农村社区高血压人群钠盐摄入水平及限盐行为的影响因素

目的了解农村社区高血压人群钠盐摄入水平及限盐行为的影响因素。方法采用随机整群抽样方法,选取临海市小芝镇2个农村社区的200名高血压患者和高危人群,开展为期一年的限盐行为干预,并在干预前后分别进行基线和终末调查,内容包括钠盐与高血压病知识、3 d氯化钠(NaCl)摄入量调查和尿钠检测等;分析限盐行为与NaCl摄入量的相关性;采用多因素Logistic回归分析限盐行为的影响因素。结果 173名调查对象在终末调查时每日NaCl摄入量的中位数(四分位数间距)为6.72(5.18)g,主要来源为食盐4.74(3.36)g/d和酱油0.04(0.63)g/d;每日尿钠排出量为90.10(62.28)mmol/24 h。拥有限盐勺152人(87.86%),正在使用108人(71.05%),能正确使用53人(49.07%);限盐勺使用频率与NaCl摄入量,及正确使用限盐勺与24 h尿钠排出量均呈负相关(P0.05);家庭年均收入水平高(OR=2.75,95%CI:1.16~6.53)、知晓每人每日6 g盐(OR=5.43,95%CI:1.22~24.07)、经常进食蔬菜(OR=9.35,95%CI:1.17~75.01)和主动采取控盐措施(OR=5.05,95%CI:1.19~21.45)的居民更倾向于使用限盐勺,饮酒(OR=0.13,95%CI:0.02~0.84)的居民不倾向于使用限盐勺。结论应针对NaCl摄入量高且不采取限盐行为的农村社区高血压人群开展钠盐知识健康教育,进一步推广限盐支持性工具的使用。     

肌酐校正尿碘指标的准确性研究

目的探索肌酐校正的尿碘指标估计尿碘排出量的准确性。方法在山东省德州市宁津县和陵县选取6所小学,间隔3w两次收集3~6年级全部儿童的一次性随机尿和24h尿。量取24h尿液体积,检测尿碘和肌酐浓度。计算得到实际24h尿碘排出量,而估计24h尿碘排出量则通过一次性随机尿尿碘肌酐的浓度比值乘以24h肌酐排出量得到。结果比较两次重复采样,随机尿的尿碘肌酐比值、24h尿碘浓度和24h尿碘排出量未见统计学差异(P0.05)。但是在每次采样中,估计24h尿碘排出量显著低于实际24h尿碘排出量(P0.001)。此外,在两次重复采样中,随机尿碘浓度(r_s=0.585,P0.001;r_s=0.570,P0.001),随机尿尿碘肌酐比值(r_s=0.620,P0.001;r_s=0.612,P0.001),估计24h尿碘排出量(r_s=0.843,P0.001;r_s=0.845,P0.001)分别与实际24h尿碘排出量呈良好线性关系。结论在学龄儿童中,由肌酐校正的一次性随机尿估计出的24h尿碘排出量,可以作为评价个体碘摄入量的有效指标。今后的研究有必要建立学龄儿童尿肌酐日排出量的标准。     

咸味喜好值、钠摄入量与24h尿钠相关性初探

目的初步探讨人群日常饮食的咸味喜好值、钠摄入量与24 h尿钠之间的相关性。方法筛选咸味喜好值低、中、高的对象共12名;为其提供3 d膳食,称重计算其每日钠摄入量,测定24 h尿钠总量;进一步对咸味喜好值、钠摄入量和24 h尿钠总量做相关性分析。结果咸味喜好值和钠摄入量之间呈正相关(r=0.598,P0.05),每日钠摄入量和24 h尿钠相关性未见统计学差异(r=0.543,P0.05)。结论通过咸味喜好值的现场测定评估食盐摄入量具有一定的参考价值。     

