利用三种点尿估算方法评估和验证中国人群24小时尿钠排泄量

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目的 :本研究旨在验证和评价Kawasaki、INTERSALT和Tanaka三种方法估算24 h尿钠排泄量在中国人群中应用的可行性和准确性。方法:本研究是前瞻性城乡流行病学研究(PURE)的子研究,抽取120名受试者(城乡各60名),同时收集受试者的空腹晨尿和24 h尿液标本,检测点尿和24 h尿液中钠、钾和肌酐水平。使用Bland-Altman法比较三种方法所估算出的24 h尿钠排泄量和实际尿钠排泄量之间的一致性。结果 :最终116名受试者被纳入到最终的统计分析。实测钠排泄的平均值为6 343 mg/d(约为盐16.2 g/d)。Kawasaki法是3种方法中偏差最小的,平均偏差值(估测值减24 h实际观察值)为-740.49 mg/d。Tanaka法的平均偏差值是-2 305.05 mg/d。差距最大的是INTERSALT法,平均偏差值为-2 797.39 mg/d。尽管与其他方法相比,Kawasaki法的估测值与24 h实测值之间的差距较小,Bland-Altman图显示仍有9人(7.76%)超出均数±1.96倍标准差的一致性界线。结论:Kawasaki法、INTERSALT法和Tanaka法三种方法估算中国城乡人群的24 h尿钠排泄量均存在不同程度的低估和局限,故需制定一个适合中国人群的估算24 h尿钠排泄量方法,从而更准确地评估中国人群的盐摄入量。 Objectives: This study was designed to validate and evaluate the feasibility and accuracy of Kawasaki, INTERSALT and Tanaka in estimating 24-h urinary sodium excretion in Chinese population. METHODS: This study was a prospective subproject of the PURE study in urban and rural areas. 120 subjects (60 in urban and rural areas) were enrolled in this study. Fasting morning urine and 24-hour urine samples were collected at the same time. Urine and 24 h urinary sodium, potassium and creatinine levels. The Bland-Altman method was used to compare the agreement between the 24 h urinary sodium excretion and the actual urinary sodium excretion estimated by the three methods. Results: The final 116 subjects were included in the final statistical analysis. The average measured sodium excretion was 6 343 mg / d (about salt 16.2 g / d). The Kawasaki method was the least biased among the three methods, with an average deviation of -740.49 mg / d from the 24 h observed value. The mean deviation of the Tanaka method was -2 305.05 mg / d. The largest difference was the INTERSALT method with an average deviation of -2 797.39 mg / d. Although the difference between the Kawasaki’s estimates and the 24-h observations was small compared with other methods, Bland-Altman plots showed that 9 (7.76%) exceeded the consensus line of mean ± 1.96 times the standard deviation . Conclusion: Kawasaki method, INTERSALT method and Tanaka method are three methods to estimate urinary sodium excretion in urban and rural populations of China in varying degrees of underestimation and limitations, it is necessary to develop a suitable Chinese population to estimate 24 h urinary sodium excretion method, So as to more accurately assess the salt intake of the Chinese population.
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