1
|
Li Y, Feng Q, Wang S, Li B, Zheng B, Peng N, Li B, Jiang Y, Liu D, Yang Z, Sha F, Tang J. The association between urinary sodium and the risk of dementia: Evidence from a population-based cohort study. J Affect Disord 2024; 362:518-528. [PMID: 39009316 DOI: 10.1016/j.jad.2024.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/14/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Sodium intake reduction is crucial for cardiovascular health, however, its lasting impact on dementia remains unclear. METHODS We included 458,577 UK Biobank participants without dementia at baseline. We estimated 24-h urinary sodium (E24hUNa) using spot urinary parameters and obtained the incidence of all-cause dementia, Alzheimer's disease, and vascular dementia from multiple sources. RESULTS The mean E24hUNa was 3.0 g (1st-99th percentile: 1.5 g-5.1 g). Over a mean follow-up of 13.6 years, 7886 (1.7 %) participants developed all-cause dementia, including 3763 (0.8 %) Alzheimer's disease and 1851 (0.4 %) vascular dementia. In the restricted cubic spline model, we identify a potential cutoff of 3.13 g for E24hUNa, below which each 1 g decrease in E24hUNa was associated with 21 % (95 % confidence interval [CI] 1.11-1.34) higher all-cause dementia risk and 35 % (95 % CI 1.11-1.63) higher vascular dementia risk (P-value <0.001 for non-linearity). The hazard ratios were 1.15 (95 % CI, 1.07-1.24) for all-cause dementia and 1.21 (95 % CI 1.04-1.40) for vascular dementia among individuals with E24hUNa below 3.13 g compared to those with E24hUNa higher than 3.13 g. LIMITATIONS One of the major limitations is the estimation of 24-h urinary sodium with spot urine samples. CONCLUSIONS An E24hUNa level below 3.13 g, equivalent to 3.37 g daily sodium intake, is associated with increased risks of all-cause and vascular dementia. This exploratory study suggests a potential lower limit below which the risk of dementia increases with a lower sodium level. Future studies are necessary to validate our findings.
Collapse
Affiliation(s)
- Ying Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Qi Feng
- Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Shiyu Wang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Bingyu Li
- Department of Government, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Bang Zheng
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Nana Peng
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Bingli Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Yiwen Jiang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Di Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Zhirong Yang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China; Department of Computational Biology and Medical Big Data, Shenzhen University of Advanced Technology, Shenzhen, China; Primary Care Unit, School of Clinical Medicine, University of Cambridge, Box 111 Cambridge Biomedical Campus, Cambridge CB2 0SP, United Kingdom.
| | - Feng Sha
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China.
| | - Jinling Tang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China; Department of Computational Biology and Medical Big Data, Shenzhen University of Advanced Technology, Shenzhen, China; Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou 510623, Guangdong Province, China; Division of Epidemiology, The JC School of Public Health & Primary Care, The Chinese University of Hong Kong, Room 202, School of Public Health Building, Prince of Wales, Hospital, Shatin, New Territories, Hong Kong, China
| |
Collapse
|
2
|
Jaques DA, Ponte B. Dietary Sodium and Human Health. Nutrients 2023; 15:3696. [PMID: 37686728 PMCID: PMC10490134 DOI: 10.3390/nu15173696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Sodium, contained in dietary salt, is essential to human life [...].
Collapse
Affiliation(s)
| | - Belen Ponte
- Division of Nephrology and Hypertension, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret Gentil 4, 1205 Geneva, Switzerland
| |
Collapse
|
3
|
da Silva Ferreira G, Catanozi S, Passarelli M. Dietary Sodium and Nonalcoholic Fatty Liver Disease: A Systematic Review. Antioxidants (Basel) 2023; 12:antiox12030599. [PMID: 36978847 PMCID: PMC10045331 DOI: 10.3390/antiox12030599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
(1) Introduction: Restriction in sodium intake is an important strategy for reducing cardiovascular morbidity and mortality, considering the direct influence of high-sodium diet consumption on the development of hypertension and cardiovascular diseases. There are only a few studies dealing with the influence of dietary sodium on the development of nonalcoholic fatty liver disease (NAFLD). In this systematic review, evidence in humans and animal models was compiled in a critical view of the influence of dietary sodium intake patterns on NAFLD markers; (2) Methods: Systematic review of PubMed data. Clinical outcomes included the prevalence/incidence of NAFLD for human studies, and NAFLD markers (hepatic lipogenesis, and markers of steatosis, fibrosis, and inflammation) for animal studies. The protocol was registered at the International Prospective Register of Systematic Review (PROSPERO; CRD42023390447); (3) Results and Conclusion: Seven studies in humans and eight in animals were included. All studies in humans were observational and associated high-sodium intake with NAFLD. However, in animals, both the increased and reduced consumption of sodium negatively influenced markers of liver steatosis, inflammation, and fibrosis.
Collapse
Affiliation(s)
- Guilherme da Silva Ferreira
- Laboratorio de Lipides (LIM-10), Hospital das Clinicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-000, Brazil
- Correspondence: ; Tel.: +5511-3061-7263
| | - Sergio Catanozi
- Laboratorio de Lipides (LIM-10), Hospital das Clinicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-000, Brazil
| | - Marisa Passarelli
- Laboratorio de Lipides (LIM-10), Hospital das Clinicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-000, Brazil
- Programa de Pós Graduação em Medicina, Universidade Nove de Julho, Sao Paulo 01525-000, Brazil
| |
Collapse
|
4
|
Aerobic Exercise Training Prevents Insulin Resistance and Hepatic Lipid Accumulation in LDL Receptor Knockout Mice Chronically Fed a Low-Sodium Diet. Nutrients 2021; 13:nu13072174. [PMID: 34202724 PMCID: PMC8308437 DOI: 10.3390/nu13072174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/13/2022] Open
Abstract
Background: A low-sodium (LS) diet reduces blood pressure, contributing to the prevention of cardiovascular diseases. However, intense dietary sodium restriction impairs insulin sensitivity and worsens lipid profile. Considering the benefits of aerobic exercise training (AET), the effect of LS diet and AET in hepatic lipid content and gene expression was investigated in LDL receptor knockout (LDLr-KO) mice. Methods: Twelve-week-old male LDLr-KO mice fed a normal sodium (NS) or LS diet were kept sedentary (S) or trained (T) for 90 days. Body mass, plasma lipids, insulin tolerance testing, hepatic triglyceride (TG) content, gene expression, and citrate synthase (CS) activity were determined. Results were compared by 2-way ANOVA and Tukey’s post-test. Results: Compared to NS, LS increased body mass and plasma TG, and impaired insulin sensitivity, which was prevented by AET. The LS-S group, but not the LS-T group, presented greater hepatic TG than the NS-S group. The LS diet increased the expression of genes related to insulin resistance (ApocIII, G6pc, Pck1) and reduced those involved in oxidative capacity (Prkaa1, Prkaa2, Ppara, Lipe) and lipoprotein assembly (Mttp). Conclusion: AET prevented the LS-diet-induced TG accumulation in the liver by improving insulin sensitivity and the expression of insulin-regulated genes and oxidative capacity.
