摘要
目的通过测量284名中小学生两时点24h尿盐/钾排出量评估其食盐/钾摄入水平。方法于2017年10—12月,采用方便抽样的方法在湖南省常德市某乡镇小学和中学招募5年级、6年级、初一至初三在校寄宿学生。剔除标准为腹泻、患有肾脏疾病、月经期女生、漏尿次数≥2次者,最终共纳入284名研究对象。进行问卷调查和体格检查并采集非连续两日24h尿液,对两次24h尿盐/钾排出量的差异性和一致性进行检验,并采用两次24h尿盐/钾排出量的均数估计每日食盐/钾摄入量。结果284名研究对象年龄为(12.1±1.5)岁,男性148名(52.4%);36名(12.7%)研究对象为超重组。两时点的24h尿量、钾离子浓度、尿钾排出量P_(50)(P_(25),P_(75))分别为670(513,868)和660(490,916)ml,29(21,39)和30(21,40)mmol/L,0.7(0.6,1.0)和0.8(0.6,1.0)g,差异均无统计学意义(P>0.05);第2次24h尿液的钠离子浓度、肌酐浓度、盐排出量的P_(50)(P_(25),P_(75))分别为188(133,248)、8.66(5.99,12.47)mmol/L,7.3(5.2,9.2)g,均高于第1次尿液的钠离子浓度、肌酐浓度和盐排出量[175(123,219)、7.20(5.15,10.86)mmol/L,6.6(5.0,8.7)g](P<0.05)。两次24h尿盐、尿钾排出量的组内相关系数分别为0.534(95%CI:0.412~0.631)和0.478(95%CI:0.341~0.587)。研究对象食盐摄入量为(7.3±2.5)g/d,最低摄入量为2.3g/d,最大摄入量为18.8g/d;超重组食盐摄入量[(8.2±2.6)g/d]高于非超重组[(7.2±2.4)g/d](P<0.05)。每日钾摄入量为(1.1±0.3)g/d,最低摄入量为0.4g/d,最高摄入量为2.3g/d;男生每日钾摄入量[(1.1±0.3)g/d]高于女生[(1.0±0.3)g/d](P<0.05),超重人群钾摄入量[(1.2±0.3)g/d]高于非超重人群[(1.0±0.3)g/d](P<0.05)。212名(74.6%)研究对象每日食盐摄入量超过推荐值,所有研究对象钾摄入量均未达到推荐标准值。结论中小学生食盐摄入量超标、钾摄入量不足问题较为严峻。
Objective To estimate the dietary salt and potassium intake by two 24 hour urine salt and potassium excretion in primary and secondary school students.Methods The boarders from Grade 5 to 6 in a rural primary school and Grade 1 to 3 in a rural middle school in Changde City,Hunan Province were recruited from October to December in 2017.Subjects who had 2 and more urinary incontinence episodes or a history of kidney disease or diarrhea and girls in menstruation were excluded.The final analysis included 284 subjects.Questionnaires on basic demographic information were collected,and height and weight were examined.Two inconsecutive 24-hour urine specimens were collected in weekdays.The differences and consistency between two 24-hour urine were tested and dietary salt and potassium intake were assessed by the average of two 24-hour urine collections.Results A Total of 284 participants was(12.1±1.5)years old,of which 148(52.1%)were boys and 36(12.7%)were overweight.In the first 24-hour urine,the volume[P_(50)(P_(25),P_(75))=670(513,868)ml],potassium concentration[P_(50)(P_(25),P_(75))=29(21,39)mmol/L]and potassium excretion[P_(50)(P_(25),P_(75))=0.7(0.6,1.0)g]were similar to those in the second 24-hour urine[P_(50)(P_(25),P_(75))values were 660(490,916)ml,30(21,40)mmol/L,and 0.8(0.6,1.0)g,respectively].But the sodium and creatinine concentrations,salt excretion in the first 24-hour urine[P_(50)(P_(25),P_(75))values were 175(123,219)mmol/L,7.20(5.15,10.86)mmol/L and 6.6(5.0,8.7)g,respectively]were lower than those in the second 24-hour urine[P_(50)(P_(25),P_(75))values were 188(133,248)mmol/L,8.66(5.99,12.47)mmol/L and 7.3(5.2,9.2)g,respectively](all P values<0.05).The intraclass correlation coefficients between salt and potassium excretions in the two 24-hour urine were 0.534(95%CI:0.412-0.631)and 0.478(95%CI:0.341-0.587)(P<0.001),respectively.The mean±SD of salt consumed was(7.3±2.5)g(range:2.3 to 18.8 g)per day by all participants.Overweight children consumed more salt[(8.2±2.6)g/d]than those non-overweight[(7.2±2.4)g/d](P<0.05).The mean±SD of potassium consumed was(1.1±0.3)g(range:0.4 to 2.3 g)per day.Boys consumed more potassium[(1.1±0.3)g/d]than girls[(1.0±0.3)g/d](P<0.05),and overweight children had higher potassium intake[(1.2±0.3)g/d]than those non-overweight[(1.0±0.3)g/d](P<0.05).A total of 212 participants(74.6%)consumed more salt than the recommended level and all participants had inadequate potassium intake.Conclusion The problem of excessive salt intake and insufficient potassium intake of rural primary and middle school students was serious.
作者
董洁
范晖
赵小元
常素英
米杰
Dong Jie;Fan Hui;Zhao Xiaoyuan;Chang Suying;Mi Jie(Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China;Department of Preventive Medicine,North Sichuan Medical College,Nanchong 637100,China;United Nations Children's Fund,Beijing 100600,China;Peking Union Medical College,Beijing 100020,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2019年第2期185-190,共6页
Chinese Journal of Preventive Medicine
基金
国家重点研发计划(2016YFC0900602、2016YFC1300101)
联合国儿童基金会资助项目(Unicef nutrition 20171.23.6).
关键词
盐类
钾
青少年
两次24h尿液
横断面研究
Salts
Potassium
Adolescents
Two 24 hour urine specimens
Cross-sectional study
