Effects of Microalbuminuria on the Relationships between Blood Pressure and Salt Intake in Japanese Population

采用1997 ~ 1999年国际人群大量营养素和血压研究（INTERMAP）收集的数据，评价生活方式相关的心血管危险因素和饮食因素与2次24小时尿白蛋白浓度的关系。研究人群包括1，071名非糖尿病的日本男性和女性，年龄40-59岁，无大量白蛋白尿（>= 300 mg/24小时），居住在4个地区。微量白蛋白尿（MA）定义为2次尿白蛋白浓度均为30- 300 mg/24小时，且两者均为MA可能（MAP），MA患病率男性为5.0%，女性为1.7%，并观察到性别差异。同样，MAP的患病率在男性中为7.4%，在女性中为4.5%，但仅在50岁时发现性别差异。有MA或MAP者的高血压（收缩压≥ 140 mmHg，舒张压≥ 90 mmHg，或正在服用降压药）发生率高于无MA或MAP者。校正年龄和BMI后，男女高血压与MA/MAP的相关性均显著。而男性MA/MAP组与非MA/MAP组的摄盐量、尿Na、Na/K比值（摄盐生物学指标）及尿C肽（与胰岛素分泌相关）无显著性差异。女性尿C肽无明显增加，但尿钠排泄量MA/MAP组高于无MA/MAP组，男性血压正常者，MA/MAP组舒张压高于无MA/MAP组，但两组间盐摄入量与血压的关系无差异。而女性MAP患者盐摄入量与舒张压呈正相关。

Data collected by the International Population Study on Macronutrients and Blood Pressure Study (INTERMAP) in 1997-99 were used to assess relations of lifestyle-related cardiovascular risk factors and dietary factors to urinary albumin concentration in two-timed 24-hour urine specimens. The study population included 1,071 non-diabetic Japanese men and women aged 40-59 without macroalbuminuria (>=300mg/24hour) living in 4 areas. Microalbuminuria (MA) was defined as urinary albumin concentration was 30-300mg/24hour in both of 2 timed urinary collections, and MA possible (MAP) as either of them.Prevalence of MA was 5.0% in men and 1.7% in women, and its gender difference was observed. Similarly, prevalence of MAP was 7.4% in men and 4.5% in women, but the gender difference was found only in 50's. The rate of hypertension (systolic blood pressure >=140mmHg, diastolic blood pressure >=90mmHg, or under unti-hypertensive medication) of the subjects with MA or MAP was higher than that of the subjects without MA or MAP. After adjusting age and BMI by logistic model, the significant relationship between hypertension and MA/MAP was found in both sexes. However, no difference of salt intake and urinary Na and Na/K ratio which are biological indices of salt intake, and urinary C-peptide which related to Insulin excretion between the subjects with and without MA/MAP in men. In women, there was no increase of urinary C-peptide, but urinary Na excretion of the subjects with MA/MAP was higher than that without MA/AMP.In normotensive men, the level of diastolic blood pressure of the subjects with MA/MAP was higher than that of the men without MA/MAP, but no difference of relationship between salt intake and blood pressure was observed between these 2 groups. However, positive relationship between salt intake and diastolic blood pressure in the women with MAP in women.