OP98 Formulas to estimate dietary sodium intake from spot urine are associated with CVD risk and mortality independently of sodium concentration
Notice bibliographique
Résumé
<h3>Background</h3> Numerous cohort studies with sodium intake measured by gold standard method (i.e. non-consecutive 24h urinary sodium excretion) identified a positive linear association of sodium intake with cardiovascular disease (CVD) risk. However, several studies using formulas to estimate sodium intake from spot urine reported opposite findings. We aim to evaluate whether and how these formulas lead to these different findings. <h3>Methods</h3> UK Biobank is a prospective cohort study with over 500,000 participants aged 40-69 years in the UK recruited during 2006-2010 and followed up. Random spot urine samples were collected and sodium concentration was measured. Sodium intake was estimated by INTERSALT, Kawasaki, and Tanaka formulas, respectively. The primary outcomes included CVD events and deaths. Hazard ratios (HRs) were estimated by Cox proportional-hazard model adjusted for multiple covariates. Quartiles and penalised splines of estimated sodium intakes were assessed to test both linear and non-linear relationships. We also fixed the sodium concentration with sex-specific mean and re-ran the above-mentioned analyses to assess whether and how formulas themselves impacted these associations. All analyses were performed on R v4.2.2. <h3>Results</h3> 435,336 participants were included. 44,268 CVD events and 3,251 CVD deaths occurred during a median follow-up of 12 years. The mean estimated sodium intake was 142.5 (SD=34.6), 178.17 (51.75), and 146.88 (32.79) mmol/day from INTERSALT, Kawasaki and Tanaka formulas. For CVD incidence, linear inverse associations were observed for INTERSALT and Tanaka estimates (HRs [95% CIs]: 0.9 [0.83, 0.97] and 0.93 [0.89, 0.97] for every 50 mmol reduction in estimated daily sodium intake; P-linear=0.0047 and 0.0021), and U-shape association for Kawasaki (P-nonlinear=0.0026). When the sodium concentration term was fixed in the formulas, inverse association was seen for all formulas (HRs [95% CIs]: 0.86 [0.77, 0.95], 0.96 [0.93, 0.99] and 0.94 [0.89, 0.99] for INTERSALT, Kawasaki and Tanaka; P-linear=0.0054, 0.0166 and 0.0188). For CVD mortality, no association was observed for any formula, but a non-linear association for INTERSALT after fixing the sodium concentration term (P-nonlinear=0.0287). <h3>Conclusion</h3> A nonlinear or inverse linear association with CVD incidence was found for formula estimates of sodium intake, and no association was found with CVD mortality. The observed relationships were problematic as formulas were associated with outcomes independently of sodium concentration. Formulas to estimate sodium intake from spot urine samples should not be used in research investigating associations of sodium intake with CVD outcomes, as they are associated with the controversy of benefits from sodium reduction and may hinder implementation of relevant policies.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».