【摘要】：背景和目的:研究表明,代謝綜合征(Metabolic syndrome,MS)與心血管疾病疾病的發(fā)生有很大關(guān)聯(lián)性。代謝異常組分越多,心血管疾病的發(fā)病、死亡風(fēng)險(xiǎn)越高。盡管已有證據(jù)表明高鈉鹽攝入與心血管事件存在關(guān)聯(lián),但目前關(guān)于鹽攝入量與MS相關(guān)性的大規(guī)模研究較少。尤其是我國居民鹽攝入量偏高,測(cè)量鹽攝入量與MS及其各組分之間的關(guān)系,具有重要的公共衛(wèi)生意義。本研究擬分析鈉鹽攝入量和代謝綜合征及其各組分的關(guān)系,評(píng)估鈉鹽攝入量和其他因素對(duì)MS的影響。方法:本研究以前瞻性城鄉(xiāng)流行病學(xué)研究(Prospective Urban Rural Epidemiology,PURE)的中國人群基線數(shù)據(jù)為基礎(chǔ)。以NCEP-ATPⅢ為MS診斷標(biāo)準(zhǔn),利用Kawasaki公式估算24小時(shí)尿鈉排泄量(24-hour urinary sodium excretion,24-h USE)。計(jì)算不同人群MS及其各組分的患病率,使用多元Logistic回歸模型探索鈉鹽與MS之間的關(guān)聯(lián),以24-h USE四分位數(shù)最低組為參照,計(jì)算鈉攝入量各組的比值比(Odds ratio,OR)和 95%置信區(qū)間(Confidence interval,CI),并按年齡、性別等進(jìn)行分層分析。結(jié)果:研究納入年齡在35-70歲之間,共40,139名研究對(duì)象�？�?cè)巳篗S患病率為32.2%,年齡標(biāo)化后患病率為30.8%,女性患病率高于男性(36.4%和27.4%,P0.001)。估算24小時(shí)尿鈉排泄量為5673.3±1704.9mg/d(約為鹽14.4克/天),男性顯著高于女性(6122.2 mg/d和5358.8 mg/d)。以尿鈉排泄最低組為參照,各組 MS 患病風(fēng)險(xiǎn)比值比分別為1.18(1.10-1.27)、1.39(1.29-1.49)、1.48(1.38-1.60),且存在線性趨勢(shì)(P0.001)。進(jìn)行多因素調(diào)整后,24 h尿鈉排泄與MS及其組分中心肥胖、血壓升高、高甘油三酯患病呈正相關(guān),趨勢(shì)檢驗(yàn)均為P0.001。而低高密度脂蛋白、糖代謝異常與24小時(shí)尿鈉排泄線性趨勢(shì)無統(tǒng)計(jì)學(xué)意義(P0.05)。根據(jù)血壓分層,血壓正常的MS患者,不同尿鈉水平各組OR值為1.13(0.97-1.32)、1.28(1.10-1.49)、0.99(0.84-1.18),趨勢(shì)檢驗(yàn)P=0.287;而含有血壓升高組分的MS患者,各組 OR 值為 1.19(1.11-1.29)、1.41(1.31-1.52)、1.59(1.47-1.72),趨勢(shì)檢驗(yàn) P0.001。結(jié)論:隨著24小時(shí)尿鈉排泄量升高,代謝綜合征患病風(fēng)險(xiǎn)呈上升趨勢(shì)。適當(dāng)降低鹽攝入量,尤其是血壓升高及中心肥胖的MS患者,可以有效降低代謝綜合征的發(fā)生風(fēng)險(xiǎn),進(jìn)而降低心腦血管疾病的發(fā)生風(fēng)險(xiǎn)。
[Abstract]:Background and objective: metabolic syndrome (Metabolic syndrome,MS) is associated with cardiovascular disease. The more components of abnormal metabolism, the higher the risk of death caused by cardiovascular disease. Although there has been evidence that high sodium intake is associated with cardiovascular events, there are few large-scale studies on the correlation between salt intake and MS. Especially, the salt intake of Chinese residents is relatively high. It is of great public health significance to measure the relationship between salt intake and MS and its components. The purpose of this study was to analyze the relationship between sodium intake and metabolic syndrome and its components, and to evaluate the effects of sodium intake and other factors on MS. Methods: this study was based on baseline data of Chinese population in a prospective urban and rural epidemiological study (Prospective Urban Rural Epidemiology,PURE). Using NCEP-ATP 鈪，

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