食盐摄入量与成人血压关系的横断面研究

目的了解食盐摄入量与成人血压的关系。方法采用多阶段整群随机抽样方法,对徐州市20个社区的9 788名≥18岁居民进行问卷调查和体格检查,运用线性回归探索食盐摄入量与血压的关系。结果高血压新发现率8.80%,调查对象食盐日均摄入量(10.00±7.60)g/d,高血压患者每日食盐摄入量高于其他两组人群,正常血压、正常高值血压和高血压人群食盐摄入量的差异具有统计学意义(P0.01)。不同性别不同食盐摄入量调查对象收缩压(F男=15.567,F女=42.026,P值均0.01)、舒张压(F男=8.201,F女=22.420,P值均0.01)差异均具有统计学意义。与食盐摄入量≤6g/d人群比较,未调整混杂因素前,食盐摄入量≥12g/d、6g/d的调查对象收缩压分别增加了2.389倍(95%CI:1.933~2.845)、3.078倍(95%CI:2.309~3.847),调整混杂因素后,分别增加了1.919倍(95%CI:1.470~2.368)、2.927倍(95%CI:2.206~3.648)。结论减少每日食盐摄入量是罹患高血压的保护因素。     

北京市顺义区成人尿钠与食盐摄入量的相关分析

目的准确了解北京市顺义区居民膳食中的食盐摄入量,针对高尿钠人群采取有效控制措施。方法采用分层整群随机抽样方法,对辖区内604户18岁以上1 425名居民进行调查,包括问卷资料、膳食调查和医学检查。内容包括年龄、职业、教育水平、婚姻状况、个人健康状况以及3日膳食摄入情况;医学体检包括测量身高、体重和24 h尿钠检测;采用双变量相关分析尿钠与食盐摄入量的相关性。结果 289份尿钠中位数为157.8 mmol,相当于9.22 g食盐,其中城市138.4 mmol(8.09 g),农村170.1 mmol(9.94 g),农村高于城市(P0.05);不同性别年龄间差异无统计学意义;729人膳食调查食盐摄入量中位数为9.8 g,其中城市8.8 g,农村10.3 g,农村高于城市(P0.05);不同性别年龄间差异无统计学意义;24 h尿钠与食盐摄入量呈正相关(r=0.139,P0.05)。结论北京市顺义区成人居民食盐摄入量、尿钠水平较高,应针对相关危险因素加强高尿钠人群的干预。     

安徽省某胃癌高发县40~69岁居民食盐及腌渍食物摄入与幽门螺杆菌感染状况的调查与分析

  目的   了解安徽省某胃癌高发县40~69岁常住居民食盐及腌渍食物摄入与幽门螺杆菌(helicobacter pylori, Hp)感染之间的关系。   方法   2015年7月-2018年8月在安徽省庐江县40~69岁居民中进行问卷调查和Hp血清学检测, 问卷着重调查食盐摄入量及腌渍食物食用频率, 按性别分析Hp感染与危险因素之间的关系, 单因素及多因素Logistic回归模型分析探讨相关影响因素。   结果   调查对象整体Hp感染率为50.07%, 男性居民年龄、体质指数(body mass index, BMI)、婚姻状况、文化程度、工作、劳动强度、经济收入与Hp感染均无关(均有P > 0.05), 女性居民BMI与Hp感染相关(χ2=13.454, P=0.001)。男性居民中, 饮酒是Hp感染的危险因素(OR=1.789, 95% CI:1.188~2.694, P=0.003), 但调整饮酒变量后的多因素分析显示男性食盐摄入量高及腌渍食物摄入频率高对Hp感染均无影响(均有P > 0.05);女性调查对象调整BMI变量后, 食盐摄入量高(≥9 g/d)是女性感染Hp的危险因素(OR=1.462, 95% CI:1.060~2.015, P=0.021), 腌渍食物摄入频率高(≥1次/d)是女性感染Hp的危险因素(OR=1.560, 95% CI:1.021~2.383, P=0.040)。   结论   在安徽省某胃癌高发县, 食盐摄入量高(≥9 g/d)及腌渍食物摄入频率高(≥1次/d)是40~69岁当地女性居民感染Hp的危险因素。     

