Blood pressure interactions with the DASH dietary pattern, sodium, and potassium: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP).
Blood pressure interactions with the DASH dietary pattern, sodium, and potassium: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP).
复制标题
DOI：
10.1093/ajcn/nqac067
复制
发表时间：
2022-07-06
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
坚持饮食方法来阻止高血压（DASH）饮食增加钾的摄入量，降低钠的摄入量和血压（BP），但潜在的代谢途径尚不清楚。在自由生活人群中，我们描绘了与DASH饮食依从性、24小时尿钠和钾排泄以及相关的潜在代谢途径相关的代谢特征。我们使用24小时尿代谢分析的质子核磁共振波谱来表征与DASH饮食模式评分相关的代谢特征在美国（n = 2164）和英国（n = 496）参加国际大量和非营养素与血压研究（INTERMAP）的参与者中，DASH评分和24小时钠和钾排泄。多元线性回归和交叉制表分析，以探讨DASH-BP的关系和钠，钾的调制。使用中介分析和代谢反应网络确定了与DASH依从性、钠和钾排泄以及BP相关的潜在途径。坚持DASH饮食与尿钾排泄相关（相关系数，r = 0.42; P < 0.0001）。在多变量回归分析中，DASH评分高5分（范围，7 - 35）与收缩压降低1.35 mmHg相关（95% CI，−1.95-−0.80 mmHg; P = 1.2 × 10 - 5）;控制钾而非钠的模型减弱了DASH-BP关系。两种常见代谢物（马尿酸盐和柠檬酸盐）介导钾-BP和DASH-BP关系，而5种代谢物（琥珀酸盐、丙氨酸、S-甲基半胱氨酸亚砜、4-羟基马尿酸盐和苯乙酰谷氨酰胺）被发现对DASH-BP关系具有特异性。更好地坚持DASH饮食与较低的血压和较高的钾摄入量有关。DASH饮食建议更多地摄入水果，蔬菜和其他富含钾的食物，这些食物可以取代富含钠的加工食品，从而通过重叠的代谢途径影响BP。推测可能的DASH特异性途径，但需要进一步研究确认。INTERMAP在www.clinicaltrials.gov上注册为NCT 00005271。
Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet enhances potassium intake and reduces sodium intake and blood pressure (BP), but the underlying metabolic pathways are unclear. Among free-living populations, we delineated metabolic signatures associated with the DASH diet adherence, 24-hour urinary sodium and potassium excretions, and the potential metabolic pathways involved. We used 24-hour urinary metabolic profiling by proton nuclear magnetic resonance spectroscopy to characterize the metabolic signatures associated with the DASH dietary pattern score (DASH score) and 24-hour excretion of sodium and potassium among participants in the United States (n = 2164) and United Kingdom (n = 496) enrolled in the International Study of Macro- and Micronutrients and Blood Pressure (INTERMAP). Multiple linear regression and cross-tabulation analyses were used to investigate the DASH-BP relation and its modulation by sodium and potassium. Potential pathways associated with DASH adherence, sodium and potassium excretion, and BP were identified using mediation analyses and metabolic reaction networks. Adherence to the DASH diet was associated with urinary potassium excretion (correlation coefficient, r = 0.42; P < 0.0001). In multivariable regression analyses, a 5-point higher DASH score (range, 7 to 35) was associated with a lower systolic BP by 1.35 mmHg (95% CI, −1.95 to −0.80 mmHg; P = 1.2 × 10−5); control of the model for potassium but not sodium attenuated the DASH-BP relation. Two common metabolites (hippurate and citrate) mediated the potassium-BP and DASH-BP relationships, while 5 metabolites (succinate, alanine, S-methyl cysteine sulfoxide, 4-hydroxyhippurate, and phenylacetylglutamine) were found to be specific to the DASH-BP relation. Greater adherence to the DASH diet is associated with lower BP and higher potassium intake across levels of sodium intake. The DASH diet recommends greater intake of fruits, vegetables, and other potassium-rich foods that may replace sodium-rich processed foods and thereby influence BP through overlapping metabolic pathways. Possible DASH-specific pathways are speculated but confirmation requires further study. INTERMAP is registered as NCT00005271 at www.clinicaltrials.gov.