三种点尿法估算中国人群24 h尿钠排泄量的可行性评价  

Feasibility evaluation of estimating the 24-hour urinary sodium excretion in Chinese population with three spot urine methods

作　　者：杜晓甫[1] 陈向宇[1] 张洁[1] 方乐[1] 徐建伟[2] 白雅敏[2] 钟节鸣[1] Du Xiaofu;Chen Xiangyu;ZhangJie;Fang Le;Xu Jianwei;Bai Yamin;Zhong Jieming(Department of Chronic Disease Prevention and Control,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;National Center for Chronic and Non-communicable Disease Controland Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]浙江省疾病预防控制中心慢性非传染性疾病预防控制所,杭州310051 [2]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050

出　　处：《中华预防医学杂志》2020年第4期420-424,共5页Chinese Journal of Preventive Medicine

摘　　要：目的评估Kawasaki法、INTERSALT法和Tanaka法估算中国人群24 h尿钠排泄量的可行性。方法采用多阶段分层随机抽样方法,于2017年在浙江省抽取义乌市、海宁市、泰顺县、宁波市鄞州区、丽水市莲都区的1499名18~69岁居民,采用问卷调查收集基本信息并进行体格测量,收集24 h尿液后记录尿量并检测尿钠、尿钾和尿肌酐浓度,最终共有1426名调查对象通过了尿液完整性检测。分别应用Kawasaki法、INTERSALT法和Tanaka法估算24 h尿钠排泄量,并与实测值进行比较。结果调查对象年龄为(46.71±14.04)岁,其中男性700名,占49.1%。调查对象24 h尿钠排泄量实测值为(167.10±74.70)mmol,Kawasaki法估值偏高,为(184.61±57.10)mmol,INTERSALT法和Tanaka法估值偏低,分别为(134.62±39.21)和(143.20±35.66)mmol。估算差值(95%CI)(mmol)由小及大依次为Kawasaki法[17.51(13.54,21.47)]、Tanaka法[-23.90(-27.60,-20.20)]和INTERSALT法[-32.48(-36.29,-28.67)]。随着24 h钠盐摄入量的增加,各估算方法均由高估转为低估:在24 h钠盐摄入量<9.0 g者中,INTERSALT法估算差值(95%CI)最小,在<6.0和6.0~8.9 g者中分别为[43.15(37.73,48.57)]和[1.26(-2.10,4.63)]mmol;在24 h钠盐摄入量≥9.0 g者中,Kawasaki法估算差值(95%CI)最小,在9.0~11.9和≥12.0 g者中分别为[-12.50(-18.14,-6.86)]和[-53.73(-61.25,-46.22)]。Bland-Altman法一致性分析显示,Kawasaki法估算值与实测值的一致性最好,范围外点数最少(69个,占4.84%)。结论在3种点尿法中,Kawasaki法对预测中国人群24 h尿钠排泄量具有更好的适用性。Objective To evaluate the feasibility of three spot urine methods(Kawasaki,INTERSALT and Tanaka)for estimating the 24 h urinary sodium excretion in the Chinese population.Methods In 2017,1499 participants aged 18 to 69 years old were selected from Yiwu City,Haining City,Taishun County,Yinzhou District of Ningbo City and Liandu District of Lishui City of Zhejiang Province by using the multistage random sampling method.Sociodemographic information of the subjects was collected with questionnaires and physical measurements were performed.24 h urine was collected and urinary volume was recorded.The concentrations of urinary sodium,potassium and creatinine were also measured.Kawasaki,INTERSALT and Tanaka spot urine methods were applied to estimate the 24 h urinary sodium excretion and compared with actual values among 1426 participants who passed urine integrity test.Results The age of participants was(46.71±14.04)years old,including 700 males,accounting for 49.1%.The actual value of 24 h urinary sodium excretion was(167.10±74.70)mmol,but Kawasaki method overestimated it as(184.61±57.10)mmol,and INTERSALT and Tanaka methods underestimated it as(134.62±39.21)and(143.20±35.66)mmol.Estimated difference(95%CI)(mmol)from small to large was Kawasaki method[17.51(13.54,21.47)],Tanaka method[-23.90(-27.60,-20.20)]and INTERSALT method[-32.48(-36.29,-28.67)].With the increase of 24 h sodium intake,all estimation methods changed from the overestimation to underestimation.In those with 24 h sodium intake<9.0 g,the estimated difference(95%CI)of the INTERSALT method was the smallest as 43.15(37.73,48.57)and 1.26(-2.10,4.63)mmol for<6.0 and 6.0-8.9 g groups,respectively.In those with 24 h sodium intake≥9.0 g,the Kawasaki method had the smallest estimated difference(95%CI)as-12.50(-18.14,-6.86)and-53.73(-61.25,-46.22)for 9.0-11.9 g and≥12.0 g group,respectively.The consistency analysis of the Bland-Altman method showed that the Kawasaki method had the best consistency with actual measured value and it had the least number of

关 键 词：尿分析 氯化钠 膳食 生物学监测 可行性研究 

分 类 号：R446[医药卫生—诊断学]