Collapse
|
5
|
Juraschek SP, Kovell LC, Appel LJ, Miller ER, Sacks FM, Chang AR, Christenson RH, Rebuck H, Mukamal KJ. Effects of Diet and Sodium Reduction on Cardiac Injury, Strain, and Inflammation: The DASH-Sodium Trial. J Am Coll Cardiol 2021; 77:2625-2634. [PMID: 34045018 PMCID: PMC8256779 DOI: 10.1016/j.jacc.2021.03.320] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/08/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The DASH (Dietary Approaches to Stop Hypertension) diet has been determined to have beneficial effects on cardiac biomarkers. The effects of sodium reduction on cardiac biomarkers, alone or combined with the DASH diet, are unknown. OBJECTIVES The purpose of this study was to determine the effects of sodium reduction and the DASH diet, alone or combined, on biomarkers of cardiac injury, strain, and inflammation. METHODS DASH-Sodium was a controlled feeding study in adults with systolic blood pressure (BP) 120 to 159 mm Hg and diastolic BP 80 to 95 mm Hg, randomly assigned to the DASH diet or a control diet. On their assigned diet, participants consumed each of three sodium levels for 4 weeks. Body weight was kept constant. At the 2,100 kcal level, the 3 sodium levels were low (50 mmol/day), medium (100 mmol/day), and high (150 mmol/day). Outcomes were 3 cardiac biomarkers: high-sensitivity cardiac troponin I (hs-cTnI) (measure of cardiac injury), N-terminal pro-B-type natriuretic peptide (NT-proBNP) (measure of strain), and high-sensitivity C-reactive protein (hs-CRP) (measure of inflammation), collected at baseline and at the end of each feeding period. RESULTS Of the original 412 participants, the mean age was 48 years; 56% were women, and 56% were Black. Mean baseline systolic/diastolic BP was 135/86 mm Hg. DASH (vs. control) reduced hs-cTnI by 18% (95% confidence interval [CI]: -27% to -7%) and hs-CRP by 13% (95% CI: -24% to -1%), but not NT-proBNP. In contrast, lowering sodium from high to low levels reduced NT-proBNP independently of diet (19%; 95% CI: -24% to -14%), but did not alter hs-cTnI and mildly increased hs-CRP (9%; 95% CI: 0.4% to 18%). Combining DASH with sodium reduction lowered hs-cTnI by 20% (95% CI: -31% to -7%) and NT-proBNP by 23% (95% CI: -32% to -12%), whereas hs-CRP was not significantly changed (-7%; 95% CI: -22% to 9%) compared with the high sodium-control diet. CONCLUSIONS Combining a DASH dietary pattern with sodium reduction can lower 2 distinct mechanisms of subclinical cardiac damage: injury and strain, whereas DASH alone reduced inflammation. (Dietary Patterns, Sodium Intake and Blood Pressure [DASH - Sodium]; NCT00000608).
Collapse
Affiliation(s)
- Stephen P Juraschek
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
| | - Lara C Kovell
- Division of Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Lawrence J Appel
- The Johns Hopkins University School of Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Edgar R Miller
- The Johns Hopkins University School of Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Frank M Sacks
- Harvard T.H. Chan School of Public Health, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | | | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Heather Rebuck
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Mill JG, Malta DC, Nilson EAF, Machado ÍE, Jaime PC, Bernal RTI, Cardoso LSDM, Szwarcwald CL. Factors associated with salt intake in the Brazilian adult population: National Health Survey. CIENCIA & SAUDE COLETIVA 2021; 26:555-567. [PMID: 33605333 DOI: 10.1590/1413-81232021262.37492020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 01/14/2023] Open
Abstract
This paper aims to identify the factors associated with high salt intake in the Brazilian adult population. This is a cross-sectional study with 8,083 adults participating in the National Health Survey (PNS, 2014/15). Salt intake was based on the estimation of 24-hour urinary sodium calculated from the sodium/creatinine ratio in spot urine samples. The highest quartile of the distribution was considered high salt intake. The relationship between high salt consumption and sociodemographic factors, lifestyles, morbidity, and self-rated health status was analyzed by calculating the crude prevalence ratios and the prevalence ratios adjusted for age and gender. Approximately 28.1% had an estimated salt intake higher than 10.56 g/day. Overweight (Adjusted Prevalence Ratio; 95%CI - PRadj 1.23; 1.09-1.39), obesity (PRadj 1.61; 1.43-1.83), and diabetes (PRadj 1.36; 1.17-1.58) were positively associated with high salt intake. Female gender (PRadj 0.73; 0.66-0.80), high schooling level (PRadj 0.88; 0.79-0.99), living in the North and chronic kidney disease (PRadj 0.71; 0.56-0.90) were protective factors. Salt consumption is elevated nationwide and in all population subgroups, requiring coordinated actions.
Collapse
Affiliation(s)
- José Geraldo Mill
- Centro de Ciências da Saúde, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468, Maruípe. 29040-090 Vitória ES Brasil.
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Ísis Eloah Machado
- Programa de Pós-Graduação em Saúde e Nutrição, Departamento de Medicina de Família, Universidade Federal de Ouro Preto. Ouro Preto MG Brasil
| | - Patrícia Constante Jaime
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Regina Tomie Ivata Bernal
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Célia Landman Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| |
Collapse
|
7
|
Pinto PR, Yoshinaga MY, Del Bianco V, Bochi AP, Ferreira GS, Pinto IFD, Rodrigues LG, Nakandakare ER, Okamoto MM, Machado UF, Miyamoto S, Catanozi S, Passarelli M. Dietary sodium restriction alters muscle lipidomics that relates to insulin resistance in mice. J Biol Chem 2021; 296:100344. [PMID: 33524391 PMCID: PMC7949138 DOI: 10.1016/j.jbc.2021.100344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Abstract
A low-sodium (LS) diet has been shown to reduce blood pressure (BP) and the incidence of cardiovascular diseases. However, severe dietary sodium restriction promotes insulin resistance (IR) and dyslipidemia in animal models and humans. Thus, further clarification of the long-term consequences of LS is needed. Here, we investigated the effects of chronic LS on gastrocnemius gene and protein expression and lipidomics and its association with IR and plasma lipids in LDL receptor knockout mice. Three-month-old male mice were fed a normal sodium diet (NS; 0.5% Na; n = 12-19) or LS (0.06% Na; n = 14-20) over 90 days. Body mass (BM), BP, plasma total cholesterol, triacylglycerol (TG), glucose, hematocrit, and IR were evaluated. LS increased BM (9%), plasma TG (51%), blood glucose (19%), and IR (46%) when compared with the NS. RT-qPCR analysis revealed that genes involved in lipid uptake and oxidation were increased by the LS: Fabp3 (106%), Prkaa1 (46%), and Cpt1 (74%). Genes and proteins (assessed by Western blotting) involved in insulin signaling were not changed by the LS. Similarly, lipid species classically involved in muscle IR, such as diacylglycerols and ceramides detected by ultra-high-performance liquid chromatography coupled to mass spectrometry, were also unchanged by LS. Species of phosphatidylcholines (68%), phosphatidylinositol (90%), and free fatty acids (59%) increased while cardiolipins (41%) and acylcarnitines (9%) decreased in gastrocnemius in response to LS and were associated with glucose disposal rate. Together these results suggest that chronic LS alters glycerophospholipid and fatty acids species in gastrocnemius that may contribute to glucose and lipid homeostasis derangements in mice.
