尿液中的和分泌和心血管事件的风险
Martin J O'Donnell1, Salim Yusuf, Andrew Mente
1Population Health Research Institute, Hamilton General Hospital, McMaster University, 237 Barton St E, Third Floor, Hamilton, ON, L8L 2X2, Canada. odonnm@mcmaster.ca
JAMA
|November 24, 2011
概括
高摄入量会增加心血管风险,而非常低的摄入量也会增加死亡率和心力衰竭的风险. 较高的摄入量与心血管疾病患者中风风险降低有关.
科学领域:
- 心血管医学 心血管医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
背景情况:
- 和摄入量与心血管疾病 (CVD) 风险之间的关系尚未完全理解,特别是在已有心血管疾病的个体中.
- 尿液分泌是通过饮食摄入和的可靠替代品.
研究的目的:
- 调查尿液中估计的和分泌量与已确诊心血管疾病或糖尿病患者心血管事件的发生之间的关联.
主要方法:
- 对两个大型队列 (ONTARGET和TRANSCEND试验,N=28,880) 的观察分析.
- 使用川崎配方从早晨禁食尿样中估计24小时尿液中的和分泌量.
- 利用受限立方斜线图和Cox比例危险多变量模型来分析与心血管事件和死亡率的关联.
主要成果:
- 较高的分泌量 (>7克/天) 与心血管死亡,心肌梗塞,中风和心力衰竭住院的风险增加有关.
- 较低的分泌量 (<3g/天) 与较高的心血管死亡和心力衰竭住院的风险有关.
- 分泌量增加与中风风险降低有关.
结论:
- 分泌和心血管事件之间的关联遵循J形曲线,高摄入量和非常低摄入量都有风险.
- 在患有已确定的心血管疾病的患者中,最佳的摄入量似乎在每天4-6g之间.
- 较高的摄入量证明了这种患者群体中对中风的保护作用.
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