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Yamagishi M, Takachi R, Ishihara J, Maruya S, Ishii Y, Kito K, Nakamura K, Tanaka J, Yamaji T, Iso H, Iwasaki M, Tsugane S, Sawada N. Development and preliminary validation of a prediction formula of sodium and sodium-to-potassium ratio based on multiple regression using 24-h urines. Sci Rep 2024; 14:9704. [PMID: 38678054 PMCID: PMC11055847 DOI: 10.1038/s41598-024-60349-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
Accurate measurement of sodium intake in the diet is challenging, and epidemiological studies can be hampered by the attenuation of associations due to measurement error in sodium intake. A prediction formula for habitual 24-h urine sodium excretion and sodium-to-potassium ratio might lead to more reliable conclusions. Five 24-h urinary samples and two Food Frequency Questionnaires (FFQs) were conducted among 244 Japanese participants aged 35-80 years. We conducted multivariate linear regression analysis with urinary excretion as dependent variables and eating behaviour and food frequency as independent variables. Empirical weights of sodium excretion and sodium-to-potassium ratio were extracted. Preliminary validity was also assessed by randomly dividing the subjects into development and validation groups based on the correlation coefficient between estimates by the prediction formula and urinary excretion. Taste preference, soy sauce use at the table, frequency of pickled vegetables intake and number of bowls of miso soup were extracted as determinants of sodium excretion. Correlation coefficients between the estimates and urinary excretion for men and women were 0.42 and 0.43, respectively, for sodium and 0.49 and 0.50, respectively, for sodium-to-potassium ratio. This prediction formula may provide more accurate estimation of sodium intake and sodium-to-potassium ratio than the food composition approach.
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Affiliation(s)
- Marina Yamagishi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Kitauoyahigashimachi, Nara-shi, Nara, 630-8506, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Kitauoyahigashimachi, Nara-shi, Nara, 630-8506, Japan.
| | - Junko Ishihara
- Graduate School of Environmental Health, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, 252-5201, Japan
| | - Sachiko Maruya
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Kitauoyahigashimachi, Nara-shi, Nara, 630-8506, Japan
| | - Yuri Ishii
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kumiko Kito
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Niigata, 951-8510, Japan
| | - Junta Tanaka
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Niigata, 951-8510, Japan
| | - Taiki Yamaji
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroyasu Iso
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Motoki Iwasaki
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- International University of Health and Welfare Graduate School of Public Health, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Qi Z, Tang S, Wu B, Li Y, Yang H, Wang K, Li Z. Evaluation of three prediction formulas of 24-hour urinary sodium excretion in Chinese residents: a systematic review and meta-analysis. Public Health Nutr 2024; 27:e71. [PMID: 38305112 DOI: 10.1017/s1368980024000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To determine the appropriateness of three widely used formulas estimating 24-h urinary Na (24hUNa) from spot urine samples in the Chinese population. DESIGN Systematic review and meta-analysis. SETTING Literature review was conducted to identify studies for estimating 24hUNa using the Kawasaki, Tanaka and INTERSALT formulas simultaneously in PubMed, Embase and the Cochrane library databases. The mean difference (MD) and correlation coefficients (r) between measures and estimates from different formulas were assessed. PARTICIPANTS Information extraction and quality assessment were performed in thirteen studies involving 8369 subjects. RESULTS Two studies which affected the overall robustness were excluded in the 'leave-one-out' sensitivity analyses. Within the final meta-analysis included eleven studies and 7197 participants, 36·07 mmol/d (95 %CI 16·89, 55·25) of MD was observed in the Kawasaki formula, and -19·62 mmol/d (95 %CI -37·37, -1·87) in the Tanaka formula and -35·78 mmol/d (95 %CI -50·76, -20·80) in the INTERSALT formula; a pooled r-Fisher's Z of 0·39 (95 %CI 0·32, 0·45) in the Kawasaki formula, 0·43 (95 %CI 0·37, 0·49) in the Tanaka formula and 0·36 (95 %CI 0·31, 0·42) in the INTERSALT formula. Subgroup analyses were conducted to explore the possible factors affecting the accuracy of the formula estimation from three mainly aspects: population types, Na intake levels and urine specimen types. CONCLUSIONS The meta-analysis suggested that the Tanaka formula performed a more accurate estimate in Chinese population. Time of collecting spot urine specimens and Na intake level of the sample population might be the main factors affecting the accuracy of the formula estimation.
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Affiliation(s)
- Zijing Qi
- School of Public Health, Shanxi Medical University, Taiyuan031000, China
| | - Shuai Tang
- School of Public Health, Shanxi Medical University, Taiyuan031000, China
| | - Beike Wu
- School of Public Health, Harbin Medical University, Harbin150081, China
| | - Yanxing Li
- School of Public Health, Shanxi Medical University, Taiyuan031000, China
| | - Hongmei Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi046000, China
| | - Kunbo Wang
- CLASS 2202, Xiangya School of Medicine, Central South University, Changsha410000, China
| | - Zhifang Li
- School of Public Health, Shanxi Medical University, Taiyuan031000, China
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi046000, China
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Sardari Masihi L, Borumandnia N, Taheri M, Basiri A, Imani H, Jalali S, Tavasoli S. Effect of two vitamin D repletion protocols on 24-h urine calcium in patients with recurrent calcium kidney stones and vitamin D deficiency: a randomized clinical trial. Eur J Med Res 2023; 28:246. [PMID: 37481570 PMCID: PMC10362614 DOI: 10.1186/s40001-023-01226-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/13/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES To evaluate the effects of two vitamin D repletion therapies (cholecalciferol) on serum levels of 25-hydroxyvitamin D (25(OH)D) and 24-h urine calcium in patients with recurrent calcium kidney stones and vitamin D deficiency (VDD). DESIGN, SETTING, PARTICIPANTS A parallel-group randomized controlled clinical trial on patients who referred to Labbafinejad kidney stone prevention clinic, Tehran, Iran. From 88 recurrent calcium stone formers, 62 patients completed the study. The age of participants was 18-70 years who had serum 25(OH)D levels of 10-20 ng/ml. INTERVENTION Participants received oral cholecalciferol 2000 IU daily for 12 weeks or 50,000 IU weekly for 8 weeks. MAIN OUTCOME MEASURES Study variables including 24-h urine calcium, supersaturations of calcium oxalate and calcium phosphate, serum 25(OH)D and parathyroid hormone were measured at the beginning of the study and after 12 weeks. RESULTS The 24-h urine calcium significantly increased in both groups (β = 69.70, p < 0.001), with no significant difference between treatments. Both groups showed no significant change in the supersaturation levels of calcium oxalate and calcium phosphate. Serum levels of 25(OH)D increased significantly (β = 12.53, p < 0.001), with more increase in the 50,000 IU group (β = 3.46, p = 0.003). Serum parathyroid hormone decreased in both groups (p < 0.001). CONCLUSIONS Although both treatment protocols increased 24-h urine calcium, they did not increase the supersaturation state of calcium oxalate or calcium phosphate. Trial registration IRCT20160206026406N4, 13/08/2019.
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Affiliation(s)
- Lilit Sardari Masihi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Islamic Republic of Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No.103, Shahid Jafari St., Pasdaran Ave., Tehran, 1666668111 Islamic Republic of Iran
| | - Maryam Taheri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No.103, Shahid Jafari St., Pasdaran Ave., Tehran, 1666668111 Islamic Republic of Iran
| | - Abbas Basiri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No.103, Shahid Jafari St., Pasdaran Ave., Tehran, 1666668111 Islamic Republic of Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Islamic Republic of Iran
| | - Saba Jalali
- Human Nutrition, Faculty of Land and Food Systems, University of British Columbia, Vancouver, CA USA
| | - Sanaz Tavasoli
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No.103, Shahid Jafari St., Pasdaran Ave., Tehran, 1666668111 Islamic Republic of Iran
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Kos M, Nađ T, Stanojević L, Lukić M, Stupin A, Drenjančević I, Pušeljić S, Davidović Cvetko E, Mihaljević Z, Dumančić D, Jukić I. Estimation of Salt Intake in Normotensive and Hypertensive Children: The Role of Body Weight. Nutrients 2023; 15:nu15030736. [PMID: 36771442 PMCID: PMC9921955 DOI: 10.3390/nu15030736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The connection between increased dietary salt intake and arterial hypertension has been recognized for a long time, even in children. This study aimed to investigate salt consumption in normotensive and hypertensive children and evaluate their dietary habits. MATERIALS AND METHODS A total of fifty participants were included in this cross-sectional study: twenty-five normotensive children and 25 children of both sexes with essential arterial hypertension from 12-17 years old. Subjects' body mass index, waist-to-hip ratio, body composition and arterial blood pressure were measured, and their daily salt intake was calculated from 24-h urine samples. Using the food frequency questionnaire (FFQ), the data on the average daily total energy and food intakes were collected and analyzed using a suitable program. RESULTS Estimated daily salt intake was significantly higher in hypertensive compared to normotensive children, and this is positively associated with blood pressure and body mass index (BMI). Hypertensive children had significantly higher BMIs, which also positively correlated with blood pressure. Consistently, resting metabolic rate (kcal) is higher in hypertensive children compared to normotensive, and this is also associated with blood pressure. Reported energy intake is also enlarged in hypertensive compared to normotensive children and for both groups, levels are significantly higher than the recommended values. CONCLUSIONS Our study results confirm the relationship between daily salt consumption, blood pressure and body weight. Sodium consumption related to blood pressure and body weight among children. Cardiovascular disease prevention should start in early childhood by reducing salt intake and preventing overweight/obesity since these are two of the most important modifiable risk factors for hypertension.
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Affiliation(s)
- Martina Kos
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Tihana Nađ
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Lorena Stanojević
- Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Matea Lukić
- Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Ana Stupin
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Ines Drenjančević
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Silvija Pušeljić
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Erna Davidović Cvetko
- Lavoslav Ružička College of Applied Sciences of Vukovar, Županijska 50, HR-32000 Vukovar, Croatia
| | - Zrinka Mihaljević
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Dijana Dumančić
- Department of Diagnostic and Interventional Radiology, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Radiology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Ivana Jukić
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
- Correspondence: ; Tel.: +385-31512869
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Wang NX, McLean RM, Cameron C, Skeaff SA. The quantification of sodium intake from discretionary salt intake in New Zealand using the lithium-tagged salt method. Front Nutr 2023; 9:1065710. [PMID: 36741993 PMCID: PMC9893271 DOI: 10.3389/fnut.2022.1065710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Discretionary salt (added in cooking at home or at the table) is a source of sodium and iodine in New Zealand. The amount of discretionary salt consumed in a population has implications on policies regarding sodium and iodine. Sodium intake from discretionary salt intake has not been quantified in New Zealand. The aim of this study was to estimate the proportion of total sodium that comes from discretionary salt in adults using the lithium-tagged salt method. Methods A total of 116 healthy adults, who were not pregnant or breastfeeding, regularly consume home-cooked meals and use salt during cooking or at the table, aged 18-40 years from Dunedin, New Zealand were recruited into the study. The study took place over a 9-day period. On Day 1, participants were asked to collect a baseline 24-h urine to establish their normal lithium output. From Day 2 to Day 8, normal discretionary salt was replaced with lithium-tagged salt. Between Day 6 and Day 8, participants collected another two 24-h urine samples. A 24-h dietary recall was conducted to coincide with each of the final two 24-h urine collections. Urinary sodium was analysed by Ion-Selective Electrode and urinary lithium and urinary iodine were analysed using Inductively Coupled Plasma Mass Spectrometry. The 24-h dietary recall data was entered into Xyris FoodWorks 10. All statistical analysis were conducted using Stata 17.0. Results A total of 109 participants with complete 24-h urine samples were included in the analysis. From the 24-h urine collections, the median urinary excretion of sodium and iodine was 3,222 mg/24 h (25th, 75th percentile: 2516, 3969) and 112 μg/24 h (82, 134). The median estimated sodium intake from discretionary salt was 13% (25th, 75th percentile: 7, 22) of the total sodium intake or 366 mg/24 h (25th, 75th percentile: 186, 705). Conclusion The total sodium intake was higher than the suggested dietary target of 2,000 mg/day. In this sample of healthy adults 18 to 40 years old, 13% of total sodium intake derived from discretionary salt. Discretionary salt is an additional source of iodine if iodised salt is used. Policies to reduce sodium intake is recommended to include a range of strategies to target discretionary and non-discretionary sources of salt and will need to take into account the contribution of iodine from discretionary salt intake.