Collapse
Affiliation(s)
- Paula Ramos Pinto
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcos Y Yoshinaga
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, Brazil
| | - Vanessa Del Bianco
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula Bochi
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme S Ferreira
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Isabella F D Pinto
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, Brazil
| | - Letícia G Rodrigues
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Edna R Nakandakare
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maristela M Okamoto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ubiratan F Machado
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Sayuri Miyamoto
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, Brazil
| | - Sergio Catanozi
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marisa Passarelli
- Laboratório de Lípides (LIM-10), Hospital das Clínicas (HCFMUSP) da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Programa de Pós-Graduação em Medicina, Universidade Nove de Julho, São Paulo, Brazil.
| |
Collapse
|
8
|
Sodium Intake and Hypertension. Nutrients 2019; 11:nu11091970. [PMID: 31438636 PMCID: PMC6770596 DOI: 10.3390/nu11091970] [Citation(s) in RCA: 291] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 12/24/2022] Open
Abstract
The close relationship between hypertension and dietary sodium intake is widely recognized and supported by several studies. A reduction in dietary sodium not only decreases the blood pressure and the incidence of hypertension, but is also associated with a reduction in morbidity and mortality from cardiovascular diseases. Prolonged modest reduction in salt intake induces a relevant fall in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group, with larger falls in systolic blood pressure for larger reductions in dietary salt. The high sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system. In this review, we have focused on the effects of sodium intake on vascular hemodynamics and their implication in the pathogenesis of hypertension.
Collapse
|
9
|
Bomfim GF, Cau SBA, Bruno AS, Fedoce AG, Carneiro FS. Hypertension: a new treatment for an old disease? Targeting the immune system. Br J Pharmacol 2019; 176:2028-2048. [PMID: 29969833 PMCID: PMC6534786 DOI: 10.1111/bph.14436] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/14/2018] [Accepted: 06/24/2018] [Indexed: 12/22/2022] Open
Abstract
Arterial hypertension represents a serious public health problem, being a major cause of morbidity and mortality worldwide. The availability of many antihypertensive therapeutic strategies still fails to adequately treat around 20% of hypertensive patients, who are considered resistant to conventional treatment. In the pathogenesis of hypertension, immune system mechanisms are activated and both the innate and adaptive immune responses play a crucial role. However, what, when and how the immune system is triggered during hypertension development is still largely undefined. In this context, this review highlights scientific advances in the manipulation of the immune system in order to attenuate hypertension and end-organ damage. Here, we discuss the potential use of immunosuppressants and immunomodulators as pharmacological tools to control the activation of the immune system, by non-specific and specific mechanisms, to treat hypertension and improve end-organ damage. Nevertheless, more clinical trials should be performed with these drugs to establish their therapeutic efficacy, safety and risk-benefit ratio in hypertensive conditions. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
Collapse
Affiliation(s)
| | - Stefany Bruno Assis Cau
- Department of Pharmacology, Institute of Biological ScienceFederal University of Minas GeraisBelo HorizonteMGBrazil
| | - Alexandre Santos Bruno
- Department of Pharmacology, Institute of Biological ScienceFederal University of Minas GeraisBelo HorizonteMGBrazil
| | - Aline Garcia Fedoce
- Department of Pharmacology, Ribeirão Preto Medical SchoolUniversity of São PauloSão PauloBrazil
| | - Fernando S Carneiro
- Department of Pharmacology, Ribeirão Preto Medical SchoolUniversity of São PauloSão PauloBrazil
| |
Collapse
|
10
|
Park YM, Kwock CK, Park S, Eicher-Miller HA, Yang YJ. An association of urinary sodium-potassium ratio with insulin resistance among Korean adults. Nutr Res Pract 2018; 12:443-448. [PMID: 30323912 PMCID: PMC6172169 DOI: 10.4162/nrp.2018.12.5.443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/05/2018] [Accepted: 09/20/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40-69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.
Collapse
Affiliation(s)
- Yeong Mi Park
- Department of Foods and Nutrition, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul 02748, Korea
| | - Chang Keun Kwock
- Nutrition and Diet Research Group, Korea Food Research Institute, Jeonbuk 55365, Korea
| | - Seyeon Park
- Department of Applied Chemistry, Dongduk Women's University, Seoul 02748, Korea
| | - Heather A Eicher-Miller
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907, USA
| | - Yoon Jung Yang
- Department of Foods and Nutrition, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul 02748, Korea.,Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907, USA
| |
Collapse
|
11
|
|
12
|
Wu CH, Mohammadmoradi S, Chen JZ, Sawada H, Daugherty A, Lu HS. Renin-Angiotensin System and Cardiovascular Functions. Arterioscler Thromb Vasc Biol 2018; 38:e108-e116. [PMID: 29950386 PMCID: PMC6039412 DOI: 10.1161/atvbaha.118.311282] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Chia-Hua Wu
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
| | - Shayan Mohammadmoradi
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
| | - Jeff Z Chen
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
| | - Hisashi Sawada
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
| | - Alan Daugherty
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
| | - Hong S Lu
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
| |
Collapse
|
13
|
Özkan G, Kara SP, Fidan Ç, Güzel S, Ulusoy Ş. Soluble endothelial protein C is associated with blood pressure variability and salt consumption but not mean blood pressure in patients with newly diagnosed primary hypertension. Clin Exp Hypertens 2018; 41:353-358. [DOI: 10.1080/10641963.2018.1481425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Gülsüm Özkan
- Department of Nephrology, Namık Kemal University, School of Medicine, Tekirdağ, Turkey
| | - Sonat Pınar Kara
- Department of Internal Medicine, Namık Kemal University, School of Medicine, Tekirdağ, Turkey
| | - Çiğdem Fidan
- Department of Biochemistry, Namık Kemal University, School of Medicine, Tekirdağ, Turkey
| | - Savaş Güzel
- Department of Biochemistry, Namık Kemal University, School of Medicine, Tekirdağ, Turkey
| | - Şükrü Ulusoy
- Department of Nephrology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey
| |
Collapse
|
14
|
Afsar B, Kuwabara M, Ortiz A, Yerlikaya A, Siriopol D, Covic A, Rodriguez-Iturbe B, Johnson RJ, Kanbay M. Salt Intake and Immunity. Hypertension 2018; 72:19-23. [PMID: 29760151 DOI: 10.1161/hypertensionaha.118.11128] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Baris Afsar
- From the Department of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey (B.A.)
