ESH2018丨钠盐摄入量对中国成人血浆及尿液中尿酸水平影响的干预性研究

2018-06-17 西安交通大学第一附属医院牟建军教授研究团队 汪洋博士 国际循环

当地时间2018年6月10日下午,在ESH 2018年会“生活方式改变、血脂及钠盐”口头报告专场,西安交通大学第一附属医院的汪洋博士介绍了其所在牟建军教授团队开展的最新干预性研究结果。

当地时间2018年6月10日下午,在ESH 2018年会“生活方式改变、血脂及钠盐”口头报告专场,西安交通大学第一附属医院的汪洋博士介绍了其所在牟建军教授团队开展的最新干预性研究结果。

研究背景

高盐可通过导致内皮功能障碍、氧化应激、炎症等途径,参与心血管事件的发生与发展,过多的盐摄入会带来心血管事件的风险显著增加,而适度限盐则可降低这一风险。尿酸(UA)是人体内嘌呤代谢的终末产物,是痛风形成过程中重要的致病因子。大量既往观察性研究发现,血尿酸升高同样是诸多心血管终点事件的危险因素,而循环中的血尿酸水平,很大程度上受饮食的影响。目前,探讨盐摄入对尿酸代谢情况的研究非常有限,更鲜有研究探讨在人群中盐敏感性与尿酸代谢的关系。

研究目的

研究饮食盐摄入与尿酸水平的关系,并探讨尿酸与盐敏感性的关系。

研究方法与结果

在陕西省礼泉及蓝田两个村、纳入共90例受试者进行慢性盐负荷实验,即在3天基线期正常饮食之后,进行7天低盐饮食(3 g/天)干预,随后再进行7天高盐饮食(18.0 g/天)干预。分析显示,受试者的基线特征(图1)。



图1. 受试者基线特征

通过分析饮食干预前后受试者血、尿中尿酸水平发现,低盐饮食后受试者血尿酸水平出现升高,而在高盐饮食后血尿酸水平出现明显下降(图2a)。然而,尿中尿酸水平出现了与之相反的变化,低盐饮食干预后,尿中尿酸排泄出现下降,而高盐后,尿中尿酸排泄明显升高(图2b)。24小时尿钠排泄与血尿酸水平呈负相关(图2c)而与尿尿酸水平呈正相关(图2d)。



图2. 饮食干预对血尿酸水平和尿中尿酸排泄的影响

此外,通过从低盐期到高盐期血压水平的变化情况,研究者进一步将受试者分为盐敏感者与盐不敏感者,通过分析数据发现,与盐不敏感者相比,在盐干预之后,盐敏感者血尿酸水平变化较大(图3a、3b),且该变化与盐敏感程度呈负相关(图3c)。



图3. (a)血尿酸水平的变化;(b)盐敏感与盐不敏感者血尿酸变化情况;(c)血尿酸变化情况与盐敏感程度的关系。

结论

该研究通过对陕西农村地区90例受试者进行盐干预研究发现,饮食中盐摄入量的变化会影响血浆和尿液的尿酸水平,而血浆尿酸水平可能与盐敏感性的形成过程有关。该研究可能对阐明饮食对尿酸的影响,以及尿酸与盐敏感性高血压的关系提供理论依据。

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    2018-11-29 hongbochen
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    2019-03-09 lmm397
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    2018-06-27 沙漠浪人

    钠与尿酸

    0

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    2018-06-23 虈亣靌

    学习了涨知识了!

    0

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    2018-06-19 wfang549

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