摄盐量对2型糖尿病患者三酰甘油的影响
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摘要
目的:探讨2型糖尿病患者摄盐量与三酰甘油的关系。方法:选取2018年1至7月在哈尔滨医科大学附属第一医院住院的2型糖尿病患者,排除合并高血压、正在服用降脂药物、肾小球滤过率(e GFR)<60m L/min等可能影响研究结果的因素后,共选取597例。收集患者基本资料和住院期间的相关检验及检查。根据患者24h尿钠排泄水平估算日摄盐量。应用多因素logistic回归分析研究2型糖尿病患者摄盐量与高三酰甘油血症的关系。结果:在调整舒张压、体重指数(B M I)、年龄、血尿酸、总胆固醇等因素后,摄盐量的增加为高三酰甘油血症的独立危险因素(P<0.05)。结论:高盐摄入会增加2型糖尿病患者发生高三酰甘油血症的风险。
Objective: To explore the relationship between salt intake and triglyceride level in patients with type 2 diabetes.Methods: Excluding hypertension, taking lipid-lowering drugs, glomerular filtration rate <60 mL/min and other factors that may affect the results of the study, we classified 597 patients with type 2 diabetes, who were inpatients at the First Affiliated Hospital of Harbin Medical University in China from January 2018 to July 2018. Salt intake was estimated by 24-hour urine sample using the equation. The association between salt intake and triglyceride level were determined by logistic regression analysis. Results: After adjusting for diastolic blood pressure, BMI,age, blood uric acid, total cholesterol and other factors, high salt intake is the risk factor of hypertriglyceridemia in patients with type 2 diabetes(P<0.05). Conclusion: High salt intake may increase the risk of hypertriglyceridemia in patients with type 2 diabetes.
Objective: To explore the relationship between salt intake and triglyceride level in patients with type 2 diabetes.Methods: Excluding hypertension, taking lipid-lowering drugs, glomerular filtration rate <60 mL/min and other factors that may affect the results of the study, we classified 597 patients with type 2 diabetes, who were inpatients at the First Affiliated Hospital of Harbin Medical University in China from January 2018 to July 2018. Salt intake was estimated by 24-hour urine sample using the equation. The association between salt intake and triglyceride level were determined by logistic regression analysis. Results: After adjusting for diastolic blood pressure, BMI,age, blood uric acid, total cholesterol and other factors, high salt intake is the risk factor of hypertriglyceridemia in patients with type 2 diabetes(P<0.05). Conclusion: High salt intake may increase the risk of hypertriglyceridemia in patients with type 2 diabetes.
引文
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14.WHO Forum on Reducing Salt Intake in Populations.Reducing salt intake in populations:report of a WHO forum and technical meeting[R].Geneva:WHO,2007,1-55.
15.陈珏材,赵志钢,何洪波,等.2型糖尿病24 h尿钠排泄与脂代谢关系研究[J].中国实用内科杂志,2014,34(4):360-363.CHEN Yucai,ZHAO Zhigang,HE Hongbo,et al.Relationship between 24-h urinary sodium and lipid metabolism in patients with type 2 diabetes[J].Chinese Journal of Practical Internal Medicine,2014,34(4):360-363.
16.Lanaspa MA,Kuwabara M,Andres-Hernando A,et al.High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism[J].Proc Natl Acad Sci U S A,2018,115(12):3138-3143.
17.Pitynski-Miller D,Ross M,Schmill M,et al.A high salt diet inhibits obesity and delays puberty in the female rat[J].Int J Obes(Lond),2017,41(11):1685-1692.
18.Graudal NA,Hubeck-Graudal T,Jurgens G.Effects of low sodium diet versus high sodium diet on blood pressure,renin,aldosterone,catecholamines,cholesterol,and triglyceride(review)[J].Cochrane Database Syst Rev,2017,4:CD004022.
19.Mahmoudabady M,Kazemi N,Niazmand S,et al.The effect of angiotensin-converting enzyme inhibition on inflammatory and angiogenic factors in hypercholesterolemia[J].Pharmacol Rep,2015,67(5):837-841.