| | - Masanari Kuwabara
- Department of Medicine (M. Kuwabara, R.J.J.).,Department of Cardiology, Toranomon Hospital, Tokyo, Japan (M. Kuwabara)
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Spain (A.O.)
| | - Aslihan Yerlikaya
- Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey (A.Y.)
| | - Dimitrie Siriopol
- Department of Nephrology, Dialysis and Renal Transplant Center, "Dr C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania (D.S., A.C.)
| | - Adrian Covic
- Department of Nephrology, Dialysis and Renal Transplant Center, "Dr C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania (D.S., A.C.)
| | - Bernardo Rodriguez-Iturbe
- Division of Renal Diseases and Hypertension (B.R.-I.), University of Colorado Anschutz Medical Campus, Aurora, CO.,Renal Service, Hospital Universitario, Universidad del Zulia and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | | | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey (M. Kanbay).
| |
Collapse
|
15
|
Hasenegger V, Rust P, König J, Purtscher AE, Erler J, Ekmekcioglu C. Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria. Nutrients 2018; 10:E311. [PMID: 29509671 PMCID: PMC5872729 DOI: 10.3390/nu10030311] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 01/11/2023] Open
Abstract
Excessive salt intake is known to increase blood pressure and cardiovascular risk. Nevertheless, salt intake exceeds the recommendations in most countries. To face this problem, it is important to identify high consumers as well as the main contributors of salt intake. Overall, data of 2018 adults between 18 and 64 years were analysed to determine the main sources, socio-demographic and anthropometric correlates of salt intake. Dietary intake was assessed from 24-h-recalls, information on socio-demographic characteristics was obtained using a questionnaire and anthropometric data were measured. Salt intake was significantly higher in males than in females. There was a significant positive association between salt intake and body mass index. No significant differences in salt intake were observed for other variables including affluence, educational level, smoking status and physical activity. The main contributor to salt intake were condiments including table salt (32.6%), followed by cereals and cereal products (27.0%), meat and meat products (16.1%) and dairy products (14.0%). These results highlight that specific population groups need to be targeted by public health initiatives and that a reduction in salt intake can only be achieved in tandem with the food producers by the reduction of salt in processed foods.
Collapse
Affiliation(s)
- Verena Hasenegger
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Petra Rust
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
| | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
| | - Anna Elisabeth Purtscher
- Health University of Applied Sciences, Tyrol, Bachelor Programm Dietetics, Innrain 98, 6020 Innsbruck, Austria.
| | - Judith Erler
- Health University of Applied Sciences, Tyrol, Bachelor Programm Dietetics, Innrain 98, 6020 Innsbruck, Austria.
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| |
Collapse
|
16
|
Kang HJ, Jun DW, Lee SM, Jang EC, Cho YK. Low salt and low calorie diet does not reduce more body fat than same calorie diet: a randomized controlled study. Oncotarget 2018; 9:8521-8530. [PMID: 29492213 PMCID: PMC5823556 DOI: 10.18632/oncotarget.23959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/16/2017] [Indexed: 11/25/2022] Open
Abstract
Background Recent several observational studies have reported that high salt intake is associated with obesity. But it is unclear whether salt intake itself induce obesity or low salt diet can reduce body fat mass. We investigated whether a low salt diet can reduce body weight and fat amount. Matrials and Methods The randomized, open-label pilot trial was conducted at a single institution. A total of 85 obese people were enrolled. All participants were served meals three times a day, and provided either a low salt diet or control diet with same calorie. Visceral fat was measured with abdominal computer tomography, while body fat mass and total body water was measured with bio-impedance. Results Reductions in body weight (–6.3% vs. –5.0%, p = 0.05) and BMI (–6.6% vs. –5.1%, p = 0.03) were greater in the low salt group than in the control group. Extracellular water and total body water were significantly reduced in the low salt group compared to the control group. However, changes in body fat mass, visceral fat area, and skeletal muscle mass did not differ between the two groups. Changes in lipid profile, fasting glucose, and HOMA-IR did not differ between the two groups. Conclusions A two-month low salt diet was accompanied by reduction of body mass index. However, the observed decrease of body weight was caused by reduction of total body water, not by reduction of body fat mass or visceral fat mass.
Collapse
Affiliation(s)
- Hye Jin Kang
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Seung Min Lee
- Department of Food and Nutrition, Sungshin Women's University, Seoul, South Korea
| | - Eun Chul Jang
- Department of Occupational and Environmental Medicine, Soonchunhyang University College of Medicine, Cheonan, South Korea
| | - Yong Kyun Cho
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
17
|
Baldo M, Faria T, Mill J. 19. Epidemiological aspects underlying the association between dietary salt intake and hypertension. HUMAN HEALTH HANDBOOKS 2017. [DOI: 10.3920/978-90-8686-853-7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- M.P. Baldo
- Department of Pathophysiology, Montes Claros State University – UNIMONTES, Av Rui Braga, Vila Mauriceia 39401-089, Montes Claros, MG, Brazil
| | - T.O. Faria
- Department of Physiological Sciences, Federal University of Espírito Santo, Av Marechal Campos, Maruípe 29042-755, Vitória, ES, Brazil
| | - J.G. Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Av Marechal Campos, Maruípe 29042-755, Vitória, ES, Brazil
| |
Collapse
|
18
|
Fusco FB, Gomes DJ, Bispo KCS, Toledo VP, Barbeiro DF, Capelozzi VL, Furukawa LNS, Velosa APP, Teodoro WR, Heimann JC, Quintao ECR, Passarelli M, Nakandakare ER, Catanozi S. Low-sodium diet induces atherogenesis regardless of lowering blood pressure in hypertensive hyperlipidemic mice. PLoS One 2017; 12:e0177086. [PMID: 28481921 PMCID: PMC5421755 DOI: 10.1371/journal.pone.0177086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 04/21/2017] [Indexed: 12/21/2022] Open
Abstract
This study investigated the influence of sodium restriction and antihypertensive drugs on atherogenesis utilizing hypertensive (H) low-density lipoprotein-receptor knockout mice treated or not with losartan (Los) or hydralazine (Hyd) and fed low-sodium (LS) or normal-sodium (NS) chow. Despite reducing the blood pressure (BP) of H-LS mice, the LS diet caused arterial lipid infiltration due to increased plasma total cholesterol (TC) and triglycerides (TG). Los and Hyd reduced the BP of H-LS mice, and Los effectively prevented arterial injury, likely by reducing plasma TG and nonesterified fatty acids. Aortic lipid infiltration was lower in Los-treated H-LS mice (H-LS+Los) than in normotensive (N)-LS and H-LS mice. Aortic angiotensin II type 1 (AT1) receptor content was greater in H-NS than H-LS mice and in H-LS+Hyd than H-LS+Los mice. Carboxymethyl-lysine (CML) and receptor for advanced glycation end products (RAGE) immunostaining was greater in H-LS than H-NS mice. CML and RAGE levels were lower in LS animals treated with antihypertensive drugs, and Hyd enhanced the AT1 receptor level. Hyd also increased the gene expression of F4/80 but not tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-10, intercellular adhesion molecule-1 or cluster of differentiation 66. The novelty of the current study is that in a murine model of simultaneous hypertension and hyperlipidemia, the pleiotropic effect of chronic, severe sodium restriction elicited aortic damage even with reduced BP. These negative effects on the arterial wall were reduced by AT1 receptor antagonism, demonstrating the influence of angiotensin II in atherogenesis induced by a severely LS diet.
