Higher dietary salt intake is associated with microalbuminuria, but not with retinopathy in individuals with type 1 diabetes: the EURODIAB Prospective Complications Study.
Higher dietary salt intake is associated with microalbuminuria, but not with retinopathy in individuals with type 1 diabetes: the EURODIAB Prospective Complications Study.
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DOI：
10.1007/s00125-014-3367-9
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发表时间：
2014-11
期刊：
影响因子：
8.2
通讯作者：
Stehouwer, Coen D. A.
中科院分区：
文献类型：
--
作者：
Engelen, Lian;Soedamah-Muthu, Sabita S.;Geleijnse, Johanna M.;Toeller, Monika;Chaturvedi, Nish;Fuller, John H.;Schalkwijk, Casper G.;Stehouwer, Coen D. A.
关键词：
高盐饮食摄入与血压升高有关，也可能对微血管并发症产生有害影响。我们研究了1型糖尿病患者饮食盐摄入量（根据24小时尿钠排泄量估计）和尿钾排泄量之间的横断面相关性，以及微血管并发症的患病率。我们测量了参与EURODIAB前瞻性并发症研究的1，212名1型糖尿病患者（40 ± 10岁，51%为男性）的两份24小时尿液样本中的钠和钾浓度。我们使用多元逻辑回归分析来研究饮食盐摄入量与微血管并发症之间的关系，这些微血管并发症根据年龄和性别进行了调整，此外还根据BMI、吸烟、尿钾排泄、抗高血压药物和体力活动以及总能量、蛋白质、酒精、饱和脂肪和纤维摄入量进行了调整。经过充分调整后，每天高1克的饮食盐摄入量与微量白蛋白尿的存在呈正相关（OR 1.06 [95% CI 1.01，1.10]），但不是大量白蛋白尿（OR 0.99 [95% CI 0.94，1.05]）、非增殖性视网膜病变（OR 1.00 [95% CI 0.96，1.04]）或增殖性视网膜病变（OR 1.02 [95% CI 0.95，1.08]）。在排除了患有心血管疾病和/或服用抗高血压药物的个体（n = 418）后，我们发现微量白蛋白尿（OR 1.04 [95% CI 0.99，1.10]）和大量白蛋白尿（OR 1.05 [95% CI 0.96，1.16]）与糖尿病无显著相关性。BMI高于25 kg/m2的个体（OR 1.11 [95% CI 1.04，1.18]）的饮食盐摄入量与微量白蛋白尿之间的相关性强于BMI低于25 kg/m2的个体（OR 1.03 [95% CI 0.97，1.09]）。尿钾排泄与微血管并发症之间无显著相关性。在1型糖尿病患者中，通过24小时尿钠排泄测定，较高的饮食盐摄入量可能与微量白蛋白尿呈正相关，特别是在超重患者中。本文的在线版本（doi：10.1007/s 00125 -014-3367-9）包含同行评审但未经编辑的补充材料，可供授权用户使用。
High dietary salt intake has been associated with elevated BP and may also have a deleterious effect on microvascular complications. We studied the cross-sectional associations between dietary salt intake (estimated from 24 h urinary sodium excretion) and urinary potassium excretion on the one hand, and the prevalence of microvascular complications on the other, in individuals with type 1 diabetes. We measured sodium and potassium concentrations in two 24 h urine samples in 1,212 individuals with type 1 diabetes (40 ± 10 years old, 51% men) who participated in the EURODIAB Prospective Complications Study. We used multiple logistic regression analyses to investigate associations between dietary salt intake and microvascular complications adjusted for age and sex, and additionally for BMI, smoking, urinary potassium excretion, antihypertensive medication and physical activity, and total energy, protein, alcohol, saturated fat and fibre intake. After full adjustment, 1 g/day higher dietary salt intake was positively associated with the presence of microalbuminuria (OR 1.06 [95% CI 1.01, 1.10]), but not macroalbuminuria (OR 0.99 [95% CI 0.94, 1.05]), non-proliferative retinopathy (OR 1.00 (95% CI 0.96, 1.04]) or proliferative retinopathy (OR 1.02 (95% CI 0.95, 1.08]). After excluding individuals with cardiovascular disease and/or antihypertensive medication (n = 418), we found a non-significant association with microalbuminuria (OR 1.04 [95% CI 0.99, 1.10]) and macroalbuminuria (OR 1.05 [95% CI 0.96, 1.16]). The association between dietary salt intake and microalbuminuria was stronger in individuals with a BMI above 25 kg/m2 (OR 1.11 [95% CI 1.04, 1.18]) than in those with BMI below 25 kg/m2 (OR 1.03 [95% CI 0.97, 1.09]). No significant associations were found between urinary potassium excretion and microvascular complications. In individuals with type 1 diabetes, higher dietary salt intake, as determined by 24 h urinary sodium excretion, may be positively associated with microalbuminuria, particularly in overweight individuals. The online version of this article (doi:10.1007/s00125-014-3367-9) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
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8.3
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