碘用食物频率问卷对在校大学生碘摄入水平调查的应用研究

目的探讨针对北方在校大学生碘营养评价而设计的碘用食物频率问卷(I-FFQ)在个体碘摄入水平评估中的应用效果和反映个体实际碘摄入水平的能力。方法针对北方在校大学生设计一份评价其碘摄入水平的I-FFQ,选取30名志愿者,平均年龄(22.0±1.5)岁,对过去半年的膳食情况进行问卷调查,并用双份饭法收集连续3d的膳食样品进行碘含量测定同时收集3d 24h尿样测定尿碘排出量。结果 I-FFQ调查显示30位志愿者的平均碘摄入量为261.18μg/d,双份饭法3d膳食碘摄入量测定值为219.51μg/d,3d 24h尿碘排出量中位数为221.35μg/d。I-FFQ与双份饭结果显著相关(r=0.497,P=0.005),24h尿碘排出量占I-FFQ碘摄入量的86%,两者之间显著相关(r=0.471,P=0.009)。结论针对碘营养水平设计的I-FFQ问卷,简便易行,可以作为快速评价北方在校大学生个体碘摄入状况及碘营养水平的有效工具,为公众提供个体碘营养评价技术支撑。     

179名居民食盐摄入量及相关因素分析

目的了解滨湖区居民食盐摄入情况,为减盐政策制定提供科学依据。方法采用多阶段整群随机抽样的方法 ,抽取滨湖区18~69岁居民180名,进行询问调查、体格测量和尿液收集。比较并分析不同特征调查对象和以不同特征分层后各食盐摄入量组间高血压患病率的差异。结果滨湖区居民每日食盐摄入量约为11.09 g;性别、年龄、文化程度、婚姻状况、职业与居民食盐摄入量差异无统计学意义;≤6g/d、6~12g/d、12g/d,3组人群的血压偏高率差异有统计学意义(X~2=6.19,P=-0.045);居民减盐知识知晓率与减盐行为率均不高,但减盐意愿较高。结论 2014年我区人均每日食盐摄入量过高,血压水平与食盐摄入量有关,需要制定减盐干预策略,加强健康教育,防控高盐饮食危害。     

宜兴市孕妇和哺乳期妇女碘摄入量调查

目的对食盐加碘剂量作出评估。方法随机检测宜兴市五个乡(镇、街道)孕妇和哺乳期妇女的尿碘排泄量、食盐食用量和24 h排尿量,计算其碘摄入量、加碘食盐供给碘量和环境碘来源。结果 230例调查对象的尿碘排泄量为146μg/L、食盐食用量6.65 g/d和24 h排尿量水平为1.8 L;其碘摄入量、加碘食盐供给碘量和环境碘来源分别为262.8μg/d、154.7μg/d和108.1μg/d。结论宜兴市孕妇和哺乳期妇女碘摄入量高于国际组织新近推荐的碘摄入量200μg/d,碘营养充分。加碘食盐供给碘量在WHO规定的150～300μg/d安全范围之间,国家当前的食盐加碘剂量标准对宜兴市而言是适宜的。     

24h尿钠法评估汕头市社区居民钠盐摄入情况

目的了解汕头市社区居民钠盐摄入情况及钠钾比,为高血压防控措施的制定提供依据。方法采用整群随机抽样方法抽取汕头市澄海区、龙湖区和金平区164名18~90岁居民,进行现场问卷调查和体格检查,并收集24 h尿液,记录尿量后检测尿液中尿钠、尿钾以及尿肌酐的含量。用SPSS 19.0进行t检验、χ~2检验和Pearson相关分析。结果平均每人每天尿量为(1 692.0±607.1)ml,平均24 h尿钠含量为(130.95±54.99)mmol,尿钾含量为(46.98±24.00)mmol,尿肌酐为(7.47±2.41)mmol,钠钾比为3.32±2.02(男性为3.58±1.96,女性为3.25±2.04),转换为钠盐摄入量为(7.65±3.21)g/d[男性为(7.49±3.12)g/d,女性为(7.70±3.25)g/d]。24 h钠肌酐比值及钾肌酐比值女性均明显高于男性,差异均有统计学意义(P<0.05),而不同性别间24 h尿钠、尿钾含量及钠钾比差异均无统计学意义(P>0.05)。24 h尿钠含量随着体质指数(BMI)的增高而上升(r=0.296,P<0.01)。钠盐摄入量与收缩压和舒张压间均呈明显的正相关(r值分别为0.224、0.275,P<0.01)。结论汕头市社区居民钠盐摄入量高于中国居民膳食指南推荐摄入量,且钠盐摄入水平与血压水平间呈正相关,仍需进一步控制钠盐摄入达标及适当增加钾盐的摄入量。     