Collapse
Affiliation(s)
- Fernanda B. Fusco
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Diego J. Gomes
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Kely C. S. Bispo
- Department of Pathology of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Veronica P. Toledo
- Rheumatology Division (LIM-17) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Denise F. Barbeiro
- Emergency Medicine Department (LIM-51) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Vera L. Capelozzi
- Department of Pathology of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Luzia N. S. Furukawa
- Experimental Hypertension Laboratory (LIM-16) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Ana P. P. Velosa
- Rheumatology Division (LIM-17) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Walcy R. Teodoro
- Rheumatology Division (LIM-17) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Joel C. Heimann
- Experimental Hypertension Laboratory (LIM-16) of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Eder C. R. Quintao
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Marisa Passarelli
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Edna R. Nakandakare
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Sergio Catanozi
- Lipids Laboratory (LIM-10) of Endocrinology Division of the University of São Paulo Medical School, São Paulo, SP, Brazil
- * E-mail:
| |
Collapse
|
19
|
Gruppen EG, Connelly MA, Vart P, Otvos JD, Bakker SJ, Dullaart RP. GlycA, a novel proinflammatory glycoprotein biomarker, and high-sensitivity C-reactive protein are inversely associated with sodium intake after controlling for adiposity: the Prevention of Renal and Vascular End-Stage Disease study. Am J Clin Nutr 2016; 104:415-22. [PMID: 27305953 DOI: 10.3945/ajcn.116.133744] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/13/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The extent to which dietary sodium intake may confer alterations in the inflammatory status is unclear. GlycA is a novel proton nuclear magnetic resonance spectroscopy-measured biomarker of systemic inflammation, which is associated with the development of cardiovascular disease and diabetes. OBJECTIVE We determined associations of the inflammatory markers GlycA and high-sensitivity C-reactive protein (hsCRP) with 24-h sodium excretion. DESIGN A cross-sectional, population-based study was performed in 3935 subjects who were not using an antihypertensive medication, lipid-lowering drugs, or a glucose-lowering treatment. Urinary sodium excretion was calculated as the mean of two 24-h urine excretions. Linear regression models were used, with 24-h sodium excretion as an independent variable and GlycA or ln hsCRP as a dependent variable. RESULTS The mean ± SD sodium excretion was 143.0 ± 53.4 mmol/24 h. The GlycA concentration was 343.6 ± 58.7 μmol/L, and the geometric mean of the hsCRP concentration was 1.20 mg/L (95% CI: 1.16, 1.25 mg/L). In age- and sex-adjusted analyses, GlycA and ln hsCRP were not significantly associated with 24-h sodium excretion [B: 1.23 (95% CI: -0.67, 3.13; P = 0.21) and 0.03 (95% CI: -0.004, 0.07; P = 0.08), respectively, per 1-SD increase]. After additional adjustment for body mass index (BMI), both GlycA (B: -2.76; 95% CI: -4.65, -0.86; P = 0.004) and ln hsCRP (B: -0.07; 95% CI: -0.11, -0.04; P < 0.001) were inversely associated with 24-h sodium excretion. These associations were similar if adjustment was performed for waist circumference instead of BMI or if additional adjustment was performed for relevant clinical and laboratory variables and were particularly present in men. CONCLUSIONS The proinflammatory biomarkers GlycA and hsCRP are inversely related to higher 24-h sodium excretion when taking into account the variation in adiposity. These inverse relations remain present after taking into account other covariates.
Collapse
Affiliation(s)
- Eke G Gruppen
- Departments of Nephrology and Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, Netherlands;
| | - Margery A Connelly
- LipoScience, Laboratory Corporation of America Holdings, Raleigh, NC; and
| | - Priya Vart
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - James D Otvos
- LipoScience, Laboratory Corporation of America Holdings, Raleigh, NC; and
| | | | - Robin Pf Dullaart
- Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
20
|
Oh H, Lee HY, Jun DW, Lee SM. Low Salt Diet and Insulin Resistance. Clin Nutr Res 2016; 5:1-6. [PMID: 26839871 PMCID: PMC4731857 DOI: 10.7762/cnr.2016.5.1.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 01/23/2016] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
It is well known that high sodium intake is closely associated with the risk of cardiovascular disease, but the effect of low sodium intake on insulin resistance is not clear. In this article, we summarize findings from previous studies focusing on the association between low sodium intake and insulin resistance. While many investigations on this topic have been conducted actively, their major findings are inconsistent, partly due to different study designs. Thus, additional randomized controlled trials with an adequate study period and reasonable levels of low sodium intake are needed.
