24 h尿钠、尿钾及钠钾比与微量白蛋白尿的关联分析

  目的  分析我国普通人群24 h尿钠、尿钾以及钠钾比与微量白蛋白尿(microalbuminuria, MAU)的关系。  方法  2018年在黑龙江省、河北省、四川省、湖南省、江西省、青海省的12个区县开展基线调查，采用问卷调查、体格测量以及24 h尿液收集的方法对抽取的18~75岁对象进行调查。采用多因素logistic回归分析模型分析24 h尿钠、尿钾以及钠钾比和MAU的相关性。  结果  最后纳入分析的研究对象共2 604名，年龄为(47.32±12.78)岁，男性有1 287人(49.42%)，MAU者共231人(8.87%)。24h尿量为(1 614.80±645.16)mL/d，尿钠为(193.07±78.87)mmol/d，尿钾为(40.18±16.59)mmol/d，钠钾比为(5.18±2.19)。随着24 h尿钠和钠钾比的增长，MAU的检出率均呈上升趋势(P_趋势 < 0.05)。多因素logistic回归分析模型分析结果显示，较高的24 h尿钠排泄量(Q5)与最低五分位数组(Q1)相比，MAU发生的风险增加(OR=2.211, 95% CI: 1.359~3.597)。较高的尿钠钾比水平(Q5)与最低五分位数组(Q1)相比，MAU发生的风险增加(OR=2.498，95% CI: 1.546~4.038)。  结论  24 h尿钠、钠钾比与MAU的发生呈正向关联，而24 h尿钾与MAU的发生无关。

Association between 24 h urinary sodium excretion,urinary potassium excretion,sodium-potassium ratio and microalbuminuria

  Objective  To analyze the association between 24 h urinary sodium excretion, urinary potassium excretion, sodium-potassium ratio, and microalbuminuria (MAU) among general people in China.  Methods  In 2018, a baseline survey was conducted in 12 counties of Heilongjiang, Hebei, Sichuan, Hunan, Jiangxi, and Qinghai Provinces. Subjects aged from 18 to 75 were selected as study subjects. All participants accepted the questionnaire survey, physical measurement, and 24 h urine collection. A multivariate logistic regression model was used to analyze the association between 24 h urinary sodium excretion, urinary potassium excretion, sodium-potassium ratio, and MAU.  Results  A total of 2 604 subjects were finally included in the analysis. The age of subjects was (47.32±12.78) years old, including 1 287 males (49.42%) and 231 (8.87%) MAU. The 24h urine volume was (1 614.80±645.16) ml/d, urinary sodium excretion was (193.07±78.87) mmol/d, urinary potassium excretion was (40.18±16.59) mmol/d, and sodium-potassium ratio was (5.18±2.19), respectively. With the increase of 24 h urinary sodium excretion and sodium-potassium ratio, the prevalence of MAU showed an upward trend (P_trend < 0.05). Multivariate logistic regression analysis showed that the higher urinary sodium excretion group (Q5) compared to the lowest group (Q1) was associated with an increased risk of MAU (OR=2.211, 95% CI: .359-3.597). Compared with the lowest group (Q1), the higher sodium-potassium ratio group (Q5) was associated with an increased risk of MAU (OR=2.498, 95% CI: 1.546-4.038).  Conclusions  The 24h urinary sodium and sodium-potassium ratio were positively associated with the prevalence of MAU, while 24h urinary potassium excretion is not related to the prevalence of MAU.