Formulas developed based on the ratio of urea nitrogen to creatinine concentrations obtained from multiple spot urine samples are acceptable to predict protein intake at group level but not at individual level

In this study, we hypothesized that spot urine can be used to predict protein intake at both group and individual levels. Participants (n = 369) of this study were recruited from all 47 prefectures in Japan. Sex-specific formulas were developed based on the ratio of urea nitrogen to creatinine concentration obtained from 3 spot urine samples. Validity of the formulas was examined against two 24-hour urine collections for 7 combinations of spot urine (single and means of 2 or 3 samples) using t test (mean estimation), Spearman correlation, and Bland-Altman plot (individual bias). Means of measured protein intake based on 24-hour urinary excretions were 87.3 g/d (standard deviation 19.7) for men and 70.5 g/d (standard deviation 14.7) for women. Irrespective of sex, the predicted intakes were not significantly different (within 2.7% of differences) from those measured by urinary excretions. Predicted intakes were moderately correlated with measured intakes (men, 0.45-0.60; women, 0.35-0.53). Even after using the mean of 3 samples, Bland-Altman plots showed a considerably wide limit of agreement (men, −30 to 33 g/d; women, −27 to 24 g/d). Except for using single spot urine samples in women, the formula tended to overestimate intake at a lower and underestimate at a higher level of protein intake (slope: men, −0.47 [P < .0001]; women, −0.38 [P = .002]). In conclusion, predictive formulas developed in this study can be used to predict protein intake at group level or to rank individuals' intake but not to predict absolute intake at individual level.     

Daily salt intake of healthy Japanese infants of 3-5 years based on sodium excretion in 24-hour urine

We measured concentrations of sodium and creatinine in previously validated overnight urine and 24-h urine of 79 healthy infants of 3 to 5 y of age in two cities in Miyagi Prefecture, Japan. Thereafter, we estimated daily salt intake from daily urinary sodium excretion and daily urinary volume. Corrections for potential sweat loss of sodium chloride were conducted based on urinary volume and urinary creatinine concentration. We also measured urinary volume and urinary sodium concentration in infants who failed to provide complete urine samples. The estimated salt intake did not differ between boys and girls, but varied between the two cities. The estimated salt intake per unit of body weight differed neither between genders nor between cities. The grand means for estimated salt intake and that per unit of body weight were 5.5 g/d (SD 1.8) and 0.32 g/kg/d (SD 0.10), which supported previous results both in Japan and abroad. It was also possible to roughly estimate salt intake from sodium concentration in overnight urine or incomplete 24-h urine, and published urine volume.     

Reliability of studies of iodine intake and recommendations for number of samples in groups and in individuals

The iodine intake level in a population is determined in cross-sectional studies. Urinary iodine varies considerably and the reliability of studies of iodine nutrition and the number of samples needed is unsettled. We performed a longitudinal study of sixteen healthy men living in an area of mild to moderate iodine deficiency. Iodine and creatinine concentrations were measured in spot urine samples collected monthly for 13 months. From these data we calculated the number of urine samples needed to determine the iodine excretion level for crude urinary iodine and for 24 h iodine excretion estimated from age- and gender-specific creatinine excretions. We found that mean urinary iodine excretion varied from 30 to 87 microg/l (31 to 91 microg/24 h). Sample iodine varied from 10 to 260 microg/l (20 to 161 microg/24 h). Crude urinary iodine varied more than estimated 24 h iodine excretion (population standard deviation 32 v. 26; individual standard deviation 29 v. 21; Bartlett's test, P < 0.01 for both). The number of spot urine samples needed to estimate the iodine level in a population with 95 % confidence within a precision range of +/- 10 % was about 125 (100 when using estimated 24 h iodine excretions), and within a precision range of +/- 5 % was about 500 (400). A precision range of +/- 20 % in an individual required twelve urine samples or more (seven when using estimated 24 h iodine excretions). In conclusion, estimating population iodine excretion requires 100-500 spot urine samples for each group or subgroup. Less than ten urine samples in an individual may be misleading.     

