Impact of urinary sodium excretion on the prevalence and incidence of metabolic syndrome: a population-based study

The dose-response relationships between all-cause and cardiovascular mortality and the accrual of various dietary habits

Objective

To evaluate the potential dose-response relationships of all-cause and cardiovascular death with the accumulation of various dietary habits.

Setting

A prospective cohort study.

Methods

Twenty-three dietary habits were assessed through face-to-face interviews with 57,737 participants in health check-up programs from 2015 to 2021. The total score of various dietary habits was calculated as the sum of each dietary habit multiplied by its own full-adjusted coefficient (β) for all-cause mortality in Cox proportional hazard models. Cox proportional hazard models were fitted for the associations of total and cause-specific mortality with the scores of various dietary habits.

Results

1,692 deaths occurred after the earliest check-ups in our center, followed up for a median time of 2.14 years (range: 1.01-7.71 years). Total mortality was 11.23/1,000 person-years, and the mean scores of dietary habits were 2.83±2.14. All-cause mortality increased significantly with the cumulative score of dietary habits (the highest quartile vs. lowest quartile: adjusted hazard ratio [AHR], 1.72; 95 % confidence interval [CI], 1.49-1.99; Plinear <0.01). Significance was also found for cardiovascular disease (CVD) mortality (HR, 1.82; 95 % CI, 1.47-2.27; Plinear <0.01), cancer mortality (AHR, 1.59; 95 % CI, 1.23-2.04; Plinear <0.01), and other-cause mortality (AHR, 2.00; 95 % CI, 1.46-2.73; Plinear <0.01). These dose-response trends were more significant in total mortality and CVD mortality among middle-aged adults, and non-obese population.

Conclusions

The greater the accumulation of diverse dietary habits, the higher the total mortality, CVD mortality, cancer mortality, and other mortality. This additive effect was particularly pronounced in the risk of death among middle-aged individuals and those with average body statures.

Sex difference in the relationship between 24-h sodium-potassium ratio and prevalence of metabolic syndromes: a cross-sectional study

Maintaining a balanced ratio between sodium and potassium intake is one of the most important dietary and lifestyle factors in the development of metabolic syndrome (MetS), but available evidence is still limited, particularly when using urine samples to estimate this ratio. We aim to evaluate the associations between the 24-h urinary sodium-potassium ratio (24hUNa/KE) and MetS risk through a large health check-up program in China. This cross-sectional study analyzed health check-up data from 59,292 participants at the Third Xiangya Hospital's Department of Health Management in Changsha, China, from 2018 to 2021. Each participant gave one fasting urine sample to analyze sodium, potassium, and creatinine levels during the check-up. The Kawasaki formula estimated 24-h urinary sodium (24hUNaE) and potassium excretion (24hUKE), with the 24hUNa/KE ratio calculated by dividing 24hUNaE by 24hUKE. The prevalence of MetS was found to be 19.27%. Notably, the overall MetS prevalence was higher in men (28.08%) than in women (7.83%). In women, MetS prevalence increased from 6.35 to 10.30% across the lowest to highest 24hUNa/KE quartiles. A significant increase in MetS prevalence was associated with each standard deviation increase in 24hUNa/KE (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI] 1.01-1.06), particularly for central obesity (AOR, 1.04; 95% CI 1.02-1.06) and elevated blood pressure (AOR, 1.20; 95% CI 1.17-1.22). In women, a one standard deviation increase in the 24hUNa/KE ratio raised the risk of MetS by 9% (AOR, 1.09; 95% CI 1.05-1.14), but no significant link was found in men. A strong positive link exists between 24hUNa/KE and MetS and its components, especially central obesity and high blood pressure, with a more significant effect in women.

Elevated serum levels of leukocyte cell-derived chemotaxin 2 are associated with the prevalence of metabolic syndrome

AIMS

Inflammation is central to the pathogenesis of metabolic syndrome (MetS). Leukocyte cell-derived chemotaxin 2 (LECT2) is constitutively secreted in response to inflammatory stimuli and oxidative stress contributing to tissue or systemic inflammation. We explored the relationship between LECT2 levels and MetS severity in humans and mice.

METHODS

Serum LECT2 levels were measured in 210 participants with MetS and 114 without MetS (non-MetS). LECT2 expression in the liver and adipose tissue was also examined in mice fed a high-fat diet (HFD) and genetically obese (ob/ob) mice.

RESULTS

Serum LECT2 levels were significantly higher in MetS participants than in non-MetS participants (7.47[3.36-17.14] vs. 3.74[2.61-5.82], P < 0.001). Particularly, serum LECT2 levels were significantly elevated in participants with hypertension, central obesity, diabetes mellitus (DM), hyperglycaemia, elevated triglyceride (TG) levels, and reduced high-density lipoprotein cholesterol (HDL-C) levels compared to those in participants without these conditions. Pearson's correlation analysis showed that serum LECT2 levels were positively associated with conventional risk factors in all patients. Moreover, LECT2 was positively associated with the number of MetS components (r = 0.355, P < 0.001), indicating that higher serum LECT2 levels reflected MetS severity. Multivariate regression analysis revealed that a one standard deviation increase in LECT2 was associated with an odds ratio of 1.52 (1.01-2.29, P = 0.044) for MetS prevalence after adjusting for age, sex, body mass index, waist circumference, smoking status, white blood cell count, fasting blood glucose, TG, total cholesterol, HDL-C, blood urea nitrogen, and alanine aminotransferase. Receiver operating characteristic curve analysis confirmed the strong predictive ability of serum LECT2 levels for MetS. The optimum serum LECT2 cut-off value was 9.05. The area under the curve was 0.73 (95% confidence interval 0.68-0.78, P < 0.001), with a sensitivity and specificity of 45.71% and 95.61%, respectively. Additionally, LECT2 expression levels were higher at baseline and dramatically enhanced in metabolic organs (e.g. the liver) and adipose tissue in HFD-induced obese mice and ob/ob mice.

CONCLUSIONS

Increased LECT2 levels were significantly and independently associated with the presence and severity of MetS, indicating that LECT2 could be used as a novel biomarker and clinical predictor of MetS.