浙江省居民膳食硒摄入水平与高血压的关系研究
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摘要
目的分析浙江省居民膳食硒摄入水平与高血压的关系。方法采用分层多阶段整群抽样方法在浙江省抽取4个城市调查点和2个农村调查点,每个调查点抽取4个居委会或村,每个居委会或村抽取20户家庭,以所有家庭成员为调查对象,采用中国健康与营养调查项目问卷调查居民人口学特征和硒摄入量,进行体格检查和实验室检测,采用Logistic回归模型分析硒摄入水平与高血压的关系。结果膳食硒摄入量有效调查1 222人,其中硒摄入量不足平均需要量(EAR)的有729人,不足率为59.66%;硒摄入量在EAR和推荐摄入量(RNI)之间的有151人,占12.36%;硒摄入量在RNI和可耐受最高摄入量(UL)之间的有341人,占27.91%;硒摄入量≥UL的有1人。927名居民测量血压,检出高血压283例,高血压患病率为30.53%。高血压患者的硒摄入量平均为(43.06±20.96)μg/d,低于非高血压人群的(51.56±30.06)μg/d (P<0.05)。Logistic回归分析结果显示,调整年龄、体质指数、总胆固醇、三酰甘油和糖尿病患病情况后,硒摄入量是高血压的保护因素(OR=0.985,95%CI:0.978～0.993)。结论浙江省约60%的居民膳食硒摄入量低于平均需要量,增加硒摄入量可能降低高血压患病风险。
Objective To investigate the association between dietary selenium intake and hypertension among Zhejiang residents.Methods By multistage stratified random sampling method,four urban sites and two rural sites out of Zhejiang Province,four communities or villages out of each site,then 20 households out of each community or village were selected,and all the family members of the selected households were recruited as participants. The questionnaire of Chinese Health and Nutrition Survey was used to collect information about socio-demographic characteristics and dietary selenium intake. The blood pressure,blood lipid and other data were collected via physical examination. A multivariate logistic regression model was used to analyze the relationship between dietary selenium intake and hypertension. Results A total of 1222 participants with complete dietary selenium intake data were included for analysis. The number(%) of participants with selenium intake higher than the level of estimated average requirement (EAR), between the levels of EAR and recommanded nutrient intake(RNI), between the levels of RNI and upper intake (UI) and higher than the level of UI were 729(59.66%),151(12.36%),341(27.91%) and 1(0.01%),respectively. There were 283(30.53%) patients with hypertension out of 927 participants examined. The mean amount of selenium intake in patients with hypertention was(43.06±20.96) μg/d,which was significantly lower than (51.56±30.06)μg/d in non-hypertention participants(P<0.05). After adjusting for age,body mass index,total cholesterol,triglyceride and diabetes mellitus in the multivariate logistic regression model, dietary selenium intake significantly reduced the risk of hypertension(OR=0.985,95%CI:0.978-0.993). Conclusion About 60% of residents in Zhejiang Province had lower dietary selenium intake than estimated average requirement. Higher selenium intake was associated with lower risk of hypertension.
Objective To investigate the association between dietary selenium intake and hypertension among Zhejiang residents.Methods By multistage stratified random sampling method,four urban sites and two rural sites out of Zhejiang Province,four communities or villages out of each site,then 20 households out of each community or village were selected,and all the family members of the selected households were recruited as participants. The questionnaire of Chinese Health and Nutrition Survey was used to collect information about socio-demographic characteristics and dietary selenium intake. The blood pressure,blood lipid and other data were collected via physical examination. A multivariate logistic regression model was used to analyze the relationship between dietary selenium intake and hypertension. Results A total of 1222 participants with complete dietary selenium intake data were included for analysis. The number(%) of participants with selenium intake higher than the level of estimated average requirement (EAR), between the levels of EAR and recommanded nutrient intake(RNI), between the levels of RNI and upper intake (UI) and higher than the level of UI were 729(59.66%),151(12.36%),341(27.91%) and 1(0.01%),respectively. There were 283(30.53%) patients with hypertension out of 927 participants examined. The mean amount of selenium intake in patients with hypertention was(43.06±20.96) μg/d,which was significantly lower than (51.56±30.06)μg/d in non-hypertention participants(P<0.05). After adjusting for age,body mass index,total cholesterol,triglyceride and diabetes mellitus in the multivariate logistic regression model, dietary selenium intake significantly reduced the risk of hypertension(OR=0.985,95%CI:0.978-0.993). Conclusion About 60% of residents in Zhejiang Province had lower dietary selenium intake than estimated average requirement. Higher selenium intake was associated with lower risk of hypertension.
引文
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[20]COMBS G F.Biomarkers of selenium status[J].Nutrients,2015,7(4):2209-2236.