Collapse
Affiliation(s)
- Hyunwoo Oh
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
| | - Hyo Young Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
| | - Seung Min Lee
- Department of Food and Nutrition, Sungshin Women's University, Seoul 01133, Korea
| |
Collapse
|
21
|
Impact of Salt Intake on the Pathogenesis and Treatment of Hypertension. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 956:61-84. [DOI: 10.1007/5584_2016_147] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
22
|
Patel SM, Cobb P, Saydah S, Zhang X, de Jesus JM, Cogswell ME. Dietary sodium reduction does not affect circulating glucose concentrations in fasting children or adults: findings from a systematic review and meta-analysis. J Nutr 2015; 145:505-13. [PMID: 25733466 PMCID: PMC4336531 DOI: 10.3945/jn.114.195982] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although evidence shows that reduced sodium intake lowers blood pressure, some studies suggest that sodium reduction may adversely affect insulin resistance and glucose tolerance. OBJECTIVES The objectives were to assess the effects of sodium reduction on glucose tolerance, evaluate strengths and weaknesses of the relevant scientific literature, and provide direction for future research. METHODS We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, and Web of Science through August 2014. Both randomized and nonrandomized intervention trials were included in our meta-analyses. The effects of sodium reduction on glucose tolerance were evaluated in 37 articles, but because of a lack of comparable data, 8 trials were excluded from the meta-analyses. RESULTS Participants were 10-79 y old, either primarily healthy or with hypertension. In meta-analyses of 20 randomized, crossover trials (n = 504 participants) and 9 nonrandomized crossover trials (n = 337), circulating glucose concentrations of fasting participants were not affected by reduction in sodium intake. In contrast, in meta-analyses of 19 of the 20 randomized, crossover trials (n = 494), fasting insulin concentrations were 9.53 pmol/L higher (95% CI: 5.04, 14.02 pmol/L higher) with sodium reduction. In 9 nonrandomized trials (n = 337), fasting insulin did not differ with reduced sodium intake. Results differed little when the analyses were restricted to studies with a low risk of bias and duration of ≥7 d. CONCLUSIONS This meta-analysis revealed no evidence that, in trials with a short intervention and large reductions in sodium, circulating glucose concentrations differed between groups. Recommendations for future studies include extending intervention durations, ensuring comparability of groups at baseline through randomization, and assessing sodium intakes relevant to population sodium reduction. In addition, analyses on other metabolic variables were limited because of the number of trials reporting these outcomes and lack of consistency across measures, suggesting a need for comparable measures of glucose tolerance across studies.
Collapse
Affiliation(s)
- Sheena M Patel
- Divisions of Heart Disease and Stroke Prevention and Oak Ridge Institute for Science and Education, Atlanta, GA; and
| | - Paul Cobb
- Divisions of Heart Disease and Stroke Prevention and
| | | | | | | | | |
Collapse
|
23
|
Procalcitonin and the inflammatory response to salt in essential hypertension: a randomized cross-over clinical trial. J Hypertens 2014; 31:1424-30; discussion 1430. [PMID: 23743803 DOI: 10.1097/hjh.0b013e328360ddd5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Inflammation is considered as a major effector of arterial damage brought about by salt excess in animal models. In a randomized, single masked, cross-over study in 32 uncomplicated essential hypertensive patients, we assessed the effect of a short-term low-salt diet on biomarkers of innate immunity [procalcitonin (PCT), interleukin-6, C-reactive protein, and tumor necrosis factor-α (TNF-α)], adiponectin (ADPN, an anti-inflammatory cytokine), and leptin. METHODS Patients were randomized to either a 10-20 mmol sodium diet and sodium tablets (180 mEq/day) to achieve a 200 mmol intake per day or the same diet and identical placebo tablets, each for 2 weeks. At the end of each of these periods, all patients underwent a 24-h urine collection, a fasting blood sampling, and a 24 h ambulatory blood pressure monitoring. RESULTS In parallel with expected increase in plasma renin activity and aldosterone (P<0.001), both PCT (+33%) and TNF-α (9%) rose at low salt intake (P≤0.007) while ADPN underwent an opposite change (- 17%, P<0.001). In a linear regression analysis for repeated measurements, PCT was significantly and inversely related to urinary salt (weighted r=-0.27, P=0.03). Changes in inflammation biomarkers did not differ in salt-sensitive (n=7) and salt-resistant (n=25) patients. CONCLUSION In essential hypertensive patients, a very low salt diet generates a pro-inflammatory phenotype characterized by an increase in PCT and TNF-α and an opposite effect on an anti-inflammatory cytokine like ADPN.
Collapse
|
24
|
Chen X, Rateri DL, Howatt DA, Balakrishnan A, Moorleghen JJ, Morris AJ, Charnigo R, Cassis LA, Daugherty A. Amlodipine reduces AngII-induced aortic aneurysms and atherosclerosis in hypercholesterolemic mice. PLoS One 2013; 8:e81743. [PMID: 24244746 PMCID: PMC3828247 DOI: 10.1371/journal.pone.0081743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/24/2013] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this study was to determine effects of amlodipine, a dihydropyridine calcium channel blocker, on development of angiotensin II (AngII)-induced vascular pathologies. Methods and Results Male LDL receptor -/- mice were infused with vehicle, amlodipine (5 mg/kg/d), AngII (1,000 ng/kg/min), or AngII + amlodipine for 4 weeks through osmotic pumps (n=10/group). Mice were fed a saturated fat-enriched diet for 1 week prior to pump implantation and during 4 weeks of infusion. Infusion of amlodipine resulted in plasma concentrations of 32 ± 2 ng/ml and 27 ± 2 ng/ml for mice in saline + amlodipine and AngII + amlodipine groups, respectively. This infusion rate of amlodipine did not affect AngII-induced increases in systolic blood pressure. Three of 10 (30%) mice infused with AngII died of aortic rupture, while aortic rupture did not occur in mice co-infused with AngII + amlodipine. Suprarenal aortic width and intimal area of ascending aortas were measured to define aortic aneurysms. In the absence of AngII infusion, amlodipine did not change suprarenal aortic width and ascending aortic area. Infusion of AngII led to profound increases of suprarenal aortic width (saline + vehicle versus AngII + vehicle: 0.86 ± 0.02 versus 1.72 ± 0.26 mm; P=0.0006), whereas co-infusion of AngII and amlodipine diminished abdominal dilation (1.02 ± 0.14 mm; P=0.003). As expected, AngII infusion increased mean intimal area of ascending aortas (saline + vehicle versus AngII + vehicle: 8.5 ± 0.3 versus 12.5 ± 1.1 mm2; P=0.001), while co-infusion of AngII and amlodipine ablated dilation of the ascending aorta (8.6 ± 0.2 mm2; P=0.03). Co-administration of amlodipine also significantly attenuated AngII-induced atherosclerosis in the thoracic region as quantified by percent lesion area (AngII + vehicle versus AngII + amlodipine: 5.8 ± 2.1 % versus 0.3 ± 0.1%; P=0.05). Conclusions Amlodipine inhibited AngII-induced aortic aneurysms in both the abdominal and ascending regions, and atherosclerosis in hypercholesterolemic mice.
