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

1997-1999年国际人群大量营养素和血压研究(INTERMAP)收集的数据被用来评估与生活方式相关的心血管危险因素和饮食因素与两次24小时尿白蛋白浓度的关系。研究人群包括居住在四个地区的1071名年龄在40-59岁之间、没有大量白蛋白尿(&gt；=300毫克/24小时)的非糖尿病日本男性和女性。微量白蛋白尿(MA)定义为两次尿标本尿白蛋白浓度均为30~300 mg/24小时，均为MA可能性(MAP)，男性MA患病率为5.0%，女性为1.7%，并观察其性别差异。同样，男性MAP患病率为7.4%，女性为4.5%，但性别差异仅见于50‘S。MA或MAP患者的高血压患病率(收缩压和舒张压分别为140 mm Hg和90 mm Hg，或服用非降压药)均高于无MA或MAP患者。经Logistic回归模型调整年龄和BMI后，发现男女高血压与MA/MAP显著相关。而男性MA/MAP组与非MA/MAP组的盐摄入量、尿钠、钠/钾比值、与胰岛素排泄相关的尿C肽等生物学指标无明显差异。在女性中，有MA/MAP者的尿钠排泄量高于无MA/MAP者，但尿C肽无明显增加。在血压正常的男性中，有MA/MAP者的舒张压水平高于无MA/MAP者，但两组间盐摄入量与血压的关系无差异。而女性MAP患者的食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.