目的:評價膳食調(diào)查法、Kawasaki法、INTERSALT法、Tanaka法四種方法估算鈉攝入量的準確性和可行性;并了解河北醫(yī)科大學(xué)大學(xué)生鈉的攝入狀況、食物來源等,為制定減鹽措施提供依據(jù)。方法:在河北醫(yī)科大學(xué)招募健康志愿者274名,男女各半。采用膳食調(diào)查法計算志愿者鈉的攝入量;同時收集受試者24小時尿液樣本、時點(隨機)尿液樣本,測定尿液樣本中鉀、鈉、肌酐的含量,對時點尿通過Kawasaki法、INTERSALT法、Tanaka法估算調(diào)查人群的鈉攝入量。最后采用Bland-Altman法比較四種方法估算的鈉攝入量和鈉攝入量評價金標準(24h尿鈉法)之間的一致性�？紤]到鈉排出途徑的多樣性,本研究分別在夏季(2017年6月底)和秋季(2017年11月底)各進行一次,以研究通過尿液推測鈉攝入量的準確性和可行性。結(jié)果:1.金標準得到的鈉攝入量結(jié)果274名對象被納入到本研究。24h尿液收集法顯示,夏季的調(diào)查結(jié)果為人均每天鈉攝入量3043.0±1223.3mg(合成鹽7.8±3.1g);秋季的調(diào)查結(jié)果為人均每天鈉攝入量3563.7±1370.0mg(折合成鹽9.1±3.5g)。與秋季比較,夏季人均尿鈉減少約520.7mg(折合成鹽1.3g)。2.各方法與金標準的一致性與相關(guān)性分析從群體水平上看,夏季INTERSALT法對上午尿進行估測的偏差最小,平均偏差值(估計值-實測值)為-39.7mg/天;膳食調(diào)查法的總平均偏差最小,平均偏差值為42.7mg/天。秋季Tanaka法對上午尿進行估測的偏差最小,偏差均值為-149.8mg/天;Kawasaki法總平均偏差最小,平均偏差值為163.7mg/天。從個體水平上看,24小時尿鈉排泄量與膳食調(diào)查法測得的鈉攝入量的相關(guān)性較低,相關(guān)系數(shù)僅為0.123,與Kawasaki法、INTERSALT法、Tanaka法三種方法的相關(guān)系數(shù)在0.52-0.64之間,夏季Kawasaki法的相關(guān)系數(shù)最高,為0.612;秋季Tanaka法的相關(guān)系數(shù)最高,最高系數(shù)為0.635。結(jié)論:1.由于氣溫原因,夏季排汗較多,用時點尿或24h尿液收集法估測膳食鈉的攝入量偏差較大,若用尿液收集法,最好避開夏季。2.膳食調(diào)查法和Kawasaki法、INTERSALT法、Tanaka法三種方法估算大學(xué)生的鈉攝入量均存在不同程度的偏差和波動性,但本研究只是部分人群的分析,需要更多研究來驗證,同時需要制定一個適合中國人群的估算鈉攝入量的方法,從而更準確地估計中國人群的食鹽攝入量。3.所調(diào)查大學(xué)生的控鹽意識不足,應(yīng)加強營養(yǎng)宣傳教育。
【學(xué)位單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位年份】：2018
【中圖分類】：R151.42
【部分圖文】：

圖 1 夏季四種方法估計值與實測值 Bland-Altman 圖Fig.1 Bland-Altman plots of four method estimates and actual measurementsin summerA is the BA graph of sodium intake estimated by 24-h urine collection and randomizedurine in the morning used I method. B is the BA graph of sodium intake estimated by 24-hurine collection and randomized urine in the morning used T method. C is the BA graph ofsodium intake estimated by 24-h urine collection and randomized urine in the afternoonused I method. D is the BA graph of sodium intake estimated by 24-h urine collection andrandomized urine in the afternoon used T method. E is the BA graph of sodium intakeestimated by 24-h urine collection and randomized urine in the evening used I method. F isthe BA graph of sodium intake estimated by 24-h urine collection and randomized urine inthe evening used T method. G is the BA graph of sodium intake estimated by 24-h urinecollection and the morning urine used K method. H is the BA graph of sodium intakeestimated by 24-h urine collection and dietary survey.

圖 2 秋季四種方法估計值與實測值 Bland-Altman 圖Fig.2 Bland-Altman plots of four method estimates and actual measurementsin late autumn.A is the BA graph of sodium intake estimated by 24-h urine collection and randomizedurine in the morning used I method. B is the BA graph of sodium intake estimated by 24-hurine collection and randomized urine in the morning used T method. C is the BA graph ofsodium intake estimated by 24-h urine collection and randomized urine in the afternoonused I method. D is the BA graph of sodium intake estimated by 24-h urine collection andrandomized urine in the afternoon used T method. E is the BA graph of sodium intakeestimated by 24-h urine collection and randomized urine in the evening used I method. F isthe BA graph of sodium intake estimated by 24-h urine collection and randomized urine inthe evening used T method. G is the BA graph of sodium intake estimated by 24-h urinecollection and the morning urine used K method. H is the BA graph of sodium intakeestimated by 24-h urine collection and dietary survey.
【參考文獻】

相關(guān)期刊論文 前1條

1 江國虹,常改;膳食調(diào)查方法[J];職業(yè)與健康;2002年03期

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