Dahl salt-sensitive rats excrete 25-hydroxyvitamin D into urine

The plasma 25-hydroxyvitamin D concentration of Dahl salt-sensitive rats (S) is markedly decreased in response to high sodium chloride (salt) intake. We tested the hypothesis that urinary excretion is a mechanism for the decrease. Female S rats excreted 0.26 +/- 0.04 nmol 25-hydroxyvitamin D/24 h at wk 2 of high salt (80 g/kg) intake, five times that of female salt-resistant (R) rats at wk 2 of high salt intake and nine times that of S rats at wk 2 of low salt (3 g/kg) intake. The 25-hydroxyvitamin D binding activity in 24-h urine of S rats was 79 +/- 11 pmol/h at wk 2 of high salt intake, two times that in urine of S rats at wk 2 of low salt intake and > 35 times that in urine of R rats at wk 2 of low or high salt intake. We conclude that markedly decreased plasma 25-hydroxyvitamin D concentrations of S rats during high salt intake result in part from excretion of protein-bound 25-hydroxyvitamin D. Low plasma 25-hydroxyvitamin D concentrations in humans may also result in part from salt sensitivity, which is prevalent in > 50% of the United States hypertensive population.     

青海省不同地区人群膳食摄碘水平调查

目的:调查青海省不同地区人群膳食碘摄入量,为科学补碘、持续消除碘缺乏危害提供依据。方法:2018-2019年,依据青海省行政区划、自然地理区划、人口分布和经济发展水平,共抽取14个调查点,每个调查点抽取1个村,每个村抽取20户世居者,采集每户家庭盐样、每个家庭成员24 h尿样,检测盐碘、尿碘;在每个村按东、西、南、北、...     

血中铅,镉水平与其尿排泄关系的研究

报道了肌酐代谢无明显异常的17名职业性铅、镉接触者在自由饮水情况下血中铅、镉水平与其尿排泄的关系。结果表明,血中铅、镉浓度以及铅、镉、肌酐的尿排泄存在明显的个体差异。血铅浓度与24h尿铅排泄量呈明显正相关,血镉浓度与24h尿镉排泄量无明显相关,而与每天吸烟量明显相关。17人的132份尿样的尿流速与肌酐、镉排泄率呈显著正相关,但与尿铅排泄率无显著相关。本研究还表明,尿中肌酐排泄率与尿铅、镉排泄率之间也有显著的正相关性。     

Human Exposure to Mercury and Silver Released from Dental Amalgam Restorations

In 35 healthy individuals, the number of amalgam surfaces was related to the emission rate of mercury into the oral cavity and to the excretion rate of mercury by urine. Oral emissions ranged up to 125 μg Hg/24 h, and urinary excretions ranged from 0.4 to 19 μg Hg/24 h. In 10 cases, urinary and fecal excretions of mercury and silver were also measured. Fecal excretions ranged from 1 to 190 μg Hg/24 h and from 4 to 97 μg Ag/24 h. Except for urinary silver excretion, a high interplay between the variables was exhibited. The worst-case individual showed a fecal mercury excretion amounting to 100 times the mean intake of total Hg from a normal Swedish diet. With regard to a Swedish middle-age individual, the systemic uptake of mercury from amalgam was, on average, predicted to be 12 μg Hg/24 h.     

Does degree of obesity influence the validity of reported energy and protein intake? Results from the SOS Dietary Questionnaire. Swedish Obese Subjects.

OBJECTIVE: To test the validity of a dietary questionnaire which was developed with the particular goal of measuring dietary intake in obese subjects. DESIGN: Reported energy intake was compared with 24 h energy expenditure measured in a chamber for indirect calorimetry (24 EE) and reported nitrogen intake with nitrogen in urine collected during the 24 h in the chamber. SUBJECTS: Twenty-nine overweight men and women, body mass index (BMI) ranging from 25.5 49.5 kg/m2. RESULTS: Reported energy intake correlated significantly with 24 EE (r = 0.50, P = 0.006) and reported urinary nitrogen correlated significantly with urinary nitrogen excretion (r=0.56, P=0.0015). Mean reported energy intake+/-s.d. was 10.2+/-3.6 MJ and mean 24 EEi s.d. was 10.3+/-1.9 MJ. Although this difference was small and non significant, it indicates some underreporting if one can assume that these overweight subjects are less physically active in the chamber than in free-living conditions. Reported nitrogen intake also suggested underreporting at the group level. However, when the data were analysed at the individual level it was clear that the underreporting errors did not increase with increasing degree of obesity. CONCLUSIONS: Previous studies with the SOS dietary questionnaire have demonstrated that it is possible to obtain plausible energy intakes from both obese and nonobese subjects. This present analysis further demonstrates that the questionnaire discriminates overweight subjects with high and low intakes of energy and protein, using unbiased biomarkers to judge validity. These data provide additional support for the usefulness of the SOS dietary questionnaire.     