Collapse
Affiliation(s)
- Xiaofeng Chen
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Ando K, Kawarazaki H, Miura K, Matsuura H, Watanabe Y, Yoshita K, Kawamura M, Kusaka M, Kai H, Tsuchihashi T, Kawano Y. [Scientific Statement]. Hypertens Res 2013; 36:1009-19. [DOI: 10.1038/hr.2013.102] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/24/2013] [Indexed: 02/05/2023]
|
26
|
Georg Jensen M, Pedersen C, Kristensen M, Frost G, Astrup A. Review: efficacy of alginate supplementation in relation to appetite regulation and metabolic risk factors: evidence from animal and human studies. Obes Rev 2013; 14:129-44. [PMID: 23145880 DOI: 10.1111/j.1467-789x.2012.01056.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 09/21/2012] [Accepted: 09/26/2012] [Indexed: 12/24/2022]
Abstract
This review provides a critical update on human and animal studies investigating the effect of alginate supplementation on appetite regulation, glycaemic and insulinemic responses, and lipid metabolism with discussion of the evidence on potential mechanisms, efficacy and tolerability. Dependent on vehicle applied for alginate supplementation, the majority of animal and human studies suggest that alginate consumption does suppress satiety and to some extent energy intake. Only one long-term intervention trial found effects on weight loss. In addition, alginates seem to exhibit beneficial influence on postprandial glucose absorption and insulin response in animals and humans. However, alginate supplementation was only found to have cholesterol-lowering properties in animals. Several mechanisms have been suggested for the positive effect observed, which involve delayed gastric emptying, increased viscosity of digesta and slowed nutrient absorption in the small intestine upon alginate gel formation. Despite reasonable efficacy and tolerability from the acute or short-term studies, we still realize there is a critical need for development of optimal alginate types and vehicles as well as studies on further long-term investigation on alginate supplementation in humans before inferring that it could be useful in the management of obesity and the metabolic syndrome.
Collapse
Affiliation(s)
- M Georg Jensen
- Department of Human Nutrition, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
| | | | | | | | | |
Collapse
|
27
|
Lu H, Wu C, Howatt DA, Balakrishnan A, Charnigo RJ, Cassis LA, Daugherty A. Differential effects of dietary sodium intake on blood pressure and atherosclerosis in hypercholesterolemic mice. J Nutr Biochem 2012; 24:49-53. [PMID: 22705323 DOI: 10.1016/j.jnutbio.2012.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 02/29/2012] [Accepted: 03/01/2012] [Indexed: 01/11/2023]
Abstract
The amount of dietary sodium intake regulates the renin angiotensin system (RAS) and blood pressure, both of which play critical roles in atherosclerosis. However, there are conflicting findings regarding the effects of dietary sodium intake on atherosclerosis. This study applied a broad range of dietary sodium concentrations to determine the concomitant effects of dietary sodium intake on the RAS, blood pressure, and atherosclerosis in mice. Eight-week-old male low-density lipoprotein receptor -/- mice were fed a saturated fat-enriched diet containing selected sodium concentrations (Na 0.01%, 0.1%, or 2% w/w) for 12 weeks. Mice in these three groups were all hypercholesterolemic, although mice fed Na 0.01% and Na 0.1% had higher plasma cholesterol concentrations than mice fed Na 2%. Mice fed Na 0.01% had greater abundances of renal renin mRNA than those fed Na 0.1% and 2%. Plasma renin concentrations were higher in mice fed Na 0.01% (14.2 ± 1.7 ng/ml/30 min) than those fed Na 0.1% or 2% (6.2 ± 0.6 and 5.8 ± 1.6 ng/ml per 30 min, respectively). However, systolic blood pressure at 12 weeks was higher in mice fed Na 2% (138 ± 3 mm Hg) than those fed Na 0.01% and 0.1% (129 ± 3 and 128 ± 4 mmHg, respectively). In contrast, mice fed Na 0.01% (0.17 ± 0.02 mm(2)) had larger atherosclerotic lesion areas in aortic roots than those fed Na 2% (0.09 ± 0.01 mm(2)), whereas lesion areas in mice fed Na 0.1% (0.12 ± 0.02 mm(2)) were intermediate between and not significantly different from those in Na 0.01% and Na 2% groups. In conclusion, while high dietary sodium intake led to higher systolic blood pressure, low dietary sodium intake augmented atherosclerosis in hypercholesterolemic mice.
Collapse
Affiliation(s)
- Hong Lu
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY 40536, USA
| | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW Recent data suggest that mineralocorticoid receptor activation can affect insulin resistance independent of its effects on blood pressure. This review discusses new evidence linking mineralocorticoid receptor to insulin resistance and the underlying mechanisms of these effects. RECENT FINDINGS Observational studies have shown mineralocorticoid activity to be associated with insulin resistance irrespective of race, blood pressure or body weight. Increased mineralocorticoid activity may be the common link between obesity, hypertension, dyslipidemia and insulin resistance, features that make up the metabolic syndrome. Treatment of primary aldosteronism is associated with a decrease in insulin resistance and provides one of the most convincing evidences in favor of the contribution of mineralocorticoid receptor to insulin resistance. Dietary salt restriction, which increases aldosterone levels, is also associated with an increase in insulin resistance. Potential mechanisms by which mineralocorticoid receptor may contribute to insulin resistance include a decreased transcription of the insulin receptor gene, increased degradation of insulin receptor substrates, interference with insulin signaling mechanisms, decreased adiponectin production and increased oxidative stress and inflammation. Advantages of mineralocorticoid receptor antagonists on insulin resistance have been demonstrated in animal models. SUMMARY There may be a benefit of mineralocorticoid receptor antagonists in human insulin resistance states, but more clinical research is needed to explore these possibilities.
Collapse
Affiliation(s)
- Rajesh Garg
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | | |
Collapse
|
29
|
Vanholder R. The ultimate salt war? Uraemic toxins are all that count in dialysis patients. Nephrol Dial Transplant 2012; 27:62-6. [DOI: 10.1093/ndt/gfr637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
de Oliveira C, de Mattos ABM, Silva CBR, Mota JF, Zemdegs JCS. Nutritional and hormonal modulation of adiponectin and its receptors adipoR1 and adipoR2. VITAMINS AND HORMONES 2012; 90:57-94. [PMID: 23017712 DOI: 10.1016/b978-0-12-398313-8.00003-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Adiponectin is the most abundant plasma protein synthesized mostly by adipose tissue and is an insulin-sensitive hormone, playing a central role in glucose and lipid metabolism. Adiponectin effects are mediated via two receptors, adipoR1 and adipoR2. Several hormones and diet components that are involved in insulin resistance may impair insulin sensitivity at least in part by decreasing adiponectin and adiponectin receptors. Adiponectin expression and serum levels are associated with the amount and type of fatty acids and carbohydrate consumed. Other food items, such as vitamins, alcohol, sodium, green tea, and coffee, have been reported to modify adiponectin levels. Several hormones, including testosterone, estrogen, prolactin, glucocorticoids, catecholamines, and growth hormone, have been shown to inhibit adiponectin production, but the studies are still controversial. Even so, adiponectin is a potential therapeutic target in the treatment of diabetes mellitus and other diseases associated with hypoadiponectinemia.
