5岁，47.8%的参与者是男性。在277，059人年的随访期间，有1714例心血管死亡。在多变量模型中，低水平的血清钠与心血管死亡风险增加相关（风险比[HR]，1.10; 95%置信区间[CI]，1.02-1.18/标准差[SD]; P = 0.009），而较低水平的血清氯化物不是（HR，1.04; 95% CI，0.97-1.12/标准差; P = 0.278）。限制性三次样条分析得出了类似的结果。结论：低血清钠，而不是氯，是独立相关的心血管死亡率的风险增加。
Background: The prognostic value of serum chloride among patients with heart failure was demonstrated by previous studies. However, the association of serum chloride and risk of cardiovascular mortality among the general population remains unclear.Methods: We included 16,483 participants in National Health and Nutrition Examination Survey III. Cox proportional hazards models were used to assess the association of serum sodium and chloride and cardiovascular mortality. Potential confounders were included in the models. Levels of serum sodium and chloride were also modeled with restrictive cubic splines for potential nonlinear associations. Subgroup analyses were based on baseline diseases and use of diuretics.Results: The mean age was 43.5 years, and 47.8% of the participants were men. During 277,059 person-years of follow-up, there were 1714 cardiovascular deaths. In the multivariate model, low-level serum sodium was associated with an increased risk of cardiovascular mortality (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.02-1.18 per standard deviation [SD]; P = 0.009), whereas a lower level of serum chloride was not (HR, 1.04; 95% CI, 0.97-1.12 per standard deviation; P = 0.278). Analyses with restrictive cubic splines yielded similar results.Conclusions: Low serum sodium, rather than chloride, was independently associated with an increased risk of cardiovascular mortality.