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Affiliation(s)
- Nan Xin Wang
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael M. McLean
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Claire Cameron
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Sheila A. Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,*Correspondence: Sheila A. Skeaff,
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Dong J, Yu X, Li X, Xiang S, Qin Y, Zhu S, Zheng J, Yan Y. Consistency between 3 days' dietary records and 24-h urine in estimating salt intake in children and adolescents. Front Public Health 2022; 10:1071473. [PMID: 36620268 PMCID: PMC9822649 DOI: 10.3389/fpubh.2022.1071473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to evaluate the salt intake in boarding school students and the consistency between salt intake measurements based on 24-h urine and weighed dietary records over 3 consecutive days in this population. Methods This was a school-based cross-sectional study. Overweight (including obesity) or hypertensive students aged 6-14 years and their normal counterparts were recruited for this study at three boarding schools in China. Three consecutive 24-h urine samples were collected from all participants. During the collection period of 24-h urine, the weighed diet records were collected in children who had all three meals at the school canteens on weekdays. Incomplete 24-h urine or dietary records were excluded from the analysis. Results The median salt excretion was 6,218 [4,636, 8,290] mg by 24-h urine and 120 (82.2%) consumed excess salt among the participants. The median salt intake was 8,132 [6,348, 9,370] mg by dietary records and 112 (97.4%) participants consumed excess salt than recommended in participants who have all three meals in the school canteens. In children with complete dietary records and 24-h urine, the level of salt intake estimated by 24-h urine accounted for 79.6% of the dietary records. Conclusion Our study showed that boarding school students consumed excessive salt from school canteens. Thus, policies or strategies targeting school canteens are urgently needed. Weighed dietary records are recommended if feasible.
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Affiliation(s)
- Jie Dong
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, Changsha, China,*Correspondence: Jie Dong ✉
| | - Xiaoran Yu
- Department of Center for Non-communicable Disease Management, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xun Li
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, Changsha, China
| | - Shiting Xiang
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, Changsha, China
| | | | - Shaolun Zhu
- The Middle School of Fengshu, Taoyuan, China
| | - Jie Zheng
- The Primary School of Qinglin, Taoyuan, China
| | - Yinkun Yan
- Department of Center for Non-communicable Disease Management, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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Levy J, Silva AM, De Carli E, Cacau LT, de Alvarenga JFR, Fiamoncini J, Benseñor IM, Lotufo PA, Marchioni DM. Biomarkers of Fruit Intake Using a Targeted Metabolomics Approach: an Observational Cross-Sectional Analysis of the ELSA-Brasil Study. J Nutr 2022; 152:2023-2030. [PMID: 35641174 DOI: 10.1093/jn/nxac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health. OBJECTIVES The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study. METHODS A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker. RESULTS Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB. CONCLUSIONS Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments.
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Affiliation(s)
- Jessica Levy
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Alexsandro Macedo Silva
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eduardo De Carli
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - José Fernando Rinaldi de Alvarenga
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Jarlei Fiamoncini
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Isabela Martins Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Ogawa F, Takachi R, Ishihara J, Yamagishi M, Maruya S, Ishii Y, Kito K, Nakamura K, Tanaka J, Yamaji T, Iso H, Iwasaki M, Tsugane S, Sawada N; JPHC-NEXT Protocol Validation Study Group. Dietary sodium sources according to four 3-d weighed food records and their association with multiple 24-h urinary excretions among middle-aged and elderly Japanese participants in rural areas. Br J Nutr 2022;:1-9. [PMID: 35978495 DOI: 10.1017/S0007114522002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reducing Na intake is an urgent global challenge, especially in East Asia and high-income Asia-Pacific regions. However, the sources of Na and their effects on urinary Na excretion have not been fully studied. We sought to clarify these sources and their association with urinary Na excretion. We examined four 3-d weighed food records and five 24-h urinary collections from each of 253 participants in Japan, aged 35-80 years, between 2012 and 2013. We compared the levels of Na according to four categories: foods contributing to discretionary or non-discretionary Na intake, the situation in which dishes were cooked and consumed, food groups and types of cuisine. We also conducted regression analysis in which 24-h urinary Na excretion was a dependent variable and the amounts of food intake in the four categories were independent variables. Levels of Na were the highest in discretionary intake (60·6 %) and in home-prepared dishes (84·0 %). Of the food groups, miso soup showed the highest percentage contribution to Na intake (13·3 %) after seasonings such as soya sauce. In the regression analysis, the standardised coefficient for foods of non-discretionary Na sources was larger than that for discretionary sources, whereas that for home-prepared dishes was consistent with the levels of Na in those foods. Pickled products, followed by fresh fish and shellfish, miso soup and rice, were associated with high urinary Na excretion. Thus, discretionary foods (such as miso soup) contribute the most to Na consumption, although non-discretionary intake (such as pickled vegetables) may influence urinary Na excretion.
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Bal C, Topcuoğlu C, Rıfat Balık A, Yılmaz FM, Erel Ö, Yılmaz G. The effect of acid use as a preservative on the results of biochemical tests measured in 24-h urine. Scand J Clin Lab Invest 2022; 82:329-333. [PMID: 35791842 DOI: 10.1080/00365513.2022.2092899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Twenty-four-hour urine measurements play a crucial role in the diagnosis, follow-up and treatment of various diseases. There are different approaches to the collection of urine in patients who need to collect multiple urine samples at a time, especially in hospitals with heavy workloads. In this study, we compared the sodium, potassium, chloride, amylase, calcium, creatinine, phosphorus, microalbumin, protein, magnesium, urea, uric acid, adrenaline, noradrenaline, dopamine, metanephrine, normetanephrine, vanillylmandelic acid, 5-hydroxyindoleacetic acid and homovanillic acid results of 24-h urine samples analyzed immediately without acid addition, which we accepted as the reference and baseline measurement, with the results of the samples analyzed after waiting for 24 h without acid addition, analyzed immediately with acid addition and analyzed after waiting for 24 h with acid addition. Chloride, microalbumin, amylase and protein tests, which are recommended to be measured in the sample without preservatives, are affected by acid addition. Adrenaline, noradrenaline and dopamine, which are the tests recommended to be measured in acid-added urine are degraded in the samples without acid, and the levels of metanephrine and normetanephrine were not significantly degraded in the absence of preservatives.
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Affiliation(s)
- Ceylan Bal
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Canan Topcuoğlu
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Rıfat Balık
- Department of Medical Biochemistry, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Fatma Meriç Yılmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Özcan Erel
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Gülsen Yılmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
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10
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Brachem C, Oluwagbemigun K, Langenau J, Weinhold L, Alexy U, Schmid M, Nöthlings U. Exploring the association between habitual food intake and the urine and blood metabolome in adolescents and young adults: a cohort study. Mol Nutr Food Res 2022; 66:e2200023. [PMID: 35785518 DOI: 10.1002/mnfr.202200023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/08/2022] [Indexed: 11/07/2022]
Abstract
SCOPE Habitual diet may be reflected in metabolite profiles that can improve accurate assessment of dietary exposure and further enhance our understanding of their link to health conditions. We aimed to explore the relationship of habitual food intake with blood and urine metabolites in adolescents and young adults. METHODS The study population comprised 228 participants (94 male and 134 female) of the DONALD study. Dietary intake was assessed by yearly repeated 3d-food records. Habitual diet was estimated as the average consumption of 23 food groups in adolescence. Using an untargeted metabolomics approach, we quantified 2638 metabolites in plasma and 1407 metabolites in urine. In each sex, we determined unique diet-metabolite associations using orthogonal projection to latent structures (oPLS) and random forests (RF). RESULTS We observed 6 metabolites in agreement between oPLS and RF in urine, 1 in females (vanillylmandelate to processed/ other meat) and 5 in males (indole-3-acetamide, and N6-methyladenosine to eggs; hippurate, citraconate/glutaconate, and X - 12111 to vegetables). We observed no association in blood in agreement. CONCLUSION We observed a limited reflection of habitual food group intake by single metabolites in urine and not in blood. The explored biomarkers should be confirmed in additional studies. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Christian Brachem
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115, Bonn, Germany
| | - Kolade Oluwagbemigun
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115, Bonn, Germany
| | - Julia Langenau
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115, Bonn, Germany
| | - Leonie Weinhold
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, 53127, Bonn, Germany
| | - Ute Alexy
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, 53127, Bonn, Germany
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115, Bonn, Germany.,Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
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11
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da Silva IBL, Amaro CP, Amaro JL, Cunha NB, Callegari MA, Yamamoto HA, Guerra R, Quitzan JG, Reis LO, Kawano PR. Fasting and 24-h urine pH in patients with urolithiasis using potassium citrate. Am J Clin Exp Urol 2022; 10:188-193. [PMID: 35874289 PMCID: PMC9301065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/21/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the correlation between the pH readings in 24-h urine and the random fasting specimen in patients with urolithiasis using 2 methods. METHODS A total of 114 patients with urinary lithiasis using potassium citrate were prospectively analyzed. All patients collected 24-h urine and an additional sample, after nocturnal fasting, collected on the day they brought the 24-h sample at the lab. Two different methods (test strip and digital meter) were used to determine pH values. RESULTS The pH analysis using strips in the 24-h urine presented a mean value similar to the one obtained in the fasting sample (6.07 ± 0.74 vs. 6.02 ± 0.82, respectively; P > 0.05). The same behavior was seen considering the readings with a digital pH meter (5.8 ± 0.78 vs. 5.75 ± 0.83; P > 0.05). However, readings conducted in the same specimen with pH meter and test strip were dissonant (P < 0.05), suggesting that the colorimetric method is not reliable in the assessment of urinary pH in this population. CONCLUSION pH assessment in a random urinary specimen proved as efficient as the 24-h urine standard method to monitor patients with kidney stones in the use of potassium citrate. Classical test strip analysis is not sensitive enough to evaluate the urine pH in this population and digital pH meter reading is preferred.