Collapse
Affiliation(s)
- Cristiane de Oliveira
- Systemic Inflammation Laboratory, Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, USA.
| | | | | | | | | |
Collapse
|
31
|
Kalogeropoulos AP, Georgiopoulou VV, Butler J. From Risk Factors to Structural Heart Disease: The Role of Inflammation. Heart Fail Clin 2012; 8:113-23. [DOI: 10.1016/j.hfc.2011.08.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
32
|
Uurtuya S, Kotani K, Koibuchi H, Miyamoto M, Kario K, Yamada T, Taniguchi N. The relationship between serum C-reactive protein and daily physical activity in Japanese hypertensive patients. Clin Exp Hypertens 2011; 32:517-22. [PMID: 21091357 DOI: 10.3109/10641963.2010.496512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hypertension (HT) and C-reactive protein (CRP) are risk factors of cardiovascular diseases (CVD). The current study's purpose was to investigate the relationship between serum CRP levels and daily lifestyles, including physical activity, in Japanese HT patients. Lifestyle factors, blood pressure (BP), blood cholesterol, glucose, and CRP were measured in a total of 312 HT patients (153 men/159 women, mean age: 62.6 y). Women with physical activity of ≥ 1 time/week showed significantly lower CRP levels than those without it (p < 0.05). The data suggest that regular physical activity could reduce the CRP levels in HT patients, thereby maybe preventing CVD.
Collapse
Affiliation(s)
- Shuumarjav Uurtuya
- Department of Clinical Laboratory Medicine, Jichi Medical University, Tochigi, Japan
| | | | | | | | | | | | | |
Collapse
|
33
|
Sarno F, Jaime PC, Ferreira SRG, Monteiro CA. [Sodium intake and metabolic syndrome: a systematic review]. ACTA ACUST UNITED AC 2011; 53:608-16. [PMID: 19768251 DOI: 10.1590/s0004-27302009000500013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 05/29/2009] [Indexed: 01/22/2023]
Abstract
Recent studies have shown that sodium intake restrictions may increase insulin resistance (IR) and induce changes on serum lipoproteins and on inflammation markers that are similar to those found in metabolic syndrome (MS). We performed a systematic review of literature regarding the effects of restricting sodium intake on MS or on IR. Nine articles were included in the review. Restriction of sodium consumption was associated with increase insulin resistance in two articles and with decrease in three others. In seven of nine articles, salt intake restriction determined blood pressure reduction, and in two articles adverse effects on markers of MS were found. Most studies showed beneficial effects of moderate sodium intake restriction, associated or not to others nutritional modifications or increased physical activity. Further studies are needed to evaluate the effects of moderate sodium consumption reductions on MS and IR.
Collapse
Affiliation(s)
- Flávio Sarno
- Programa de Pós-graduação em Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo Av. Doutor Arnaldo, 715, 2o andar 01246-904 -- São Paulo, SP, Brasil.
| | | | | | | |
Collapse
|
34
|
Simpson NS, Banks S, Arroyo S, Dinges DF. Effects of sleep restriction on adiponectin levels in healthy men and women. Physiol Behav 2010; 101:693-8. [PMID: 20723551 PMCID: PMC2975754 DOI: 10.1016/j.physbeh.2010.08.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 08/10/2010] [Accepted: 08/12/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Population studies have consistently found that shorter sleep durations are associated with obesity and cardiovascular disease, particularly among women. Adiponectin is an adipocyte-derived, anti-inflammatory hormone that is related to cardiovascular disease risk. We hypothesized that sleep restriction would reduce adiponectin levels in healthy young adults. METHODS 74 healthy adults (57% men, 63% African American, mean age 29.9years) completed 2 nights of baseline sleep at 10h time in bed (TIB) per night followed by 5 nights of sleep restricted to 4h TIB per night. An additional 8 participants were randomized to a control group that received 10h TIB per night throughout the study. Plasma adiponectin levels were measured following the second night of baseline sleep and the fifth night of sleep restriction or control sleep. RESULTS Sleep restriction resulted in a decrease in plasma adiponectin levels among Caucasian women (Z=-2.19, p=0.028), but an increase among African American women (Z=-2.73, p=0.006). No significant effects of sleep restriction on adiponectin levels were found among men. A 2×2 between-group analysis of covariance on adiponectin change scores controlling for BMI confirmed significant interactions between sleep restriction and race/ethnicity [F(1,66)=13.73, p<0.001], as well as among sleep restriction, race/ethnicity and sex [F(1,66)=4.27, p=0.043)]. CONCLUSIONS Inflammatory responses to sleep loss appear to be moderated by sex and race/ethnicity; observed decreases in adiponectin following sleep restriction may be one avenue by which reduced sleep duration promotes cardiovascular risk in Caucasian women.
Collapse
Affiliation(s)
- Norah S Simpson
- Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave/DA-779, Boston, MA 02215, United States.
| | | | | | | |
Collapse
|
35
|
Lima N, Tozetto D, Lima L, Nobre F, Moriguti J, Ferriolli E, Foss M. Salt and insulin sensitivity after short and prolonged high salt intake in elderly subjects. Braz J Med Biol Res 2009; 42:738-43. [DOI: 10.1590/s0100-879x2009000800008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Accepted: 05/13/2009] [Indexed: 02/05/2023] Open
Affiliation(s)
| | | | | | - F. Nobre
- Universidade de São Paulo, Brasil
| | | | | | | |
Collapse
|
36
|
Fogarty AW, Lewis SA, McKeever TM, Britton JR. Is higher sodium intake associated with elevated systemic inflammation? A population-based study. Am J Clin Nutr 2009; 89:1901-4. [PMID: 19386745 DOI: 10.3945/ajcn.2008.27006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Observational epidemiologic studies have suggested that a low-sodium diet is associated with reduced mortality. OBJECTIVE The objective was to test the hypothesis that a higher dietary intake of sodium is associated with increased systemic inflammation--a potential risk factor for both cardiovascular disease and cancer. DESIGN The study design consisted of a randomly selected, cross-sectional, population-based study of 2633 individuals surveyed in 1991, of whom 1597 participants provided paired urinary and blood samples permitting measurement of 24-h urinary sodium excretion and serum C-reactive protein (CRP) concentrations. RESULTS The mean (+/-SD) 24-h sodium intake for the population was 177 +/- 69 mmol. In the basic model adjusted for age, sex, and smoking, higher levels of 24-h sodium excretion were directly associated with serum CRP, with an increase in serum CRP of 1.20 mg/L per 100-mmol increment in sodium excretion (95% CI: 1.11, 1.30). However, this association was reduced after adjustment for body mass index, with an increase in serum CRP of 1.06 mg/L per 100-mmol increment in sodium excretion (95% CI: -1.02, 1.15). CONCLUSIONS We observed a linear association between an objective measure of sodium intake and serum CRP that may be influenced by confounding by body mass index. The magnitude of these associations suggests that dietary sodium consumption is unlikely to be an important modifiable risk factor for increased systemic inflammation.
Collapse
Affiliation(s)
- Andrew W Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, United Kingdom.
| | | | | | | |
Collapse
|