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| 中国非糖尿病患者的代谢综合征和血压盐敏性：一项膳食干预研究 |
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| Metabolic syndrome and salt sensitivity of blood pressure in non-diabetic people in China: a dietary intervention study |
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| Chen J., Gu D., Huang J., Rao D.C., Jaquish C.E., Hixson J.E., Chen C.-S., Chen J., Lu F., Hu D., Rice T., Kelly T.N., Hamm L.L., Whelton P.K., He J. 2009/5/29 18:39:20 |
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The Lancet, 2009, Volume 373, Issue 9666
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| Background: Since insulin resistance is thought to be the underlying mechanism for metabolic syndrome, affected individuals might be sensitive to a dietary sodium intervention. We aimed to examine the association between metabolic syndrome and salt sensitivity of blood pressure. Methods: 1906 Chinese participants without diabetes, aged 16 years or more, were selected to receive a low-sodium diet (51·3 mmol per day) for 7 days followed by a high-sodium diet (307·8 mmol per day) for an additional 7 days. Participants were excluded from the analysis if metabolic risk factor information was missing or if they did not complete their dietary interventions. Blood pressure was measured at baseline and on days 2, 5, 6, and 7 of each intervention. Metabolic syndrome was defined as the presence of three or more of: abdominal obesity, raised blood pressure, high triglyceride concentration, low HDL cholesterol, or high glucose. High salt sensitivity was defined as a decrease in mean arterial blood pressure of more than 5 mm Hg during low-sodium or an increase of more than 5 mm Hg during high-sodium intervention. This study is registered with ClinicalTrials.gov, number NCT00721721. Findings: Of the 1881 participants with information regarding metabolic syndrome, 283 had metabolic syndrome. 1853 participants completed the low-sodium diet and 1845 completed the high-sodium diet. Multivariable-adjusted mean changes in blood pressure were significantly greater in participants with metabolic syndrome than in those without on both low-sodium and high-sodium diets (p<0·0001 for all comparisons). Additionally, risk of salt sensitivity rose with increasing numbers of risk factors for metabolic syndrome. Compared with those with no risk factors, participants with four or five had a 3·54-fold increased odds (95% CI 2·05-6·11) of high salt-sensitivity during the low-sodium and a 3·13-fold increased odds (1·80-5·43) of high salt-sensitivity during the high-sodium intervention. Interpretation: These results suggest that metabolic syndrome enhances blood pressure response to sodium intake. Reduction in sodium intake could be an especially important component in reducing blood pressure in patients with multiple risk factors for metabolic syndrome. Funding: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. © 2009 Elsevier Ltd. All rights reserved. |
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| Correspondence Address: Chen, J.; Department of Medicine and Tulane Hypertension, Renal Center of Excellence, School of Medicine, New Orleans, LA, United States; email: jchen@tulane.edu |
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 疾病资源中心
摘自：《西氏内科学》，第23版
患者女性，21岁，因干咳、间歇性气促2个月到急诊科就诊。开始症状为上呼吸道感染引起的鼻塞、流涕和咳嗽。医生检查后开了抗生素。服药后鼻部症状缓解，但仍有轻微干咳和呼吸困难。其他症状包括疲劳和焦虑。否认发热、体重减轻、胸痛、端坐呼吸、气喘、鼻后滴漏、胃灼热以及神经系统症状。
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