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Affiliation(s)
| | - Carmen Petean Amaro
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - João Luiz Amaro
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Natália Baraldi Cunha
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Matheus Augusto Callegari
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Hamilto Akihissa Yamamoto
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Rodrigo Guerra
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Juliany Gomes Quitzan
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
| | - Leonardo O Reis
- UroScience, University of Campinas, UNICAMP and Pontifical Catholic University of CampinasPUC-Campinas, Campinas-SP, Brazil
| | - Paulo Roberto Kawano
- Botucatu School of Medicine and Veterinary Medicine, UNESP-Univ. Estadual PaulistaBotucatu-SP, Brazil
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12
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Golpour-Hamedani S, Rafie N, Pourmasoumi M, Morteza Safavi S, Mohammadifard N. Sodium and potassium intakes and adiposity among Iranian pre-adolescents and adolescents: a cross-sectional study. Nutr J 2022; 21:23. [PMID: 35477471 PMCID: PMC9047328 DOI: 10.1186/s12937-022-00776-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/14/2022] [Indexed: 09/14/2023] Open
Abstract
Background High sodium and low potassium intakes are associated with the early development of chronic diseases (e.g., hypertension, obesity). Taking into account the limited data on sodium and potassium intakes by 24-h excretion in urine in pre-adolescents and adolescents, we wished to determine baseline salt intake in Iranian subjects aged 11–18 years. Methods This was an observational study involving 374 pre-adolescents and adolescents (154 boys and 220 girls). Sodium and potassium intakes were ascertained by measuring sodium and potassium excretion in urine over 24 h. Creatinine level was used to validate the completeness of the urine collections. The association between sodium and potassium intake and adiposity was determined based on body fat percentage. Results The mean 24-h urine sodium concentration was 3130 ± 2200 mg/day, equal to 7.961 ± 5.596 g/day salt intake. Approximately half of the study participants exceeded the upper limit of Na intake. The mean potassium intake was estimated 1480 ± 1050 mg/day. There was a positive association between urinary sodium excretion and adiposity in crude (OR 1.79; 95% CI: 1.08—2.74) and full adjusted model (OR: 3.15; 95% CI: 2.28–4.63). Also, in subsample analysis, there was a positive correlation between urinary sodium and adiposity in both pre-adolescents (OR: 2.71; 95% CI: 2.29—3.93) and adolescents (OR: 3.55; 95% CI: 2.17—4.74). However, no significant association was found between 24-h urinary potassium and adiposity. Conclusion Sodium intake, as estimated by 24-h urinary excretion, was higher than recommended and it was positively associated with adiposity. Also, this study reported low compliance of potassium intake recommendations in 11–18 years’ Iranian pre-adolescents and adolescents. Health promotion interventions are needed in order to broaden public awareness of high sodium intake and potassium inadequacy to reduce chronic diseases.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Rafie
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sayyed Morteza Safavi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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13
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Penczynski KJ, Cramer B, Dietrich S, Humpf HU, Abraham K, Weikert C. Mycotoxins in Serum and 24-h Urine of Vegans and Omnivores from the Risks and Benefits of a Vegan Diet (RBVD) Study. Mol Nutr Food Res 2022; 66:e2100874. [PMID: 35072972 DOI: 10.1002/mnfr.202100874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/17/2021] [Indexed: 11/05/2022]
Abstract
Scope Vegans might have a higher exposure to mycotoxins due to their heightened consumption of typical mycotoxin containing food sources. Yet, data on internal exposure among vegans in comparison to omnivores are currently lacking. Methods and Results This cross-sectional study included 36 vegans and 36 omnivores (50% females, 30-60 years). A set of 28 and 27 mycotoxins was analyzed in 24-h urine and serum samples, respectively, by validated multi-mycotoxin methods (HPLC-MS/MS). Ochratoxin A (OTA), 2'R-OTA, and enniatin B in serum as well as deoxynivalenol-glucuronide in 24-h urine were quantified in 57 to 100% of the samples. Serum OTA levels were twofold higher in vegans than in omnivores (median 0.24 versus 0.12 ng/mL; P <0.0001). No further significant differences were observed. Serum OTA levels were associated with intake of "vegan products" (r = 0.50, P <0.0001) and "pasta & rice" (r = 0.33, P = 0.006). Sensitivity analyses advise cautious interpretation. Furthermore, serum levels of 2'R-OTA were related to coffee consumption (r = 0.64, P <0.0001). Conclusion Our results indicate a higher exposure of vegans to OTA, but not to other mycotoxins. However, larger studies with repeated measurements are required to better evaluate the exposure to mycotoxins from plant-based diets. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Katharina J Penczynski
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Benedikt Cramer
- Institute of Food Chemistry, Westfälische Wilhelms-Universität Münster, Münster, 48149, Germany
| | - Stefan Dietrich
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Hans-Ulrich Humpf
- Institute of Food Chemistry, Westfälische Wilhelms-Universität Münster, Münster, 48149, Germany
| | - Klaus Abraham
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Cornelia Weikert
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
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14
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Tavasoli S, Borumandnia N, Basiri A, Taheri M. Effects of COVID-19 pandemics on urinary metabolites in kidney stone patients: our kidney stone prevention clinic experience. Environ Health Prev Med 2021; 26:112. [PMID: 34856919 PMCID: PMC8638224 DOI: 10.1186/s12199-021-01037-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/20/2021] [Indexed: 01/18/2023] Open
Abstract
Background The dietary habits and lifestyle changes during the COVID-19 pandemic could affect the urinary risk factors in kidney stone formers. In this study, we investigated the effects of the COVID-19 pandemic on 24-h urine metabolites, as a surrogate for dietary intake, in patients with kidney stones, in Tehran, Iran. Methods We evaluated the medical records of all patients with urolithiasis who visited in our stone prevention clinic from the beginning of COVID-19 in Iran to 1 year later (Feb 2020–Feb 2021) and compared it with the patients’ medical records in the same period a year before COVID-19 (Feb 2019–Feb 2020). Results The results of our stone prevention clinic showed a decrease in the number of visits during COVID-19. Twenty-four-hour urine urea, sodium, and potassium were significantly lower, and 24-h urine magnesium was significantly higher during COVID-19. Higher 24-h urine oxalate was only shown in patients with the first-time visit, whereas lower 24-h urine uric acid and citrate were only shown in patients with the follow-up visits. Conclusions COVID-19 pandemics may change some of the dietary habits of the patients, including lower salt, protein, and fruit and vegetable intake. Although economic issues, restricted access, or sanitation issues may be the reason for the undesirable dietary changes, the importance of a quality diet should be discussed with all patients, as possible. Since the number of patients visited in the stone clinic was lower during COVID-19, virtual visits could be an excellent alternative to motivate patients with kidney stones.
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Affiliation(s)
- Sanaz Tavasoli
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Abbas Basiri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Maryam Taheri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
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15
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Grez-Capdeville M, Crenshaw TD. Evaluation of calcium to phosphorus ratio in spot urine samples as a practical method to monitor phosphorus intake adequacy in sows. J Anim Sci 2021; 99:6427505. [PMID: 34791271 DOI: 10.1093/jas/skab335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/08/2021] [Indexed: 11/12/2022] Open
Abstract
The objective of this study was to evaluate the reliability of using Ca to P ratio measured in spot urine samples to assess P intake adequacy in gestating and lactating sows. A total of 36 sows were fed one of six concentrations of dietary total P (0.40%, 0.48%, 0.56%, 0.64%, 0.72%, and 0.80%) from day 7.5 ± 1 after breeding until the end of lactation (day 26.6 ± 1). Dietary Ca to P ratio was maintained constant across treatments at 1.25:1. Total 24-h urine samples were collected in mid- and late gestation (days 77.1 ± 2 and 112.4 ± 1), and early and late lactation (days 4.5 ± 1 and 18.2 ± 1). In parallel to 24-h collections, spot urine samples were collected at three different times (early morning, late morning, and late afternoon) in late gestation and late lactation. Urine Ca and P concentrations were measured and Ca to P ratio was calculated. Sows were classified as P-adequate or P-deficient according to dietary P intake. Urine Ca to P ratio was greater in sows fed P-deficient diets than sows fed P-adequate diets (P < 0.001). Receiver operating characteristic (ROC) curves were used to determine the cutoff values for urine Ca to P ratio to predict P intake adequacy. Three different categories of P intake were defined according to urine Ca to P ratio: deficient, adequate, and excessive. The area under the ROC for Ca to P ratio was 0.88 (95% CI 0.81 to 0.95). Best cutoff value of urine Ca to P ratio was 1.5 (sensitivity 94% and specificity 68%) to identify sows fed P-deficient diets and 0.5 for P-excessive diets (sensitivity 82% and specificity 82%). A strong relationship between Ca to P ratio in 24-h and spot urine samples was determined (r = 0.93, P < 0.01), independent of physiological state and collection time of spot samples (adjusted-R2 = 0.86, P < 0.01). The degree of agreement between spot and 24-h urine for P intake adequacy, assessed by Cohen's weighted kappa analysis, was substantial (0.78, 95% CI 0.69 to 0.88). We conclude that urinary Ca to P ratio provides a reliable prediction of the adequacy of P intake in reproducing sows. Urinary Ca to P ratio measurements in random spot urinary offers a practical method to determine dietary P adequacy.
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Affiliation(s)
- Mariola Grez-Capdeville
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Thomas D Crenshaw
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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16
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Tasevska N, Sagi-Kiss V, Palma-Duran SA, Barrett B, Chaloux M, Commins J, O'Brien DM, Johnston CS, Midthune D, Kipnis V, Freedman LS. Investigating the performance of 24-h urinary sucrose and fructose as a biomarker of total sugars intake in US participants - a controlled feeding study. Am J Clin Nutr 2021; 114:721-730. [PMID: 34036321 PMCID: PMC8326031 DOI: 10.1093/ajcn/nqab158] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Developing approaches for the objective assessment of sugars intake in population research is crucial for generating reliable disease risk estimates, and evidence-based dietary guidelines. Twenty-four-hour urinary sucrose and fructose (24uSF) was developed as a predictive biomarker of total sugars intake based on 3 UK feeding studies, yet its performance as a biomarker of total sugars among US participants is unknown. OBJECTIVES To investigate the performance of 24uSF as a biomarker of sugars intake among US participants, and to characterize its use. METHODS Ninety-eight participants, aged 18-70 y, consumed their usual diet under controlled conditions of a feeding study for 15 d, and collected 8 nonconsecutive 24-h urines measured for sucrose and fructose. RESULTS A linear mixed model regressing log 24uSF biomarker on log total sugars intake along with other covariates explained 56% of the biomarker variance. Total sugars intake was the strongest predictor in the model (Marginal R2 = 0.52; P <0.0001), followed by sex (P = 0.0002) and log age (P = 0.002). The equation was then inverted to solve for total sugars intake, thus generating a calibrated biomarker equation. Calibration of the biomarker produced mean biomarker-based log total sugars of 4.79 (SD = 0.59), which was similar to the observed log 15-d mean total sugars intake of 4.69 (0.35). The correlation between calibrated biomarker and usual total sugars intake was 0.59 for the calibrated biomarker based on a single biomarker measurement, and 0.76 based on 4 biomarker repeats spaced far apart. CONCLUSIONS In this controlled feeding study, total sugars intake was the main determinant of 24uSF confirming its utility as a biomarker of total sugars in this population. Next steps will include validation of stability assumptions of the biomarker calibration equation proposed here, which will allow its use as an instrument for dietary validation and measurement error correction in diet-disease association studies.
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Affiliation(s)
- Natasha Tasevska
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Virag Sagi-Kiss
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | | | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, USA
| | | | - John Commins
- Information Management Services, Inc., Rockville, MD, USA
| | - Diane M O'Brien
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Carol S Johnston
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Douglas Midthune
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Victor Kipnis
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Laurence S Freedman
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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17
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Qian N, Jiang Y, Wang Y, Yan P, Yao F, Sun M, Liu X, Zhang Y, Cheng Y, Lu Y, Song W. Validity of five formulas in estimating 24-h urinary sodium via spot urine sampling in hypertensive patients living in Northeast China. J Hypertens 2021; 39:1326-1332. [PMID: 33323909 PMCID: PMC8183493 DOI: 10.1097/hjh.0000000000002769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective was to evaluate the accuracy of five formulas -- the Kawasaki, Tanaka, INTERSALT, Mage, and Uechi methods -- using spot urinary sampling for 24-h urinary sodium (UNa) prediction in hypertensive patients living in northeast China. METHODS There were 1154 hypertensive patients enrolled from multiple centers. Five different formulas were used to predict 24-h UNa excretion via spot morning urinary samples. Actual UNa excretion was measured from 24-h urine samples. The estimated value was compared with the actual value by examining biases, the intraclass correlation coefficients (ICC), and Bland-Altman plots. RESULTS The average excretion of sodium was 2.97 ± 1.26 g/day. The formula-produced mean biases for actual UNa were 0.31 g/day for INTERSALT, 0.80 g/day for Mage, 0.88 g/day for Tanaka, 1.14 g/day for Uechi, and 1.95 g/day for Kawasaki. The ICC was 0.511 for Kawasaki, 0.499 for INTERSALT, 0.468 for Tanaka, 0.402 for Mage, and 0.378 for Uechi. The least mean bias in the lower and moderate salt intake subgroups was 1.22 and 0.07 g/day, respectively, which was calculated using the Mage and INTERSALT methods. The least mean bias in the higher salt intake subgroup was 0.10 g/day for the Uechi method. The INTERSALT method was more efficiency at the individual level, with 17.4% of participants having relative differences within 10%, and 22.3% participants having absolute differences within 393 mg. CONCLUSION The INTERSALT method may exhibit a good performance in estimating 24-h urinary sodium level for the hypertensive population living in northeast China.