Day-to-day and within-day variation in urinary iodine excretion.

OBJECTIVE: To examine the day-to-day and within-day variation in urinary iodine excretion and the day-to-day variation in iodine intake. DESIGN: Collection of consecutive 24-h urine samples and casual urine samples over 24h. SETTING: The study population consisted of highly motivated subjects from our Institute. SUBJECTS: Study 1: Ten healthy subjects (seven females and three males) aged 30-46 y. Study 2: Twenty-two healthy subjects (9 males and 13 females) aged 30-55 y. METHODS: Study 1: 24-h urine samples were collected for four consecutive days. Study 2: Each urine voided over 24 h was collected into separate containers. In both studies dietary records were kept. MAIN OUTCOME MEASURES: Twenty-four-hour urinary iodine excretion, 24-h urinary iodine excretion estimated as I/Cr*24 h Cr and as a concentration in casual urine samples. RESULTS: Study 1: Both iodine excreted in 24-h urine and iodine intake varied from day-to-day. Iodine excretion correlated with iodine intake (=-0.46, P=0.01). Iodine intake (mean 89 +/- 6.5 microg/d) was not significantly different from iodine excretion (mean 95 +/- 5.3 microg/d). Study 2: Twenty-four hour iodine excretion estimated as I/Cr*24 h Cr from the morning urine sample was significantly lower than actual 24-h iodine excretion, whereas 24-h iodine excretion estimated as I/Cr*24 h Cr from the first sample after the morning sample and the last sample before the subjects went to bed was not significantly different from actual 24-h iodine excretion. Twenty-four-hour urine excretion estimated as a concentration was lower than actual 24-h iodine excretion in casual urine taken at any time of the day. CONCLUSIONS: For determination of iodine status in an individual, more than one 24-h urine sample must be used. The use of the I/Cr ratio in casual urine samples is a usable measure of iodine status if corrected for the age- and sex-adjusted 24-h creatinine excretion. Further, the study suggests that fasting morning urine samples would underestimate iodine status in this population.     

Usual dietary consumption of soy foods and its correlation with the excretion rate of isoflavonoids in overnight urine samples among Chinese women in Shanghai

Soy foods and certain soy constituents, particularly isoflavones, have been suggested to have potential cancer-inhibitory effects in laboratory and epidemiological studies. Chinese women in Shanghai consume high levels of soy foods and have low incidence rates of breast and other hormone-related cancers. To assess the usual dietary consumption of soy foods and evaluate the correlation of soy food consumption with the urinary excretion of isoflavonoids in overnight urine samples in this population, we analyzed data from 60 healthy women included in an ongoing population-based case-control study of breast cancer in Shanghai. Usual consumption of soy foods in the previous five-year period was assessed using a food-frequency questionnaire, and urinary excretion of daidzein, genistein, glycitein, equol, and O-desmethylangolensin was measured from overnight urine samples collected at the time of dietary assessment. Virtually all women (96.7%) in Shanghai consumed soy foods at least once a week. The median intake of soy food was 100.6 g/day, with 25th and 75th percentiles of 36.8 and 238.2 g, respectively. The median intake of isoflavones was 39.26 mg/day, and there was a nearly fourfold difference between the 25th and 75th percentiles of this measurement. With the increasing intake of soy foods, urinary excretion rates of total isoflavonoids and all individual major isoflavonoids were increased in a dose-response manner (trend test p < or = 0.05). At individual levels the urinary excretion rate of total isoflavonoids was correlated closely with dietary soy food intake, with a correlation coefficient of around 0.5 (p < 0.001). These results indicate that the urinary excretion rate of total isoflavonoids measured from overnight urine samples may reflect reasonably well the usual intake of soy foods in a population with a high level of soy food consumption.