Urinary calcium excretion, sodium intake and blood pressure in a multi-ethnic population: results of the Wandsworth Heart and Stroke Study
Urinary calcium excretion, sodium intake and blood pressure in a multi-ethnic population: results of the Wandsworth Heart and Stroke Study
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DOI：
10.1038/sj.jhh.1001171
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发表时间：
2001-04-01
影响因子：
2.7
通讯作者：
Cappuccio, FP
中科院分区：
文献类型：
--
作者：
Blackwood, AM;Sagnella, GA;Cappuccio, FP
背景：高血压与尿钙排泄（UCa）增加有关。高钠摄入量会增加尿钙和血压 (BP)。然而，尚不清楚这些影响是否会因性别或种族血统而改变。 目的：在一项基于人群的研究中，检查血压、尿钠 (UNa)、性别和种族血统与每日和空腹 UCa 之间的关系。 设计和方法：在参与横断面调查的 1577 名个人中，743 人被纳入本分析（407 名女性，336 名男性），因为他们均未接受治疗，并提供了完整的 24 小时尿液收集，并进行了人体测量、BP、UNa 和 UCa 的所有测量。其中 277 名白人、227 名非洲黑人和 239 名南亚人。还对 630 名提供 3 小时空腹尿液采集的参与者进行了比较。结果：在调整年龄和性别等混杂因素后，24 小时 UCa 与种族、血压和 UNa 显着且独立相关。白人平均 24 小时 UCa 为 4.62 (s.e. 0.11) mmol/d，南亚人为 3.33 (0.12)，黑人为 3.16 (0.13) (P < 0.001)。 UNa 升高 200 mmol 预测每日 UCa 升高 1.04 mmol (P < 0.001)，收缩压升高 20 mm Hg 预测 UCa 升高 0.28 mmol。不同种族群体的斜率没有显着差异。当使用空腹 UCa 代替时，UCa 存在种族差异（白人为 1.64 [0.05] mu mol/min，南亚人为 1.08 [0.06]，黑人为 1.13 [0.063]；P < 0.001）。结论：这些结果表明，在未选择的人群中，血压、盐摄入量和种族血统是 UCa 的独立预测因子。这些关系不太可能是钙摄入量或肠道钙吸收差异的结果，因为它们在禁食过夜后也会出现，这表明它们可能反映了肾小管处理的差异。 BP 错误的钠摄入量对 UCa 的估计影响持续多年，可能与骨钙含量的显着影响有关。
Background: Hypertension is associated with increased urinary calcium excretion (UCa). A high sodium intake increases both UCa and blood pressure (BP). However, it is not clear whether these effects are modified by gender or ethnic origin.Objectives: To examine the relationships between BP, urinary sodium (UNa), gender and ethnic origin with both daily and fasting UCa in a population-based study.Design and Methods: Out of 1577 individuals taking part in a cross-sectional survey, 743 were considered for the present analysis (407 women, 336 men) as they were ail untreated, had provided a complete 24-h urine collection, and had all measurements of anthropometry, BP, UNa and UCa. They were 277 whites, 227 of black African origin and 239 South Asians. Comparisons were also carried out in the 630 participants who also provided 3-h fasting urine collections.Results: After adjustment for confounders including age, and gender, 24-h UCa was significantly and independently associated with ethnic origin, BP and UNa. Mean 24-h UCa was 4.62 (s.e. 0.11) mmol/d in whites, 3.33 (0.12) in South Asians and 3.16 (0.13) in blacks (P < 0.001). A 200 mmol higher UNa predicted a 1.04 mmol higher daily UCa (P < 0.001), and a 20 mm Hg higher systolic BP predicted a 0.28 mmol higher UCa. The slopes were not significantly different by ethnic group. The ethnic differences in UCa were present when fasting UCa was used instead (1.64 [0.05] mu mol/min In whites, 1.08 [0.06] in South Asians and 1.13 [0.063] in blacks; P < 0.001).Conclusions: These results indicate that BP, salt intake and ethnic origin are independent predictors of UCa in an unselected population. These relationships are unlikely to be the result of differences in Ca intake or intestinal Ca absorption as they are seen also after an overnight fast, suggesting that they may reflect differences in renal tubular handling. The estimated effects of either BP err sodium intake on UCa, sustained over many years, may be associated with significant effects an bone calcium content.