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Affiliation(s)
- Ni Qian
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Yinong Jiang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Ying Wang
- Department of General Medicine, The First People's Hospital of Guiyang, Guiyang
| | - Peishi Yan
- Department of Cardiology, The Center Hospital of Dalian
| | - Fumei Yao
- Department of Cardiology, The 2 Hospital of Dalian
| | - Min Sun
- Department of Cardiology, The 3 Hospital of Dalian
| | - Xiaojie Liu
- Department of Cardiology, The Liaoyu Hospital of Dalian, Liaoning, China
| | - Ying Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Yunpeng Cheng
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Yan Lu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Wei Song
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
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18
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Xiang A, Nourian A, Ghiraldi E, Friedlander JI. Improving Compliance with 24-H Urine Collections: Understanding Inadequacies in the Collection Process and Risk Factors for Poor Compliance. Curr Urol Rep 2021; 22:38. [PMID: 34086154 DOI: 10.1007/s11934-021-01057-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review paper is to describe the 24-h urine collection in terms of its utility, collection process, and common problems with its acquisition. RECENT FINDINGS Although 24-h urine collections are standard of care for high-risk stone formers, several nuances in test acquisition including inaccurate urine collections 50% of the time and poor patient compliance limit its potential utility. Compliance in obtaining 24-h urine collections has been shown to be improved in patients who have not undergone surgical treatment of urinary calculi, patients with metabolic stone disease or family history of stone disease, Caucasian ethnicity, and in those with more sedentary occupations. Studies show conflicting data of compliance regarding patient age and gender. Physicians must understand the difficulties regarding 24-h urine collections including patient compliance, variability between collections, and complexities with interpretation to best utilize this tool in guiding clinical management for the treatment of nephrolithiasis.
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Affiliation(s)
- Alice Xiang
- Department of Urology, Einstein Healthcare Network, 1200 W. Tabor Road 3 Sley Building/MossRehab, Philadelphia, PA, 19141, USA
| | - Alex Nourian
- Department of Urology, Einstein Healthcare Network, 1200 W. Tabor Road 3 Sley Building/MossRehab, Philadelphia, PA, 19141, USA
| | - Eric Ghiraldi
- Department of Urology, Einstein Healthcare Network, 1200 W. Tabor Road 3 Sley Building/MossRehab, Philadelphia, PA, 19141, USA
| | - Justin I Friedlander
- Department of Urology, Einstein Healthcare Network, 1200 W. Tabor Road 3 Sley Building/MossRehab, Philadelphia, PA, 19141, USA.
- Division of Urologic Oncology and Urology, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
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19
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Marangella M, Petrarulo M, Ferraro PM, Miano R. [A comparison between 24h urine collection and overnight spot urines in evaluating the risk of stone disease]. G Ital Nefrol 2021; 38:38-1-2021-07. [PMID: 33599426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite being recommended by most guidelines, the metabolic evaluation of patients with nephrolithiasis has limited diffusion due to difficulties relating both to the access to laboratory investigations and to urine collection modalities. Consequently, in addition to the classical 24-h collection, alternative and simplified collection modes have been proposed. We report here on the comparison between metabolic evaluation carried out on 24-h double collection (Lithotest) and overnight spot urines (RF test). Fifty-four patients with stone disease were enrolled, excluding patients with infection or cystine stones. For Lithotest, we measured all analytes necessary to calculate state of saturation (ß) with calcium oxalate, brushite and uric acid, by means of Lithorisk.com. For RF, we measured calcium, magnesium, oxalate, citrate, sulphate, phosphate, pH and creatinine. The comparison was made with creatinine ratios. An estimate of ßCaOx, ßbrushite and ßAU was obtained also on RF urines by using simplified algorithms. We found highly significant correlations between all parameters, despite quite different means. There was a nice correspondence between the two sets of measurements, assessed by the Bland-Altmann test, for calcium, oxalate, citrate, sulphate, urate and pH. Overnight urine had higher saturations compared to 24-h one owing to higher concentration of the former. In conclusion, RF test on overnight urine cannot completely replace Lithotest on 24-hr urine. However, it can represent a simplified tool for either preliminary evaluation or follow-up of patients with stone disease.
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Affiliation(s)
| | | | - Pietro Manuel Ferraro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia; Università Cattolica del Sacro Cuore, Roma, Italia
| | - Roberto Miano
- Dipartimento di Urologia, Università di Tor Vergata, Roma, Italia
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20
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Santos JA, Li KC, Huang L, Mclean R, Petersen K, Di Tanna GL, Webster J. Change in mean salt intake over time using 24-h urine versus overnight and spot urine samples: a systematic review and meta-analysis. Nutr J 2020; 19:136. [PMID: 33280602 PMCID: PMC7720567 DOI: 10.1186/s12937-020-00651-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/23/2020] [Indexed: 11/15/2022] Open
Abstract
Background Little is known about the capacity of overnight and spot urine samples to estimate changes in mean salt intake over time. The objective of this review was to compare the estimates of change in mean population salt intake based on 24-h urine and overnight/spot urine samples. Methods Studies were systematically identified through searches of peer-reviewed databases (Medline, Embase, Global Health, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) and grey literature. Studies that reported estimates of mean salt intake for at least two time points based on both 24-h and overnight/spot urines were deemed eligible. The capacity of overnight/spot urine samples to estimate the change in mean salt intake was assessed both at the individual-study level and overall through random-effects meta-analyses. The level of heterogeneity was assessed through the I2 statistic. Subgroup and sensitivity analyses were conducted to explore possible sources of heterogeneity, and check the robustness of the findings from the primary analysis. Results A total of 1244 records were identified, 50 were assessed as full text, and 14 studies met the criteria, capturing data on 7291 participants from seven countries. Nine and five studies collected overnight and spot urines, respectively. The comparison of the change in mean salt intake between 24-h and overnight/spot urines showed some inconsistencies at the individual study-level. The pooled mean change in salt intake was − 0.43 g/day (95% CI − 1.16 to 0.30; I2 = 95%) using 24-h urines, and − 0.22 g/day (− 0.65 to 0.20; I2 = 87%) using overnight/spot urines, with a pooled difference-in-differences between the two methods of 0.27 g/day (− 0.23 to 0.77; I2 = 89%). Subgroup analyses showed substantial heterogeneity for most subgroups. Sensitivity analyses did not change the effect observed in the primary analysis. Conclusion The evidence for the capacity of overnight/spot urines to estimate changes in mean salt intake over time is uncertain. More research where overnight/spot urines are collected in parallel with 24-h urines is needed to enable a more in-depth evaluation of these alternative approaches to estimating change in mean salt intake. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-020-00651-8.
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Affiliation(s)
- Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Ka Chun Li
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Liping Huang
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Rachael Mclean
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Kristina Petersen
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Gian Luca Di Tanna
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2052, Australia
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21
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Wong ATY, Munt A, Allman-Farinelli M, Badve SV, Boudville N, Coolican H, Chandra AN, Coulshed S, Fernando M, Grantham J, Haloob I, Harris DCH, Hawley CM, Holt J, Johnson DW, Kumar K, Lee VW, Lonergan M, Mai J, Rangan A, Roger SD, Saravanabavan S, Sud K, Torres VE, Vilayur E, Zhang JQJ, Rangan GK. Assessment of Dietary Sodium Intake Using the Scored Salt Questionnaire in Autosomal Dominant Polycystic Kidney Disease. Nutrients 2020; 12:E3376. [PMID: 33147804 DOI: 10.3390/nu12113376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 11/16/2022] Open
Abstract
The excess intake of dietary sodium is a key modifiable factor for reducing disease progression in autosomal dominant polycystic kidney disease (ADPKD). The aim of this study was to test the hypothesis that the scored salt questionnaire (SSQ; a frequency questionnaire of nine sodium-rich food types) is a valid instrument to identify high dietary salt intake in ADPKD. The performance of the SSQ was evaluated in adults with ADPKD with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 during the screening visit of the PREVENT-ADPKD trial. High dietary sodium intake (HSI) was defined by a mean 24-h urinary sodium excretion ≥ 100 mmol/day from two collections. The median 24-h urine sodium excretion was 132 mmol/day (IQR: 112–172 mmol/d) (n = 75; mean age: 44.6 ± 11.5 years old; 53% female), and HSI (86.7% of total) was associated with male gender and higher BMI and systolic blood pressure (p < 0.05). The SSQ score (73 ± 23; mean ± SD) was weakly correlated with log10 24-h urine sodium excretion (r = 0.29, p = 0.01). Receiving operating characteristic analysis showed that the optimal cut-off point in predicting HSI was an SSQ score of 74 (area under the curve 0.79; sensitivity 61.5%; specificity 90.0%; p < 0.01). The evaluation of the SSQ in participants with a BMI ≥ 25 (n = 46) improved the sensitivity (100%) and the specificity (100%). Consumers with an SSQ score ≥ 74 (n = 41) had higher relative percentage intake of processed meats/seafood and flavourings added to cooking (p < 0.05). In conclusion, the SSQ is a valid tool for identifying high dietary salt intake in ADPKD but its value proposition (over 24-h urinary sodium measurement) is that it may provide consumers and their healthcare providers with insight into the potential origin of sodium-rich food sources.
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Taguchi K, Hamamoto S, Okada A, Tanaka Y, Sugino T, Unno R, Kato T, Ando R, Tozawa K, Yasui T. Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: a single-center retrospective cohort study. BMC Urol 2020; 20:174. [PMID: 33121459 PMCID: PMC7596945 DOI: 10.1186/s12894-020-00749-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022] Open
Abstract
Background Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-h urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio = 0.44, p = 0.007), whereas a T-score < − 2.5 and hyperoxaluria were associated with symptoms (odds ratio = 2.59, p = 0.037; odds ratio = 0.45, p = 0.01; respectively). Conclusion These results revealed that low T-scores might cause symptoms in patients with urolithiasis, suggesting the importance of BMD examination for high-risk Japanese patients with urolithiasis having hypocitraturia.
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Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan.
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Yutaro Tanaka
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Teruaki Sugino
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Rei Unno
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Taiki Kato
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Keiichi Tozawa
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
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23
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Ginos BN, Engberink RHO. Estimation of Sodium and Potassium Intake: Current Limitations and Future Perspectives. Nutrients 2020; 12:nu12113275. [PMID: 33114577 PMCID: PMC7692368 DOI: 10.3390/nu12113275] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/24/2022] Open
Abstract
Globally, average dietary sodium intake is double the recommended amount, whereas potassium is often consumed in suboptimal amounts. High sodium diets are associated with increased cardiovascular and renal disease risk, while potassium may have protective properties. Consequently, patients at risk of cardiovascular and renal disease are urged to follow these recommendations, but dietary adherence is often low due to high sodium and low potassium content in processed foods. Adequate monitoring of intake is essential to guide dietary advice in clinical practice and can be used to investigate the relationship between intake and health outcomes. Daily sodium and potassium intake is often estimated with 24-h sodium and potassium excretion, but long-term balance studies demonstrate that this method lacks accuracy on an individual level. Dietary assessment tools and spot urine collections also exhibit poor performance when estimating individual sodium and potassium intake. Collection of multiple consecutive 24-h urines increases accuracy, but also patient burden. In this narrative review, we discuss current approaches to estimating dietary sodium and potassium intake. Additionally, we explore alternative methods that may improve test accuracy without increasing burden.
