山东省居民尿钠钾水平及其与血压的相关性研究  

Association between urinary sodium and potassium excretion and blood pressure among adults in Shandong Province, China

作　　者：郭瑞 张丙银 徐春晓[2] 董静[2] 任杰[2] 刘丹茹[2] 鹿子龙[2] 郭晓雷[2] GUO Rui;ZHANG Bingyin;XU Chunxiao;DONG Jing;REN Jie;LIU Danru;LU Zilong;GUO Xiaolei(Department of Epidemiology,School of Public Health,Shandong University,Jinan 250012,China;Department of Non-Communicable Disease Prevention,Shandong Province Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东大学公共卫生学院流行病学系,济南250012 [2]山东省疾病预防控制中心慢性非传染性疾病防制所,济南250014

出　　处：《中华疾病控制杂志》2024年第8期929-936,共8页Chinese Journal of Disease Control & Prevention

基　　金：国家卫生健康委山东省人民政府联合三减控三高项目(2019)。

摘　　要：目的 分析山东省居民尿钠钾水平与高血压患病风险及血压水平的关系。方法 2019年在山东省选取18~69岁居民进行问卷调查、体格测量及随机点尿采集。通过Tanaka公式以点尿估计24 h尿钠钾水平,采用限制性立方样条、logistic回归分析模型和线性回归分析模型分析24 h尿钠钾水平与高血压患病风险及血压水平的剂量-反应关系及关联模式,并按年龄、性别和是否服用降压药进行亚组分析。结果 共纳入3 280人,24 h尿钠、尿钾及尿钠钾比为(4.12±0.95)g/d、(1.70±0.39)g/d和(2.51±0.69)。24 h尿钠升高1 g/d,收缩压升高1.221 mmHg(95%CI:0.611~1.830,P<0.001)、舒张压升高0.612 mmHg(95%CI:0.201~1.023,P=0.004),24 h尿钾升高1 g/d,收缩压降低2.297 mmHg(95%CI:-3.797~-0.796,P=0.003)、舒张压降低1.159mmHg(95%CI:-2.171~-0.147,P=0.025)。与尿钠钾比<2.0组相比,≥2.9组高血压患病风险增加37%(95%CI:1.062~1.769,P=0.015),收缩压升高3.047 mmHg(95%CI:1.470~4.624,P<0.001),舒张压升高1.796 mmHg(95%CI:0.734~2.859,P=0.001)。除性别和尿钾与收缩压的关联存在相乘交互作用(P=0.015),其他指标无交互作用。结论 随尿钠升高、尿钾降低,高血压患病风险、收缩压和舒张压均呈上升趋势,随机点尿用于大型流行病学调查中评估高血压患病风险具有一定科学性。Objective To analyze the association between urinary sodium and potassium excretion with the risk of hypertension and blood pressure levels among adults in Shandong Province,China.Methods Residents aged 18-69 years were selected for questionnaire survey,physical examination,and random spot urine collection in Shandong Province in 2019.The 24 hour urinary sodium and potassium excretion was estimated by spot urine through the Tanaka formula.Dose-response relationship and association of 24 hour urinary sodium and potassium excretion with the risk of hypertension and blood pressure levels using restricted cubic spline,logistic regression models,and linear regression models.Subgroup analyses were conducted according to different ages,genders,and antihypertensive drug usage.Results A total of 3280 subjects were included,24 hour urinary sodium,urinary potassium and urinary sodium-potassium ratios were(4.12±0.95)g/d,(1.70±0.39)g/d and(2.51±0.69).For every 1g/d increase in sodium excretion,systolic blood pressure increases by 1.221 mmHg(95%CI:0.611-1.830,P<0.001),and diastolic blood pressure increases by 0.612 mmHg(95%CI:0.201-1.023,P=0.004).For every 1g/d increase in potassium excretion,systolic blood pressure decreases by 2.297 mmHg(95%CI:-3.797--0.796,P=0.003)and diastolic blood pressure decreases by 1.159 mmHg(95%CI:-2.171--0.147,P=0.025).Compared with the group with a urinary sodium-potassium ratio of<2.0,the≥2.9 group increases the risk of hypertension by 37%(95%CI:1.062-1.769,P=0.015),with an increase in systolic blood pressure of 3.047 mmHg(95%CI:1.470-4.624,P<0.001)and diastolic blood pressure of 1.796 mmHg(95%CI:0.734-2.859,P=0.001).There was no interaction for any of the metrics except for a multiplicative interaction for gender and urinary potassium in the association with systolic blood pressure(P=0.015).Conclusions With the increase of urinary sodium and the decrease of urinary potassium,the risk of hypertension,systolic blood pressure and diastolic blood pressure all increase,and the use of random spot

关 键 词：尿钠钾排泄 高血压 收缩压 舒张压 

分 类 号：R181.23[医药卫生—流行病学]