2.Taskinen MR.Diabetic dyslipidaemia:from basic research to clinical practice[J].Diabetologia,2003,46(6):733-749.
3.Mooradian AD.Dyslipidemia in type 2 diabetes mellitus[J].Nat Clin Pract Endocrinol Metab,2009,5(3):150-159.
4.Tada H,Kawashiri MA,Yamagishi M.Comprehensive genotyping in dyslipidemia:Mendelian dyslipidemias caused by rare variants and Mendelian randomization studies using common variants[J].Hum Genet,2017,62(4):453-458.
5.Tada H,Kawashiri MA.Genetic variations,triglycerides,and atherosclerotic disease[J].J Atheroscler Thromb,2019,26(2):128-131.
6.中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年)[J].中华糖尿病杂志,2018,10(1):4-67.Chinese Diabetes Society.Guidelines for the prevention and control of type 2 diabetes in China(2017 edition)[J].Chinese Journal of Diabetes Mellitus,2018,10(1):4-67.
7.Nomura K,Asayama K,Jacobs L,et al.Renal function in relation to sodium intake:a quantitative review of the literature[J].Kidney Int,2017,92(1):67-78.
8.Roy MS,Janal MN.High caloric and sodium intakes as risk factors for progression of retinopathy in type 1 diabetes mellitus[J].Arch Ophthalmol,2010,128(1):33-39.
9.Bell GM,Reid W,Ewing DJ,et al.Abnormal diurnal urinary sodium and water excretion in diabetic autonomic neuropathy[J].Clin Sci(Lond),1987,73(3):259-265.
10.Levey AS,Stevens LA,Schmid CH,et al.A new equation to estimate glomerular filtration rate[J].Ann Intern Med,2009,150(9):604-612.
11.Brown IJ,Ioanna T,Vanessa C,et al.Salt intakes around the world:implications for public health[J].Int J Epidemiol,2009,38(3):791-813.
12.Suckling RJ,He FJ,Markandu ND,et al.Modest salt reduction lowers blood pressure and albumin excretion in impaired glucose tolerance and type 2 diabetes mellitus a randomized double-blind trial[J].Hypertension,2016,67(6):1189-1195.
13.Horikawa C,Yoshimura Y,Kamada C,et al.Dietary sodium intake and incidence of diabetes complications in Japanese patients with type 2 diabetes:analysis of the Japan Diabetes Complications Study(JDCS)[J].J Clin Endocrinol Metab,2014,99(10):3635-3643.
14.WHO Forum on Reducing Salt Intake in Populations.Reducing salt intake in populations:report of a WHO forum and technical meeting[R].Geneva:WHO,2007,1-55.
15.陈珏材,赵志钢,何洪波,等.2型糖尿病24 h尿钠排泄与脂代谢关系研究[J].中国实用内科杂志,2014,34(4):360-363.CHEN Yucai,ZHAO Zhigang,HE Hongbo,et al.Relationship between 24-h urinary sodium and lipid metabolism in patients with type 2 diabetes[J].Chinese Journal of Practical Internal Medicine,2014,34(4):360-363.
16.Lanaspa MA,Kuwabara M,Andres-Hernando A,et al.High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism[J].Proc Natl Acad Sci U S A,2018,115(12):3138-3143.
17.Pitynski-Miller D,Ross M,Schmill M,et al.A high salt diet inhibits obesity and delays puberty in the female rat[J].Int J Obes(Lond),2017,41(11):1685-1692.
18.Graudal NA,Hubeck-Graudal T,Jurgens G.Effects of low sodium diet versus high sodium diet on blood pressure,renin,aldosterone,catecholamines,cholesterol,and triglyceride(review)[J].Cochrane Database Syst Rev,2017,4:CD004022.
19.Mahmoudabady M,Kazemi N,Niazmand S,et al.The effect of angiotensin-converting enzyme inhibition on inflammatory and angiogenic factors in hypercholesterolemia[J].Pharmacol Rep,2015,67(5):837-841.