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Affiliation(s)
- Bigina N.R. Ginos
- Department of Nephrology, Amsterdam University Medical Centres, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Correspondence:
| | - Rik H.G. Olde Engberink
- Amsterdam Cardiovascular Sciences, VU University Medical Center, 1081 HV Amsterdam, The Netherlands;
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24
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Zhao Y, Liu W, Liu S, Li X, Yin T, Liu X, Wang F, Chang X, Zhang T, Tian M, Zhang Y. Estimating 24-h urinary sodium excretion from casual spot urine specimen among hypertensive patients in Northwest China: the Salt Substitute and Stroke Study. Public Health Nutr 2020; 24:1-7. [PMID: 32345383 DOI: 10.1017/s1368980019005019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop an equation that can estimate the 24-h urinary Na excretion by using casual spot urine specimen for older hypertensive participants in rural Ningxia and further to compare with the INTERSALT method, Kawasaki method and Tanaka method. DESIGN Older hypertensive participants in rural Ningxia provided their casual spot urine samples and 24-h urine samples between January 2015 and February 2017. Sex-specific equation was developed using linear forward stepwise regression analysis. Model fit was assessed using adjusted R2. Approximately half of all participants were randomly selected to validate the equation. Mean differences, intraclass correlation coefficients and Bland-Altman plots were used to evaluate the performance of all methods. SETTING Pingluo County and Qingtongxia County in Ningxia Hui Autonomous Region, China. PARTICIPANTS Older hypertensive participants in rural Ningxia. RESULTS Totally, 807 of 1120 invited participants provided qualified 24-h urine samples and spot urine samples. There was no statistical difference comparing the laboratory-based method against the new method and the INTERSALT method, while Kawasaki method had the largest bias with a mean difference of 40·81 g/d (95 % CI 39·27, 42·35 g/d). Bland-Altman plots showed similar pattern of the results. CONCLUSION The INTERSALT method and the new equation have the potential to estimate the 24-h urinary Na excretion in this study population. However, the extrapolation of the results to other population needs to be careful. Future research is required to establish a more reliable method to estimate 24-h urinary Na excretion.
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Affiliation(s)
- Yi Zhao
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Wanlu Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Sha Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiaoxia Li
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Ting Yin
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiuying Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Faxuan Wang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiaoyu Chang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Tianjing Zhang
- The People's Hospital of Anyang City, Anyang City, Henan Province, China
| | - Maoyi Tian
- The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing100088, China
- The George Institute for Global Health, University of New South Wales, Newtown, NSW2042, Australia
| | - Yuhong Zhang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
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25
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Peniamina R, Skeaff S, Haszard JJ, McLean R. Comparison of 24-h Diet Records, 24-h Urine, and Duplicate Diets for Estimating Dietary Intakes of Potassium, Sodium, and Iodine in Children. Nutrients 2019; 11:E2927. [PMID: 31816844 DOI: 10.3390/nu11122927] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Accurately estimating nutrient intake can be challenging, yet it is important for informing policy. This cross-sectional validation study compared the use of three methods for estimating the intake of sodium, potassium, and iodine in children aged 9–11 years in New Zealand. Over the same 24 hour period, participants collected duplicate diets (n = 37), weighed food records (n = 84), and 24 hour urine samples (n = 82). Important differences were found between dietary estimates of sodium, potassium, and iodine using the three methods of dietary assessment, suggesting that different methods of assessment have specific limitations for the measurement of these nutrients in children. Bland Altman plots show relatively wide limits of agreement for all measures and nutrients. These results support the World Health Organization’s (WHOs) recommendations to use urinary assessment to measure population sodium and iodine intake, while dietary assessment appears to be more accurate for estimating potassium intake. Compared to reference values, our results suggest that the children in this study consume inadequate iodine, inadequate potassium, and excess dietary sodium. Public health measures to reduce sodium intake, increase intake of fruit and vegetables, and iodine-rich foods are warranted in New Zealand.
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26
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Wilson T, Garcia-Perez I, Posma JM, Lloyd AJ, Chambers ES, Tailliart K, Zubair H, Beckmann M, Mathers JC, Holmes E, Frost G, Draper J. Spot and Cumulative Urine Samples Are Suitable Replacements for 24-Hour Urine Collections for Objective Measures of Dietary Exposure in Adults Using Metabolite Biomarkers. J Nutr 2019; 149:1692-1700. [PMID: 31240300 DOI: 10.1093/jn/nxz138] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/17/2019] [Accepted: 05/24/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Measurement of multiple food intake exposure biomarkers in urine may offer an objective method for monitoring diet. The potential of spot and cumulative urine samples that have reduced burden on participants as replacements for 24-h urine collections has not been evaluated. OBJECTIVE The aim of this study was to determine the utility of spot and cumulative urine samples for classifying the metabolic profiles of people according to dietary intake when compared with 24-h urine collections in a controlled dietary intervention study. METHODS Nineteen healthy individuals (10 male, 9 female, aged 21-65 y, BMI 20-35 kg/m2) each consumed 4 distinctly different diets, each for 1 wk. Spot urine samples were collected ∼2 h post meals on 3 intervention days/wk. Cumulative urine samples were collected daily over 3 separate temporal periods. A 24-h urine collection was created by combining the 3 cumulative urine samples. Urine samples were analyzed with metabolite fingerprinting by both high-resolution flow infusion electrospray mass spectrometry (FIE-HRMS) and proton nuclear magnetic resonance spectroscopy (1H-NMR). Concentrations of dietary intake biomarkers were measured with liquid chromatography triple quadrupole mass spectrometry and by integration of 1H-NMR data. RESULTS Cross-validation modeling with 1H-NMR and FIE-HRMS data demonstrated the power of spot and cumulative urine samples in predicting dietary patterns in 24-h urine collections. Particularly, there was no significant loss of information when post-dinner (PD) spot or overnight cumulative samples were substituted for 24-h urine collections (classification accuracies of 0.891 and 0.938, respectively). Quantitative analysis of urine samples also demonstrated the relation between PD spot samples and 24-h urines for dietary exposure biomarkers. CONCLUSIONS We conclude that PD spot urine samples are suitable replacements for 24-h urine collections. Alternatively, cumulative samples collected overnight predict similarly to 24-h urine samples and have a lower collection burden for participants.
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Affiliation(s)
- Thomas Wilson
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Isabel Garcia-Perez
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Diseases, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Joram M Posma
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Diseases, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Amanda J Lloyd
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Edward S Chambers
- Nutrition and Dietetic Research Group, Division of Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, United Kingdom
| | - Kathleen Tailliart
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Hassan Zubair
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Manfred Beckmann
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elaine Holmes
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Diseases, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Gary Frost
- Nutrition and Dietetic Research Group, Division of Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, United Kingdom
| | - John Draper
- Institute of Biological, Environmental, and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
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27
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Santos JA, Rosewarne E, Hogendorf M, Trieu K, Pillay A, Ieremia M, Naseri LTT, Tukana I, Snowdon W, Petersen K, Webster J. Estimating mean population salt intake in Fiji and Samoa using spot urine samples. Nutr J 2019; 18:55. [PMID: 31506072 PMCID: PMC6737719 DOI: 10.1186/s12937-019-0484-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing interest in finding less costly and burdensome alternatives to measuring population-level salt intake than 24-h urine collection, such as spot urine samples. However, little is known about their usefulness in developing countries like Fiji and Samoa. The purpose of this study was to evaluate the capacity of spot urine samples to estimate mean population salt intake in Fiji and Samoa. METHODS The study involved secondary analyses of urine data from cross-sectional surveys conducted in Fiji and Samoa between 2012 and 2016. Mean salt intake was estimated from spot urine samples using six equations, and compared with the measured salt intake from 24-h urine samples. Differences and agreement between the two methods were examined through paired samples t-test, intraclass correlation coefficient analysis, and Bland-Altman plots and analyses. RESULTS A total of 414 participants from Fiji and 725 participants from Samoa were included. Unweighted mean salt intake based on 24-h urine collection was 10.58 g/day (95% CI 9.95 to 11.22) in Fiji and 7.09 g/day (95% CI 6.83 to 7.36) in Samoa. In both samples, the INTERSALT equation with potassium produced the closest salt intake estimate to the 24-h urine (difference of - 0.92 g/day, 95% CI - 1.67 to - 0.18 in the Fiji sample and + 1.53 g/day, 95% CI 1.28 to 1.77 in the Samoa sample). The presence of proportional bias was evident for all equations except for the Kawasaki equation. CONCLUSION These data suggest that additional studies where both 24-h urine and spot urine samples are collected are needed to further assess whether methods based on spot urine samples can be confidently used to estimate mean population salt intake in Fiji and Samoa.
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Affiliation(s)
- Joseph Alvin Santos
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
| | - Emalie Rosewarne
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
| | - Martyna Hogendorf
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
| | - Kathy Trieu
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
| | - Arti Pillay
- Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases, Fiji National University, Nasinu, Fiji
| | | | | | - Isimeli Tukana
- National Wellness Centre, Ministry of Health and Medical Services, Suva, Fiji
| | - Wendy Snowdon
- Global Obesity Centre, Deakin University, Geelong, 3216 Australia
| | - Kristina Petersen
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802 USA
| | - Jacqui Webster
- The George Institute for Global Health, The University of New South Wales, Sydney, 2052 Australia
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28
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Verkaik-Kloosterman J, Dekkers ALM, de Borst MH, Bakker SJL. Estimation of the salt intake distribution of Dutch kidney transplant recipients using 24-h urinary sodium excretion: the potential of external within-person variance. Am J Clin Nutr 2019; 110:641-651. [PMID: 31274143 DOI: 10.1093/ajcn/nqz134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 06/06/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is growing interest in assessing a population's prevalence of inadequate nutrient intake using biomarkers. However, within-person variation is generally ignored because repeated data collections are considered costly and burdensome. OBJECTIVES The study aimed to show the importance of estimating, from repeated 24-h urine collections, a population's habitual salt intake and to explore the potential of using the ratio of within-person variance to total variance from an external source (W:T variance) with single 24-h urine collection. METHODS Salt intake was predicted from data for 24-h urinary sodium excretion in adult kidney transplant recipients in 1992-1997 (n = 432) and 2006-2011 (n = 1159). The salt intake distribution of single-day measurements was compared with estimates from multiple 24-h urine collections, which were statistically corrected for within-person variance. Habitual salt intake was also estimated using single-day measurements and external variance estimates. From each distribution, the proportion below specified cut-off values was estimated. RESULTS In 2006-2011 the average habitual salt intake was 10.6 g/d (men) and 8.5 g/d (women); in 1992-1997 these values were 8.6 g/d and 7.5 g/d, respectively. The proportion with salt intake <6 g/d was 5% and 13% in 2006-2011 and 22% and 28% in 1992-1997, respectively, for men and women. Correction for within-person variance significantly narrowed the salt intake distribution-the proportion with salt intake <6 g/d was overestimated by 3-13 percentage points using single-day data. Sensitivity analyses showed the importance of a sufficient sample size for estimating variance components. Variation of the W:T variance showed up to 40 percentage points deviation in the proportion with intakes below a specified cut-off value. CONCLUSIONS To estimate a population's salt intake distribution, it is important to correct 24-h urinary sodium excretion for within-person variance. Predicting habitual salt intake distribution using single-day measurements with external variances is promising; a sensitivity analysis is recommended to show the effect of different external variances.
