评估日本简易食盐问卷在中国高血压人群中的适用性  

Assessment of the applicability of Japanese simple salt questionnaire in the Chinese hypertensive population

作　　者：袁亦方 王鸿懿[1] 孙宁玲[1] YUAN Yi-fang;WANG Hong-yi;SUN Ning-ling(Department of Hypertension,Peking University People’s Hospital,Beijing 100044,China;Peking University Clinical Research Institute)

机构地区：[1]北京大学人民医院高血压研究室,北京100044 [2]北京大学临床研究所

出　　处：《中华高血压杂志》2022年第9期841-848,共8页Chinese Journal of Hypertension

摘　　要：目的评估日本简易食盐问卷在我国高血压人群中的适用性。方法该研究为一项多中心横断面研究。对来自全国10家医院的734例高血压患者,通过现场调查采集日本简易食盐问卷信息,同时采用离子选择电极法测定24 h尿钠排泄。采用Pearson相关性分析评估日本简易食盐问卷整体得分与24 h尿钠的相关性。以24 h尿钠为金标准,绘制受试者工作特征(ROC)曲线评价该问卷诊断尿钠超标的效能,描述灵敏度、特异度等指标。采用线性模型对与24 h尿钠相关的高盐行为进行单因素分析和多因素分析。结果受试者平均年龄为(55.8±14.7)岁,女性占44%,平均尿钠(142.8±81.1)mmol/d,相当于食钠盐8.4 g/d,日本简易食盐问卷分数(10.7±5.0)分。日本简易食盐问卷分数与实测24 h尿钠的相关性为0.23(P<0.01)。不同问卷分数段区分度欠佳,且在0~8分(对应食盐摄入量低)时已达24 h尿钠超标阶段(119.3 mmol/d)。日本简易食盐问卷判断尿钠超标的曲线下面积为0.60(95%CI 0.55~0.64),以日本简易食盐问卷分数≥14分作为判断尿钠超标的标准,灵敏度仅为28.8%,特异度为81.0%。多因素分析显示,饭量大、在外就餐、经常酱油拌菜、经常食用面条等膳食习惯与24 h尿钠增加相关。结论日本简易食盐问卷分数与我国24 h尿钠实测值呈弱相关,现有判定标准低估了24 h尿钠,不宜直接应用于我国高血压人群。Objective To assess the applicability of the Japanese simple salt questionnaire in Chinese hypertensive population.Methods A multicenter cross-sectional study was conducted.A total of 734 hypertensive patients from 10 hospitals in China were enrolled.The information of the Japanese salt questionnaire was collected by on-site survey,and 24 h urinary sodium excretion was measured by ion-selective electrode method.Pearson correlation analysis was used to analyze the correlation between the questionnaire score and 24 h urinary sodium.Using 24 h urinary sodium as the gold standard,receiver operating characteristic(ROC)curve was performed to evaluate the efficacy of the questionnaire in diagnosing urinary sodium overload.And the sensitivity and specificity were described.Univariate and multivariate analyses were performed using linear models to determine the association of hypersaline behavior with 24 h urinary sodium.Results The average age of the subjects was(55.8±14.7)years,44%were female.The mean urinary sodium was(142.8±81.1)mmol/d,equivalent to 8.4 g/d of dietary sodium.The score of Japanese simple salt questionnaire was 10.7±5.0.The correlation between questionnaire score and 24 h urinary sodium was 0.23(P<0.01).The differentiation of different questionnaire score bands was poor.When the score was 0-8(corresponding to low salt intake),the 24 h urinary sodium had been exceeded(119.3 mmol/d).The area under the ROC curve was 0.60(95%CI 0.55-0.64).The sensitivity was only 28.8%and specificity was 81.0%using questionnaire score≥14 to determine urinary sodium overload.Multifactorial analysis showed that dietary habits such as eating a lot,eating out,frequent consumption of soy sauce and noodles were associated with increased 24 h urinary sodium.Conclusions The score of Japanese simple salt questionnaire is weakly correlated with and underestimates 24 h urinary sodium in China.The questionnaire should not be directly applied to the hypertensives in China.

关 键 词：日本简易食盐问卷 适用性 筛查 尿钠排泄 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]