[21]HE M J,ZHANG S Q,MU W,et al.Selenium in infant formula milk[J].Asia Pacific Journal of Clinical Nutrition,2018,27(2):284-292.
[22]OGAWA-WONG A N,BERRY M J,SEALE L A.Selenium and metabolic disorders:an emphasis on type 2 diabetes risk[J].Nutrients,2016,8(2):80.
[23]GROTTO D,CARNEIRO M F H,CASTRO M M D,et al.Long-term excessive selenium supplementation induces hypertension in rats[J].Biological Trace Element Research,2017,182(1):1-8.
[24]SU L,JIN Y,UNVERZAGT F W,et al.Longitudinal association between selenium levels and hypertension in a rural elderly Chinese cohort[J].Journal of Nutrition Health&Aging,2016,20(10):983-988.
[2]袁丽君,袁林喜,尹雪斌,等.硒的生理功能、摄入现状与对策研究进展[J].生物技术进展,2016,6(6):396-405.
[3]LI Q,LIU M,HOU J,et al.The prevalence of keshan disease in China[J].International Journal of Cardiology,2013,168(2):1121-1126.
[4]LIU H,YU F,SHAO W,et al.Associations between selenium content in hair and kashin-beck disease/keshan disease in children in northwestern China:a prospective cohort study[J].Biological Trace Element Research,2018,184(1):16-23.
[5]GHARIPOUR M,SADEGHI M,BEHMANESH M,et al.Selenium homeostasis and clustering of cardiovascular risk factors:a systematic review[J].Acta bio-medica:Atenei Parmensis,2017,88(3):263-270.
[6]BALTACI A K,MOGULKOC R,AKIL M,et al.Reviewselenium-its metabolism and relation to exercise[J].Pakistan Journal of Pharmaceutical Sciences,2016,29(5):1719-1725.
[7]NAREGAL G V,DEVARANAVADAGI B B,PATIL S G,et al.Elevation of oxidative stress and decline in endogenous antioxidant defense in elderly individuals with hypertension[J].Journal of Clinical and Diagnostic Research,2017,11(7):BC09-BC12.
[8]KURUPPU D,HENDRIE H C,YANG L,et al.Selenium levels and hypertension:a systematic review of the literature[J].Public Health Nutrition,2014,17(6):1342-1352.
[9]ARNAUD J,AKBARALY T N,HININGER I,et al.Factors associated with longitudinal plasma selenium decline in the elderly:the EVA Study[J].Journal of Nutritional Biochemistry,2007,18(7):482-487.
[10]ZHANG B,ZHAI F,DU S,et al.The China health and nutrition survey,1989-2011[J].Obesity Reviews,2013,15(S1):2-7.
[11]中国营养学会.中国居民膳食营养素参考摄入量[M].北京:科学出版社,2014.
[12]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中国实用乡村医生杂志,2012,19(10):1-15.
[13]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):893-942.
[14]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,16(10):15-35.
[15]顾炜,周标,黄李春,等.城乡居民膳食硒摄入水平研究[J].浙江预防医学,2014,26(10):977-981.
[16]中华人民共和国国家卫生和计划生育委员会.中国居民营养与慢性病状况报告[R].北京:人民卫生出版社,2015.
[17]SALONEN J T,ALFTHAN G,HUTTUNEN J K,et al.Association between cardiovascular death and myocardial infarction and serum selenium in a matched-pair longitudinal study[J].Lancet,1982,320(8291):175-179.
[18]MIHAILOVIA M B,AVRAMOVIA D M,JOVANOVIA I B,et al.Blood and plasma selenium levels and gsh-px activities in patients with arterial hypertension and chronic heart disease[J].J Environ Pathol Toxicol Oncol,1998,17(3/4):285-289.
[19]黄益民,韩玲.硒对心肌缺血/再灌注期间冠状静脉窦血中红细胞流变性的保护作用[J].中华医学杂志,1998,78(2):101-104.
[20]COMBS G F.Biomarkers of selenium status[J].Nutrients,2015,7(4):2209-2236.
[21]HE M J,ZHANG S Q,MU W,et al.Selenium in infant formula milk[J].Asia Pacific Journal of Clinical Nutrition,2018,27(2):284-292.
[22]OGAWA-WONG A N,BERRY M J,SEALE L A.Selenium and metabolic disorders:an emphasis on type 2 diabetes risk[J].Nutrients,2016,8(2):80.
[23]GROTTO D,CARNEIRO M F H,CASTRO M M D,et al.Long-term excessive selenium supplementation induces hypertension in rats[J].Biological Trace Element Research,2017,182(1):1-8.
[24]SU L,JIN Y,UNVERZAGT F W,et al.Longitudinal association between selenium levels and hypertension in a rural elderly Chinese cohort[J].Journal of Nutrition Health&Aging,2016,20(10):983-988.