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Affiliation(s)
| | - Arnold L M Dekkers
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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Kobayashi S, Amano H, Terawaki H, Ogura M, Kawaguchi Y, Yokoo T. Spot urine protein/creatinine ratio as a reliable estimate of 24-hour proteinuria in patients with immunoglobulin A nephropathy, but not membranous nephropathy. BMC Nephrol 2019; 20:306. [PMID: 31387546 PMCID: PMC6685245 DOI: 10.1186/s12882-019-1486-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/23/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Proteinuria is known to be associated with both kidney function deterioration and cardiovascular diseases. While proteinuria estimation from 24-h urine samples has traditionally been considered as the standard method for assessment of the degree of urinary protein excretion, sample collection is associated with several technical problems such as inaccurate collection and the potential spread of drug-resistant pathogens. Therefore, the spot urine protein/creatinine ratio (PCR) assessment is currently recommended as an alternative. While the utility of PCR has been validated, studies on the association between spot urine PCR and 24-h proteinuria (24HP) in patients with chronic glomerular nephritis (CGN) and nephrotic syndrome (NS) are limited. This study aimed to evaluate whether an estimated result from a spot urine PCR could sufficiently approximate the daily urine protein excretion amount from a 24-h urine sample in patients with immunoglobulin A nephropathy (IgAN), minimal change disease (MCD), and membranous nephropathy- nephrotic syndrome (MN-NS). METHODS The study participants included 161 patients with IgAN, MCD, or MGN-NS at the Jikei University Kashiwa Hospital and Kanagawa Prefecture Shiomidai Hospital. The correlation between spot urine PCR and a 24-h urine protein was investigated using linear regression analysis with Spearman's correlation (r) coefficient and intraclass correlation coefficient (ICC). RESULTS While high correlation coefficients (r = 0.86, P < 0.001) and substantial agreement (ICC: 0.806, P < 0.001) were observed in patients with IgAN, similar correlations were not observed in patients with MCD or MN-NS. In the patients with MCD, r was 0.53 (P < 0.001), which signified a slight correlation, and in the patients with MN-NS, r was 0.289 (P = 0.17), which was not statistically significant. CONCLUSIONS This study revealed that spot urine PCR is a reliable estimate of 24HP value in patients with IgAN. In contrast, there is a considerable difference between the daily urine protein excretion amount based on a 24-h urine sample and that which is calculated from spot urine PCR in patients with NS.
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Affiliation(s)
- Seiji Kobayashi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Hoichi Amano
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Hiroyuki Terawaki
- Department of Internal Medicine, Nephrology Teikyo University School of Medicine Teikyo University Chiba Medical Center, Ichihara, Chiba Japan
| | - Makoto Ogura
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshindo Kawaguchi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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Meyer HE, Johansson L, Eggen AE, Johansen H, Holvik K. Sodium and Potassium Intake Assessed by Spot and 24-h Urine in the Population-Based Tromsø Study 2015-2016. Nutrients 2019; 11:E1619. [PMID: 31315306 DOI: 10.3390/nu11071619] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022] Open
Abstract
Reduction of salt intake is a public health priority and necessitates the surveillance of salt intake in the population. The validity of salt intake assessed by dietary surveys is generally low. We, therefore, aimed to estimate salt intake by 24-h urine collection and to assess the usefulness of spot urine collection for surveillance purposes. In the population-based Tromsø Study 2015-2016, 493 men and women aged 40-69 years collected 24-h urine, of whom 475 also collected spot urine. Sodium and potassium excretions were calculated by multiplying respective urinary concentrations by the total volume of urine. Based on the sodium concentration in spot urine, we also estimated 24-h sodium excretion by three different equations. Mean sodium excretion was 4.09 ± 1.60 and 2.98 ± 1.09 g/24-h in men and women, respectively, corresponding to a calculated salt intake of 10.4 and 7.6 g. The sodium to potassium molar (Na/K) ratio was approximately 1.8 in both genders. Of the three equation utilizing spot urine, estimated mean 24-h sodium excretion was closest for the INTERSALT formulae (4.29 and 2.96 g/24-h in men and women, respectively). In this population-based study, the estimated salt intake was higher than the recommended intake. However, urine potassium excretion was rather high resulting in a favorable Na/K ratio. Mean sodium excretion calculated from spot urine by the INTERSALT equation predicted the mean sodium excretion in 24-h urine reasonably well.
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Mai Z, Li X, Cui Z, Wu W, Liu Y, Ou L, Liang Y, Zhao Z, Liu Y, Mai X, Zhu W, Zhang T, Cai C, Yang H, Zeng G. Reference intervals for stone risk factors in 24-h urine among healthy adults of the Han population in China. Clin Chem Lab Med 2018; 56:642-648. [PMID: 29095693 DOI: 10.1515/cclm-2017-0401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/27/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of the study was to establish reference intervals for 24-h urinary stone risk factors in the healthy Chinese Han population. METHODS From May 2013 to July 2014, we collected and analyzed 24-h urine samples from healthy adult Han population during a cross-sectional study across China. The protocol for analysis of 24-h urine included volume, pH, oxalate, citrate, sodium, potassium, chloride, calcium, phosphorous, creatinine, urate, magnesium, the ion activity products of calcium oxalate (AP(CaOx) indexs) and calcium phosphate (AP(CaP) indexs). We calculated the reference intervals according to the Clinical and Laboratory Standards Institute (CLSI) 2008 guidelines and compared them with those recorded in other studies. RESULTS A total of 132 male and 123 female healthy subjects with a mean (SD, range) age of 52.4 (15.2, 19-89) years were eligible in the final analysis. Men had higher 24-h excretion of creatinine, calcium, urate and phosphorus and lower levels of citrate, magnesium, chloride, sodium and potassium than women. AP(CaOx) indexs and AP(CaP) indexs were significantly higher among men than women. When urinary findings were compared with the reference intervals, most of our data showed a high abnormality rate, especially for creatinine, calcium, citrate, magnesium, chloride, sodium and potassium. CONCLUSIONS The present study revealed the normal metabolic status for stone risk factors of the Chinese Han population. It is therefore necessary for each country or region to define their own reference intervals for comparison of stone risk factors between patients and healthy subjects.
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Affiliation(s)
- Zanlin Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Xiaoxia Li
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Zelin Cui
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Department of Urology, The Central Hospital of Yongzhou, Yongzhou, Hunan, P.R. China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yongda Liu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Lili Ou
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yueping Liang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Zhijian Zhao
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yang Liu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Xing Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Wei Zhu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Tao Zhang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Chao Cai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Houmeng Yang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
- Department of Urology, Ningbo Urologic and Nephrotic Hospital, Ningbo, Zhejiang, P.R. China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
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Yamori Y, Sagara M, Arai Y, Kobayashi H, Kishimoto K, Matsuno I, Mori H, Mori M. Taurine Intake with Magnesium Reduces Cardiometabolic Risks. Adv Exp Med Biol 2018; 975 Pt 2:1011-1020. [PMID: 28849518 DOI: 10.1007/978-94-024-1079-2_80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
WHO-CARDIAC (Cardiovascular Diseases and Alimentary Comparison) Study revealed the quintile analyses of 24-h urinary (24 U) taurine (T) and magnesium (Mg) excretions were inversely related with cardiometabolic risks (CMR) such as obesity, hypertension and hypercholesterolemia in 50 population samples in the world. To exclude the influence of ethnicity in the study, 24 U T and Mg excretions were analyzed for the association with CMR in one ethnicity, Japanese population.24 U T/creatinine (C) ratios were divided into 5 quintiles and the ratios of Japanese to the total of each quintile were analyzed from CARDIAC Study samples. The highest 24 U T quintile consisted of 60% Japanese, indicating high seafood consumption in Japanese.Over 600 Japanese aged 30-79 were invited to a health examination for blood pressure measurement and for fasting blood and 24 U samplings. Tertile analysis of 24 U T/C ratios in relation to CMR indicated the third tertile had significantly higher HDL cholesterol, 24 U potassium (K) and 24 U salt than the first (lowest) tertile. Tertile analysis of 24 U Mg/C ratios indicated the third tertile had significantly lower body mass index and significantly higher folic acid, 24 U isoflavones, K and salt than the first tertile after age and gender adjustment. The third tertile of both T/C and Mg/C had significantly lower body mass index, LDL/HDL and Na/K ratios, and significantly higher HDL cholesterol and folic acid than the first tertile, indicating seafood eaters taking Mg rich diets had lower risks of obesity, atherosclerosis, hypertension and higher folic acid, beneficial for healthy longevity.
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Affiliation(s)
- Yukio Yamori
- , 4-16, Edagawa Town, Hyogo Pref., Nishinomiya City, 663-8143, Japan.
| | - Miki Sagara
- Laboratory of Preventive Nutritional Medicine, Research Institute for Production and Development, 15, Shimogamo Morimotocho, Sakyoku, Kyoto City, 606-8413, Japan
| | - Yoshimi Arai
- Hyogo Prefecture Health Promotion Association, 2-1-12, Aratacho, Hyogo-ku, Kobe City, 652-0032, Japan
| | - Hitomi Kobayashi
- Hyogo Prefecture Health Promotion Association, 2-1-12, Aratacho, Hyogo-ku, Kobe City, 652-0032, Japan
| | - Kazumi Kishimoto
- Hyogo Prefecture Health Promotion Association, 2-1-12, Aratacho, Hyogo-ku, Kobe City, 652-0032, Japan
| | - Ikuko Matsuno
- Hyogo Prefecture Health Promotion Association, 2-1-12, Aratacho, Hyogo-ku, Kobe City, 652-0032, Japan
| | - Hideki Mori
- , 4-16, Edagawa Town, Hyogo Pref., Nishinomiya City, 663-8143, Japan
| | - Mari Mori
- , 4-16, Edagawa Town, Hyogo Pref., Nishinomiya City, 663-8143, Japan
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Penczynski KJ, Remer T, Herder C, Kalhoff H, Rienks J, Markgraf DF, Roden M, Buyken AE. Habitual Flavonoid Intake from Fruit and Vegetables during Adolescence and Serum Lipid Levels in Early Adulthood: A Prospective Analysis. Nutrients 2018; 10:E488. [PMID: 29662000 DOI: 10.3390/nu10040488] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/05/2018] [Accepted: 04/11/2018] [Indexed: 01/14/2023] Open
Abstract
Flavonoids have been implicated in the prevention of cardiovascular diseases (CVD). In a prospective approach, we investigated whether habitual flavonoid intake from fruit, vegetables and juices (FlavFVJ) during adolescence is associated with adult levels of serum lipids, one of the main CVD risk factors. This analysis included healthy participants from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, who had provided a fasting blood sample in adulthood (aged 18–39 years), data on FlavFVJ intake during adolescence (females: 9–15 years, males: 10–16 years)—estimated either from multiple 3-day weighed dietary records (n = 257), or from validated biomarker hippuric acid (uHA) excretion from multiple 24-h urine samples (n = 233)—together with information on relevant covariates. In multivariable linear regression analyses, a higher FlavFVJ intake during adolescence was independently associated with higher serum high-density lipoprotein cholesterol (HDL-C) levels among males (Ptrend = 0.038); however, the inclusion of adult waist circumference attenuated this association (Ptrend = 0.053). FlavFVJ was not associated with triglycerides (TG), total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C; all Ptrend ≥ 0.1), nor was uHA excretion with any serum lipid outcome among males (all Ptrend ≥ 0.5). Neither FlavFVJ intake nor uHA excretion was associated with serum lipids among women (all Ptrend ≥ 0.1). However, a higher flavonoid intake from fruit and vegetables was independently related to lower LDL-C levels (Ptrend = 0.021), while a higher intake from juices was associated with higher LDL-C levels (Ptrend = 0.016) among females. In conclusion, a higher flavonoid intake from fruit, vegetables and/or juices during adolescence may be linked to cholesterol levels in early adulthood in a sex- and food source-specific manner.
