Being overweight worsens the relationship between urinary sodium excretion and albuminuria: the Wakuya study.
Journal
European journal of clinical nutrition
ISSN: 1476-5640
Titre abrégé: Eur J Clin Nutr
Pays: England
ID NLM: 8804070
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
09
02
2023
accepted:
03
08
2023
revised:
01
08
2023
medline:
9
11
2023
pubmed:
17
8
2023
entrez:
16
8
2023
Statut:
ppublish
Résumé
(Micro)albuminuria (a manifestation of renal microvascular damage) is an independent predictor of mortality risk, even when the urinary albumin/creatinine ratio is ≥ 10 mg/g in the general population. Excessive sodium intake and obesity are strong predictors of cardiovascular disease. However, the effect of obesity on the relationship between sodium intake and albuminuria is not fully understood. The purpose of the present study was to investigate the cross-sectional relationships among dietary sodium intake, obesity, and albuminuria in a general population cohort. Subjects were 928 apparently healthy adults. Body mass index was calculated using the height and body weight. Urinary sodium/creatinine and albumin/creatinine ratios were measured in spot urine samples. Estimated 24-h urinary sodium/creatinine ratio (e24UNa/Cr) was assessed using age, height, body weight, and spot urinary sodium/creatinine ratio. Both the body mass index and e24UNa/Cr positively correlated with the urinary albumin/creatinine ratio (both, P < 0.001), and had a synergistic effect on increasing urinary albumin/creatinine ratio independent of age, sex, mean arterial pressure, and diabetes (interaction P = 0.04). When subjects were divided into 6 groups according to the tertiles of e24UNa/Cr and body mass index < (normal-weight) or ≥ 25 (overweight), the prevalence rate of urinary albumin/creatinine ratio ≥ 10 mg/g increased with rising e24UNa/Cr and being overweight (P < 0.001). An increase in body mass index increases the positive association between urinary sodium excretion and (micro)albuminuria in the general population. Excess sodium intake may strengthen cardiovascular risk by increasing (micro)albuminuria, particularly in overweight individuals.
Sections du résumé
BACKGROUND/OBJECTIVES
(Micro)albuminuria (a manifestation of renal microvascular damage) is an independent predictor of mortality risk, even when the urinary albumin/creatinine ratio is ≥ 10 mg/g in the general population. Excessive sodium intake and obesity are strong predictors of cardiovascular disease. However, the effect of obesity on the relationship between sodium intake and albuminuria is not fully understood.
SUBJECTS/METHODS
The purpose of the present study was to investigate the cross-sectional relationships among dietary sodium intake, obesity, and albuminuria in a general population cohort. Subjects were 928 apparently healthy adults. Body mass index was calculated using the height and body weight. Urinary sodium/creatinine and albumin/creatinine ratios were measured in spot urine samples. Estimated 24-h urinary sodium/creatinine ratio (e24UNa/Cr) was assessed using age, height, body weight, and spot urinary sodium/creatinine ratio.
RESULTS
Both the body mass index and e24UNa/Cr positively correlated with the urinary albumin/creatinine ratio (both, P < 0.001), and had a synergistic effect on increasing urinary albumin/creatinine ratio independent of age, sex, mean arterial pressure, and diabetes (interaction P = 0.04). When subjects were divided into 6 groups according to the tertiles of e24UNa/Cr and body mass index < (normal-weight) or ≥ 25 (overweight), the prevalence rate of urinary albumin/creatinine ratio ≥ 10 mg/g increased with rising e24UNa/Cr and being overweight (P < 0.001).
CONCLUSION
An increase in body mass index increases the positive association between urinary sodium excretion and (micro)albuminuria in the general population. Excess sodium intake may strengthen cardiovascular risk by increasing (micro)albuminuria, particularly in overweight individuals.
Identifiants
pubmed: 37587243
doi: 10.1038/s41430-023-01327-2
pii: 10.1038/s41430-023-01327-2
pmc: PMC10630129
doi:
Substances chimiques
Sodium
9NEZ333N27
Creatinine
AYI8EX34EU
Sodium, Dietary
0
Albumins
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1044-1050Informations de copyright
© 2023. The Author(s).
Références
JAMA. 2007 Nov 21;298(19):2275-80
pubmed: 18029831
Lancet. 2010 Jun 12;375(9731):2073-81
pubmed: 20483451
Am J Kidney Dis. 2007 Dec;50(6):927-37
pubmed: 18037093
Am J Med Sci. 2002 Sep;324(3):127-37
pubmed: 12240710
Clin J Am Soc Nephrol. 2007 May;2(3):581-90
pubmed: 17699466
Nat Rev Nephrol. 2017 Mar;13(3):181-190
pubmed: 28090083
ScientificWorldJournal. 2022 Mar 23;2022:8110229
pubmed: 35370481
J Am Soc Nephrol. 2005 Jan;16(1):219-28
pubmed: 15563572
Am J Kidney Dis. 2003 Apr;41(4):733-41
pubmed: 12666059
Metab Syndr Relat Disord. 2017 Oct;15(8):416-422
pubmed: 28832275
Eur J Clin Nutr. 2012 Nov;66(11):1214-8
pubmed: 22909578
Clin J Am Soc Nephrol. 2007 Nov;2(6):1207-14
pubmed: 17942783
BMJ. 1996 May 18;312(7041):1249-53
pubmed: 8634612
Am J Clin Nutr. 2011 Oct;94(4):1071-8
pubmed: 21880845
J Intern Med. 2004 Oct;256(4):324-30
pubmed: 15367175
Lancet Diabetes Endocrinol. 2021 Jul;9(7):419-426
pubmed: 33989535
Diabetes Care. 2018 Nov;41(11):2414-2420
pubmed: 30217931
Am J Physiol Regul Integr Comp Physiol. 2006 May;290(5):R1294-301
pubmed: 16357094
Circulation. 2010 Jan 19;121(2):230-6
pubmed: 20038741
Hypertens Res. 2007 Oct;30(10):887-93
pubmed: 18049019
Hypertension. 2011 Nov;58(5):839-46
pubmed: 21968753
Circulation. 2006 Jun 27;113(25):2943-6
pubmed: 16801475
Lancet. 2018 Aug 11;392(10146):496-506
pubmed: 30129465
Circ J. 2002 Nov;66(11):987-92
pubmed: 12419927
N Engl J Med. 2002 Feb 7;346(6):393-403
pubmed: 11832527