期刊
HYPERTENSION RESEARCH
卷 42, 期 10, 页码 1590-1598出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/s41440-019-0263-1
关键词
Sodium-to-potassium ratio; sodium; potassium; casual urine; 24-h urine excretion
资金
- JSPS KAKENHI [JP 18K17377]
- Council on Epidemiology and Prevention of the World Heart Federation (Geneva, Switzerland)
- World Health Organization (Geneva, Switzerland)
- Wellcome Trust (London, United Kingdom)
- National Heart, Lung, and Blood Institute, National Institutes of Health (Bethesda, MD)
- Heart and Stroke Foundation of Canada (Ottawa, ON)
- British Heart Foundation (London, Great Britain)
- Japan Heart Foundation (Tokyo, Japan)
- Netherlands Heart Foundation (Den Haag, Netherlands)
- Chicago Health Research Foundation (Chicago, IL)
- Belgian National Research Foundation (Brussels, Belgium)
- Parastatal Insurance Company (Brussels, Belgium)
- National Institute for Health Research (NIHR) Imperial College Healthcare NHS Trust (ICHNT) and Imperial College Biomedical Research Centre (BRC)
- Medical Research Council (MRC)-Public Health England (PHE) Centre for Environment and Health [MRC G0801056]
- NIHR Health Protection Research Unit in Health Impact of Environmental Hazards [HPRU-2012-10141]
- UK MEDical BIOinformatics partnership (UK MED-BIO)
- MRC [MR/L01632X/1]
- MRC as part of the Dementia Research Institute at Imperial College London
- International Society of Hypertension (Ware, United Kingdom)
- MRC [G0801056, MR/L01632X/1, MR/L01341X/1] Funding Source: UKRI
The Na/K ratio may be more strongly related to blood pressure and cardiovascular disease than sodium or potassium. The casual urine Na/K ratio can provide prompt on-site feedback, and with repeated measurements, may provide useful individual estimates of the 24-h ratio. The World Health Organization has published guidelines for sodium and potassium intake, but no generally accepted guideline prevails for the Na/K ratio. We used standardized data on 24 h and casual urinary electrolyte excretion obtained from the INTERSALT Study for 10,065 individuals aged 20-59 years from 32 countries (52 populations). Associations between the casual urinary Na/K ratio and the 24-h sodium and potassium excretion of individuals were assessed by correlation and stratification analyses. The mean 24-h sodium and potassium excretions were 156.0 mmol/24 h and 55.2 mmo1/24 h, respectively; the mean 24-h urinary Na/K molar ratio was 3.24. Pearson's correlation coefficients (r) for the casual urinary Na/K ratio with 24-h sodium and potassium excretions were 0.42 and -0.34, respectively, and these were 0.57 and -0.48 for the 24-h ratio. The urinary Na/K ratio predicted a 24-h urine Na excretion of <85 mmol/day (the WHO recommended guidelines) with a sensitivity of 99.7% and 94.0%, specificity of 39.5% and 48.0%, and positive predictive value of 96.3% and 61.1% at the cutoff point of 1 in 24 h and casual urine Na/K ratios, respectively. A urinary Na/K molar ratio <1 may be a useful indicator for adherence to the WHO recommended levels of sodium and, to a lesser extent, the potassium intake across different populations; however, cutoff points for Na/K ratio may be tuned for localization.
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