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Beer-Borst S, Luta X, Hayoz S, Sommerhalder K, Krause CG, Eisenblätter J, Jent S, Siegenthaler S, Aubert R, Haldimann M, Strazzullo P. Study design and baseline characteristics of a combined educational and environmental intervention trial to lower sodium intake in Swiss employees. BMC Public Health 2018; 18:421. [PMID: 29606103 PMCID: PMC5879608 DOI: 10.1186/s12889-018-5366-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/22/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Blood pressure is a primary cardiovascular disease risk factor. Population-wide governmental strategies aim to reduce lifestyle and dietary risk factors for hypertension, one of which is an unbalanced diet with high sodium and low potassium intakes. Nutrition interventions in the workplace are considered a promising approach in encouraging health-promoting behaviors. We developed and conducted the health promoting sodium reduction trial "Healthful & Tasty: Sure!" in worksites in the German-speaking part of Switzerland from May 2015 to Nov 2016, for which we present the study protocol and baseline characteristics. METHODS Healthful & Tasty, a cluster nonrandomized single-arm trial with calibration arm, aimed to demonstrate the effectiveness of a combined educational and environmental intervention in the workplace in reducing employees' average daily sodium/salt intake by 15%. To this end, health and food literacy of employees and guideline compliance among the catering facility team needed to be improved. The primary outcome measure was sodium/salt intake estimated from sodium excretion in a 24-h urine sample. Secondary outcome measures included changes in the overall qualitative diet composition, blood pressure, anthropometric indices, and health and food literacy. Of eight organizations with catering facilities, seven organizations took part in the nutrition education and catering salt reduction interventions, and one organization participated as a control. Overall, 145 consenting employees were included in the staggered, one-year four-phase trial, of which 132 participated in the intervention group. In addition to catering surveys and food sampling, the trial included five follow-up health assessments including questionnaires, blood pressure measurements, anthropometrics, and sodium, potassium, and iodine intake measurements obtained from 24-h and spot urine samples, and a food record checklist. Exploratory and hypothesis generating baseline statistical analysis included 141 participants with adequate 24-h urine samples. DISCUSSION Despite practice-driven limitations to the study design and small cluster and participant numbers, this trial has methodological strength and will provide important insights into the effectiveness of a combined educational and environmental intervention to reduce salt intake among female and male Swiss employees. TRIAL REGISTRATION German Clinical Trials Register, DRKS00006790 . Registered 23 September 2014.
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Affiliation(s)
- Sigrid Beer-Borst
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
| | - Xhyljeta Luta
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
| | - Stefanie Hayoz
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
| | - Kathrin Sommerhalder
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Corinna Gréa Krause
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
| | - Julia Eisenblätter
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Sandra Jent
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Stefan Siegenthaler
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Rafael Aubert
- Federal Food Safety and Veterinary Office, Division of Risk Assessment, Laboratories, Schwarzenburgstrasse 155, 3003, Bern, Switzerland
| | - Max Haldimann
- Federal Food Safety and Veterinary Office, Division of Risk Assessment, Laboratories, Schwarzenburgstrasse 155, 3003, Bern, Switzerland
| | - Pasquale Strazzullo
- Department of Clinical Medicine & Surgery, Federico II University of Naples Medical School, via S. Pansini 5, 80131, Naples, Italy
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Lazda I, Goldmanis M, Siksna I. Salt Consumption in Latvian Population: A Pilot Study. Medicina (Kaunas) 2018; 54:medicina54010010. [PMID: 30344241 PMCID: PMC6037234 DOI: 10.3390/medicina54010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 11/16/2022]
Abstract
Background and objective: High dietary sodium intake is associated with multiple health risks, and the average sodium intake in Latvia is higher than the World Health Organization has recommended. In Latvia, no study so far has combined self-reported dietary data on sodium and potassium intake with objective measurements in 24-h urine samples. This pilot study aimed to cross-validate both methods and to assess any possible factors interfering with the collection of samples and data in large, population-based future studies of sodium and potassium intake in Latvian adults. Materials and methods: A stratified random sample of healthy Latvian adults aged 19–64 (n = 30) was drawn. Dietary data of sodium and potassium was collected using one 24-h dietary recall and a two-day food diary. Sodium and potassium excretion was measured by one 24-h urinary collection. Results: Median intake of sodium and potassium based on dietary data was 2276.4 mg/day (interquartile range (IQR), 1683.3–3979.4) and 2172.0 mg/day (IQR, 1740.6–3506.5), respectively. Median intake of sodium and potassium based on urinary data was 3500.3 mg/day (IQR, 2191.0–5535.0) and 2965.4 mg/day (IQR, 2530.2–3749.9), respectively. Urinary data showed significantly higher results than dietary records (Wilcoxon signed rank test, p = 0.023). Only 13% of the subjects did not exceed the WHO-recommended limit of 2000 mg of sodium per day, and only 33% consumed at least the recommended allowance of 3510 mg of potassium per day. Median intake of salt was 8.8 g/day (IQR, 5.5–13.8) (according to urinary data). Conclusions: The findings from the present study showed considerable underestimation of dietary sodium and potassium intake based on self-reported dietary data. Urinary data revealed more accurate results, and showed that Latvian adults exceed the amount of salt recommended and consume less potassium than recommended. The pilot study also showed that the chosen methods are adequate for implementation in large, population-based studies to evaluate dietary intake of salt, sodium, and potassium in populations of Latvian adults.
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Affiliation(s)
- Ilva Lazda
- Department of Risk Assessment and Epidemiology, Institute of Food Safety, Animal Health and Environment BIOR, Lejupes Street 3, LV-1076 Riga, Latvia.
| | - Māris Goldmanis
- Department of Economics, Royal Holloway University of London, Egham TW20 0EX, UK.
| | - Inese Siksna
- Department of Risk Assessment and Epidemiology, Institute of Food Safety, Animal Health and Environment BIOR, Lejupes Street 3, LV-1076 Riga, Latvia.
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Luta X, Hayoz S, Gréa Krause C, Sommerhalder K, Roos E, Strazzullo P, Beer-Borst S. The relationship of health/food literacy and salt awareness to daily sodium and potassium intake among a workplace population in Switzerland. Nutr Metab Cardiovasc Dis 2018; 28:270-277. [PMID: 29310971 DOI: 10.1016/j.numecd.2017.10.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 08/14/2017] [Accepted: 10/31/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS High sodium (Na) and low potassium (K) intake are associated with hypertension and CVD risk. This study explored the associations of health literacy (HL), food literacy (FL), and salt awareness with salt intake, K intake, and Na/K ratio in a workplace intervention trial in Switzerland. METHODS AND RESULTS The study acquired baseline data from 141 individuals, mean age 44.6 years. Na and K intake were estimated from a single 24-h urine collection. We applied validated instruments to assess HL and FL, and salt awareness. Multiple linear regression was used to investigate the association of explanatory variables with salt intake, K intake, and Na/K. Mean daily salt intake was 8.9 g, K 3.1 g, and Na/K 1.18. Salt intake was associated with sex (p < 0.001), and K intake with sex (p < 0.001), age (p = 0.02), and waist-to-height ratio (p = 0.03), as was Na/K. HL index and FL score were not significantly associated with salt or K intake but the awareness variable "salt content impacts food/menu choice" was associated with salt intake (p = 0.005). CONCLUSION To achieve the established targets for population Na and K intake, health-related knowledge, abilities, and skills related to Na/salt and K intake need to be promoted through combined educational and structural interventions. Clinical Trials Registry number: DRKS00006790 (23/09/2014).
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Affiliation(s)
- X Luta
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - S Hayoz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - C Gréa Krause
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - K Sommerhalder
- Bern University of Applied Science, Health Section, Bern, Switzerland
| | - E Roos
- Folkhälsan Research Center, Helsinki, Finland; Department of Public Health, University of Helsinki, Finland
| | - P Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, Naples, Italy
| | - S Beer-Borst
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
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Zhang T, Chang X, Liu W, Li X, Wang F, Huang L, Liao S, Liu X, Zhang Y, Zhao Y. Comparison of sodium, potassium, calcium, magnesium, zinc, copper and iron concentrations of elements in 24-h urine and spot urine in hypertensive patients with healthy renal function. J Trace Elem Med Biol 2017; 44:104-108. [PMID: 28965563 DOI: 10.1016/j.jtemb.2017.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/07/2017] [Accepted: 06/24/2017] [Indexed: 02/02/2023]
Abstract
UNLABELLED Sodium, potassium, calcium, magnesium, zinc, copper and iron are associated with the sequela of hypertension. The most reliable method for testing those elements is by collecting 24-h urine samples. However, this is cumbersome and collection of spot urine is more convenient in some circumstance. The aim of this study was to compare the concentrations of different elements in 24-h urine and spot urine. METHODS Data was collected from a sub-study of China Salt Substitute and Stroke Study. 240 participants were recruited randomly from 12 villages in two counties in Ningxia, China. Both spot and 24-h urine specimens were collected from each patient. Routine urine test was conducted, and concentration of elements was measured using microwave digestion and Inductively Coupled Plasma-Optical Emission Spectrometry. Partial correlation analysis and Spearman correlation analysis were used to investigate the concentration of different elements and the relationship between 24- h urine and spot urine. RESULTS A partial correlation in sodium, potassium, calcium, magnesium and iron was found between paired 24-h urine and spot urine samples except copper and zinc: 0.430, 0.426, 0.550, 0.221 and 0.191 respectively. CONCLUSIONS Spot urine can replace 24-h urine for estimating some of the elements in hypertensive patients with normal renal function.
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Affiliation(s)
- Tianjing Zhang
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Xiaoyu Chang
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Wanlu Liu
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Xiaoxia Li
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Faxuan Wang
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Liping Huang
- The George Institute for Global Heath, B1801, No. 6 Zhichun Rd, Haidian District, Beijing 100088, China
| | - Sha Liao
- Sichuan Center for Disease Control and Prevention, 6 Xiaoxue Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Xiuying Liu
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Ningxia, China.
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Chen K, Chen D, Lan C, Liang X, Zeng T, Huang J, Duan X, Kong Z, Li S, Tiselius HG, Gurioli A, Lu X, Zeng G, Wu W. Does green tea consumption increase urinary oxalate excretion? Results of a prospective trial in healthy men. Int Urol Nephrol 2017; 50:29-33. [PMID: 29052087 DOI: 10.1007/s11255-017-1720-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/06/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the impact of green tea on urinary oxalate excretion in healthy male volunteers. MATERIALS AND METHODS The oxalate concentrations after different brewing times (2-60 min) of different qualities (2-8 g) of green tea were measured in in vitro experiment. In in vivo experiment, the effects on urine composition were assessed in 12 healthy men with an age of 24-29 years. Each subject was requested to collect two 24-h urine samples under normal dietary conditions. Green tea prepared from tea bags containing 2 g of tea leafs was consumed by the subjects for 7 consecutive days, and 24-h urine samples were collected and analyzed on days 6 and 7. After 3-week washout interval, all subjects consumed green tea containing 4 g of leaf tea for another 7 consecutive days. Two 24-h urine samples were collected on the last 2 days. Urine volume, pH, calcium, magnesium, sodium, phosphate, potassium, chloride, citrate, oxalate, urate and creatinine were measured. RESULTS In the in vitro experiments, oxalate in solution increased with brewing time (p < 0.05) and tea quality (p < 0.05). In the in vivo experiment, 24-h urinary oxalate increased significantly (0.24 ± 0.09 mmol to 0.32 ± 0.13 mmol, p = 0.045) when tea was prepared from 2-g bags of green leaf tea. Consumption of green tea containing 4 g of leaf tea resulted in 24-h urinary oxalate increase (0.25 ± 0.25 mmol to 0.34 ± 0.22 mmol, p = 0.041). CONCLUSIONS In vitro studies showed that there was a gradual increase in solution concentrations of oxalate that was associated with increased brewing time and increased quality of green tea. Studies in normal men showed that green tea consumption was associated with increased urinary exertion of oxalate.
