Abstract
Background: Excessive sodium intake is linked to high blood pressure. Estimating sodium intake is difficult. The 24-h urine collection is currently the recommended method for estimating intake but cumbersome for large population studies. Predictive model to estimate sodium intake based on single spot urine were developed, but showed inconsistency when used in extern populations. This study aims to develop a specific model for estimating sodium excretion over 24 hours for the Moroccan population. Methods: 371 participants in the urinary validation sub-study of the STEP-wise survey-Morocco 2017-2018 provided a valid 24-hour urine collection and spot urine specimens. Participant were randomly assigned to the training (n=183) and the validation data set (n=188). Results: A prediction model for 24-hour sodium excretion was developed. Adjusted R2 was 0.258. In the validation data set, correlation was 0.431 [95%CI; 0.258-0.580], and the adjusted R2 was 0.190. The Bland-Altman plot showed a nonsignificant small mean bias of -18 mg (95%CI, -213 to 177) in predicting 24-h urinary sodium excretion at the group level. At the individual level, limits of agreement were wide. Conclusion: This new model developed from a single spot urine could be used to predict the average 24-h sodium excretion of Moroccan adults.
Highlights
Excessive sodium intake is associated with high blood pressure level and a high risk of cardiovascular events [1,2,3,4]
World Health Organization (WHO) sets a global target of reducing the salt consumption of the population by 2025 as part of its fight against non-communicable diseases (NCDs) (WHO, 2020) [8], each country having the possibility of setting its voluntary target
Research examining the utility of spot urine as a simpler and easier to implement method to replace 24hour urine collection, which is accurately the reference method for estimating sodium intake in individual and population, are of great importance as studies suggested that the 24-hour urine collection may be a barrier to estimate sodium intake, in poor countries [33]
Summary
Excessive sodium (salt) intake is associated with high blood pressure level and a high risk of cardiovascular events [1,2,3,4]. Sodium intake in individuals around the world exceeds their physiological needs (i.e. 200–500 mg/day) [5] Estimates of this mean in adults have been found to be equal to 3.95 g per day [6], almost double the World Health Organization (WHO) recommendations of no more than 2 g/day of sodium intake (equivalent to 5 g per day of salt) [7]. The 24-h urine collection is currently the recommended method for estimating intake but cumbersome for large population studies. Predictive model to estimate sodium intake based on single spot urine were developed, but showed inconsistency when used in extern populations. This study aims to develop a specific model for estimating sodium excretion over 24 hours for the Moroccan population. Conclusion: This new model developed from a single spot urine could be used to predict the average 24-h sodium excretion of Moroccan adults
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