Abstract

Sodium intake is associated with obesity and metabolic disorder in the general population. However, sodium intake is significantly reduced according to the decrease of energy intake in older adults although the prevalence of obesity is higher than younger adults. We evaluate the association of sodium excretion (UNa) with blood pressure, obesity, metabolic disorders, and albuminuria according to age. An observational study using data from the Korean National Health and Nutrition Examination Survey IV-V (2008–2011) was performed (N = 18,146). The 24 hour UNa was estimated from a single fasting urine sample.Participants aged≥75 years showed the highest risk for hypertension (HTN) in the highest quartile of UNa (1.769, 95% CI, 1.174–2.665), and the risks for HTN increased with advancing age. Obesity was not associated with UNa in participants aged≥75 years, and hypertriglyceridemia and body fat were not related to UNa in participants aged≥65 years, although these values were significantly associated with UNa in participants aged<65 years. Impaired fasting glucose (IFG) and insulin resistance (IR) were associated with UNa only in participants aged 20–39 years. The highest quartile of UNa showed a 3.777 fold increased risk for albuminuria in those aged 20–39 years (95% CI, 1.130–12.630), and a 1.885 fold increased risk (95% CI, 1.156–3.075) among participants aged 40–64 years. In participants aged≥65 years, albuminuria was not associated with UNa. In contrast with HTN, UNa was not associated with albuminuria, obesity, hypertriglyceridemia, IFG, and IR in older adults despite a strong association in younger adults.

Highlights

  • High sodium intake is associated with increased risk of hypertension (HTN), cardiovascular disease (CVD), decreased renal function, and death [1,2,3,4,5,6]

  • We evaluated the association of blood pressure (BP), obesity, hypertriglyceridemia, impaired fasting glucose (IFG), and insulin resistance (IR) with sodium excretion in participants stratified according to age

  • Estimated means of sodium excretion were the lowest in participants aged !75 years (3.839, 95% confidence intervals (95% CIs) 3.712–3.966), and sodium excretion was 4.288, 4.370, and 4.204 in participants aged 20–39, 40–64, and 65–74 years, respectively after adjusting for age, systolic blood pressure (SBP), Body mass index (BMI), glucose, haemoglobin, triglyceride, white blood cell count, high density lipoprotein, alkaline phosphatase (ALP), AST, alanine aminotransferase, cholesterol, estimated glomerular filtration rate (eGFR), and energy intake

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Summary

Introduction

High sodium intake is associated with increased risk of hypertension (HTN), cardiovascular disease (CVD), decreased renal function, and death [1,2,3,4,5,6]. Current guidelines and studies recommend sodium restriction especially in patients with CVD and chronic kidney disease (CKD) [7, 8].

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