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Affiliation(s)
- Kang Chen
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Dong Chen
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Chuangxin Lan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Xiongfa Liang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Tao Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Jian Huang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Zhenzhen Kong
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Shujue Li
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Hans-Göran Tiselius
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alberto Gurioli
- Department of Urology, Turin University of Studies, Turin, Italy
| | - Xiaogang Lu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China.
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Ma W, Yin X, Zhang R, Liu F, Yang D, Fan Y, Rong J, Tian M, Yu Y. Validation and Assessment of Three Methods to Estimate 24-h Urinary Sodium Excretion from Spot Urine Samples in High-Risk Elder Patients of Stroke from the Rural Areas of Shaanxi Province. Int J Environ Res Public Health 2017; 14:E1211. [PMID: 29019912 DOI: 10.3390/ijerph14101211] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 12/21/2022]
Abstract
Background: 24-h urine collection is regarded as the "gold standard" for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods have been used to estimate 24-h urinary sodium excretion from spot urine samples in some countries, but few studies have been performed to compare and validate these methods in the Chinese population. Objective: To compare and validate the Kawasaki, INTERSALT and Tanaka formulas in predicting 24-h urinary sodium excretion using spot urine samples in 365 high-risk elder patients of strokefrom the rural areas of Shaanxi province. Methods: Data were collected from a sub-sample of theSalt Substitute and Stroke Study. 365 high-risk elder patients of stroke from the rural areas of Shaanxi province participated and their spot and 24-h urine specimens were collected. The concentrations of sodium, potassium and creatinine in spot and 24-h urine samples wereanalysed. Estimated 24-h sodium excretion was predicted from spot urine concentration using the Kawasaki, INTERSALT, and Tanaka formulas. Pearson correlation coefficients and agreement by Bland-Altman method were computed for estimated and measured 24-h urinary sodium excretion. Results: The average 24-h urinary sodium excretion was 162.0 mmol/day, which representing a salt intake of 9.5 g/day. Three predictive equations had low correlation with the measured 24-h sodium excretion (r = 0.38, p < 0.01; ICC = 0.38, p < 0.01 for the Kawasaki; r = 0.35, p < 0.01; ICC = 0.31, p < 0.01 for the INTERSALT; r = 0.37, p < 0.01; ICC = 0.34, p < 0.01 for the Tanaka). Significant biases between estimated and measured 24-h sodium excretion were observed (all p < 0.01 for three methods). Among the three methods, the Kawasaki method was the least biased compared with the other two methods (mean bias: 31.90, 95% Cl: 23.84, 39.97). Overestimation occurred when the Kawasaki and Tanaka methods were used while the INTERSALT method underestimated 24-h sodium excretion. Conclusion: The Kawasaki, INTERSALT and Tanaka methods for estimation of 24-h urinary sodium excretion from spot urine specimens were inadequate for the assessment of sodium intake at the population level in high-risk elder patients of stroke from the rural areas of Shaanxi province, although the Kawasaki method was the least biased compared with the other two methods.
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Iwahori T, Miura K, Ueshima H, Chan Q, Dyer AR, Elliott P, Stamler J. Estimating 24-h urinary sodium/potassium ratio from casual ('spot') urinary sodium/potassium ratio: the INTERSALT Study. Int J Epidemiol 2017; 46:1564-1572. [PMID: 28039381 PMCID: PMC5837629 DOI: 10.1093/ije/dyw287] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 01/20/2023] Open
Abstract
Background Association between casual and 24-h urinary sodium-to-potassium (Na/K) ratio is well recognized, although it has not been validated in diverse demographic groups. Our aim was to assess utility across and within populations of casual urine to estimate 24-h urinary Na/K ratio using data from the INTERSALT Study. Methods The INTERSALT Study collected cross-sectional standardized data on casual urinary sodium and potassium and also on timed 24-h urinary sodium and potassium for 10 065 individuals from 52 population samples in 32 countries (1985-87). Pearson correlation coefficients and agreement were computed for Na/K ratio of casual urine against 24-h urinary Na/K ratio both at population and individual levels. Results Pearson correlation coefficients relating means of 24-h urine and casual urine Na/K ratio were r = 0.96 and r = 0.69 in analyses across populations and individuals, respectively. Correlations of casual urine Na/creatinine and K/creatinine ratios with 24-h urinary Na and K excretion, respectively, were lower than correlation of casual and 24-h urinary Na/K ratio in analyses across populations and individuals. The bias estimate with the Bland-Altman method, defined as the difference between Na/K ratio of 24-h urine and casual urine, was approximately 0.4 across both populations and individuals. Spread around, the mean bias was higher for individuals than populations. Conclusion With appropriate bias correction, casual urine Na/K ratio may be a useful, low-burden alternative method to 24-h urine for estimation of population urinary Na/K ratio. It may also be applicable for assessment of the urinary Na/K ratio of individuals, with use of repeated measurements to reduce measurement error and increase precision.
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Affiliation(s)
- Toshiyuki Iwahori
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Research and Development Department, OMRON HEALTHCARE Co., Ltd, Kyoto, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Alan R Dyer
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Abstract
Obesity is rampant across the spectrum of age, gender, and race in the Unites States. Paralleling this epidemic, kidney stone prevalence is also rising, affecting nearly 1 in 11 individuals. Bariatric surgical procedures, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), are the most effective weight loss options for morbidly obese or severely obese individuals with comorbidities. A number of studies have linked kidney stone development to bariatric surgical history, particularly RYGB, which portends up to a threefold increase in calcium oxalate stone risk compared with age-matched, obese controls. Stone development after malabsorptive (RYGB) and restrictive (SG) bariatric procedures are driven primarily by alterations in 24-h urine profiles, such as increased urinary oxalate, decreased urine volume, and reduced urinary citrate levels-all of which have been linked to increased kidney stone risk. What clinical recommendations, if any, can be given to reduce kidney stone risk in bariatric kidney stone patients? This review provides not only updated stone incidence and 24-h urine data in this population, but also reassurance-the metabolic alterations that result from bariatric surgery can be successfully mitigated by increased provider awareness, patient education, and a combination of dietary and pharmacological adjustments.
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Okuda N, Okayama A, Miura K, Yoshita K, Saito S, Nakagawa H, Sakata K, Miyagawa N, Chan Q, Elliott P, Ueshima H, Stamler J. Food sources of dietary sodium in the Japanese adult population: the international study of macro-/micronutrients and blood pressure (INTERMAP). Eur J Nutr 2016; 56:1269-1280. [PMID: 26903049 DOI: 10.1007/s00394-016-1177-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 02/06/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE It is often reported that Na intake levels are higher in Japan than in western countries. Detailed analysis of food intake and its association with Na intake are necessary for supporting further decreases in Na consumption in Japan. We investigated the association between Na and food intake by food group using data from the Japanese participants of the INTERMAP Study. METHOD Results from the Japanese participants of the INTERMAP Study who did not use antihypertensive medication and/or consume a reduced Na diet were used (531 men and 518 women, aged 40-59 years), obtained from four 24-h dietary recalls and two 24-h urine collections from each participant. We developed a classification system with 46 food group classifications; food consumption and Na intake from these groups were compared across quartiles of participants determined by 24-h urinary Na excretion per unit of body weight (UNa/BW). RESULTS Average daily Na intake from Japanese high-Na foods was 2552 mg/day. Participants with a higher UNa/BW consumed a significantly greater amount of high-Na Japanese foods, such as salted fish (P = 0.001) and miso soup (P < 0.001). They also had greater amount of rice (P = 0.001). Participants with lower UNa/BW consumed a significantly greater amount of western foods, such as bread (P < 0.001) and milk and dairy products (P < 0.001). CONCLUSIONS Detailed analyses of various Japanese and western food intakes in addition to Na intake were performed. These results can be used to help draw up effective programs for the reduction in Na intake and prevention of prehypertension/hypertension in the Japanese population.
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Affiliation(s)
- Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, 1288 Magome, Iwatsuki-ku, Saitama, 339-8539, Japan.
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Katsushi Yoshita
- Department of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - Shigeyuki Saito
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Hideaki Nakagawa
- Department of Public Health, Kanazawa Medical University, Kanazawa, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Public Health, Iwate Medical University, Yahaba, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Queenie Chan
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Jeremiah Stamler
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Mizéhoun-Adissoda C, Desport JC, Houinato D, Bigot A, Dalmay F, Preux PM, Bovet P, Moesch C. Evaluation of iodine intake and status using inductively coupled plasma mass spectrometry in urban and rural areas in Benin, West Africa. Nutrition 2015; 32:560-5. [PMID: 26796150 DOI: 10.1016/j.nut.2015.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 10/21/2015] [Accepted: 11/17/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Iodine deficiency has severe pathological repercussions. The aim of this study was to evaluate iodine intake and status in adults in Benin, West Africa. METHODS We randomly selected 420 participants ages 25 to 64 y and free of visible goiter from urban and rural settings of South Benin. The participants had a diet based on carbohydrates and fish. Urine was collected over a 24-h period and samples were assayed for iodine analysis using inductively coupled plasma mass spectrometry. RESULTS We studied 401 urinary iodine samples. The overall median urinary iodine concentration (UIC) in 24-h urine was 62.9 μg/L (interquartile range: 40-96.2 μg/L). UIC was significantly lower in women than men (56.5 versus 78.6 μg/L; P < 0.001) and in rural versus urban areas (54.7 versus 77.8 μg/L; P < 0.001). In multivariate analysis, low UIC (<100 μg/L) was positively associated with women (odds ratio, 2.48; 95% confidence interval, 1.44-4.26; P = 0.001) and body mass index <25 kg/m(2) (odds ratio, 2.06; 95% confidence interval, 1.20-3.54; P = 0.008). CONCLUSION Iodine intake appeared to be fairly low in the Beninese population, according to World Health Organization criteria, and factors associated with low iodine intake were identified. Public health interventions to increase iodine intake, such as iodization of commercial salt and/or fortification of selected nutrients, should be strengthened at the national level.
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Affiliation(s)
- Carmelle Mizéhoun-Adissoda
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Laboratory of Non-communicable and Neurologic Diseases Epidemiology, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin; CHU Limoges, Unit of Nutrition, Limoges, France
| | - Jean-Claude Desport
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, Unit of Nutrition, Limoges, France.
| | - Dismand Houinato
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Laboratory of Non-communicable and Neurologic Diseases Epidemiology, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin
| | - André Bigot
- Department of Pharmacy, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin
| | - François Dalmay
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Pierre-Marie Preux
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Pascal Bovet
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - Christian Moesch
- INSERM, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, Department of Pharmacology and Toxicology, Limoges, France
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Jenny-Burri J, Haldimann M, Brüschweiler BJ, Bochud M, Burnier M, Paccaud F, Dudler V. Cadmium body burden of the Swiss population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32:1265-72. [PMID: 26062765 DOI: 10.1080/19440049.2015.1051137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Urinary cadmium (Cd) excretion was measured within a representative Swiss collective. With a median of 0.23 µg/24 h (n = 1409) and the 95th percentile at 0.81 µg/24 h, no increased health risk for the general non-exposed population was identified. The independent variables Age, BMI and Smoking habit had a significant effect on urinary Cd excretion. No association was found with the region of residence and sex. A subsample comparison between 24-h and spot urines of the same subjects (n = 90) did not reveal an evident concentration difference for both creatinine-adjusted sample types. Dependencies on age and gender were observed for creatinine, which consequently impacts on the creatinine normalisation of urine samples.
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Affiliation(s)
- Judith Jenny-Burri
- a Federal Food Safety and Veterinary Office , Risk Assessment Division , Bern , Switzerland
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