PDF(Pubmed)
Abstract：
The hyperglycemia condition disrupts metabolism of nitrate/nitrite and nitric oxide, and dietary nitrate intake can restore nitric oxide homeostasis.
This study aims to examine whether urinary nitrate is associated with diabetes complications and long-term survival among people with hyperglycemia.
A total of 6208 people with hyperglycemia who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 were enrolled. Diabetes complications included congestive heart failure, coronary heart disease, angina, stroke, myocardial infarction, diabetic retinopathy, and nephropathy. Mortality was obtained from the National Death Index until 2015. Urinary nitrate was measured by ion chromatography coupled with electrospray tandem mass spectrometry, which was log-transformed and categorized into tertiles. Logistic regression models and Cox proportional hazards models were respectively performed to assess the association of urinary nitrate with the risk of diabetes complications and disease-specific mortalities.
After adjustment for potential confounders, including urinary perchlorate and thiocyanate, compared with the participants in the lowest tertile of nitrate, the participants in the highest tertile had lower risks of congestive heart failure (odds ratio [OR] 0.41; 95% CI, 0.27-0.60) and diabetic nephropathy (OR 0.50; 95% CI, 0.41-0.62). Meanwhile, during a total follow-up period of 41 463 person-years, the participants in the highest tertile had lower mortality risk of all-cause (hazard ratio [HR] 0.78; 95% CI, 0.62-0.97), cardiovascular disease (CVD) (HR 0.56; 95% CI, 0.37-0.84), and diabetes (HR 0.47; 95% CI, 0.24-0.90), which showed dose-dependent linear relationships (P for nonlinearity > 0.05). Moreover, no association between nitrate and cancer mortality was observed (HR 1.13; 95% CI, 0.71-1.80).
Higher urinary nitrate is associated with lower risk of congestive heart failure and diabetic nephropathy, and lower risk of all-cause, CVD, and diabetes mortalities. These findings indicate that inorganic nitrate supplementation can be considered as a supplementary treatment for people with hyperglycemia.
This study aims to examine whether urinary nitrate is associated with diabetes complications and long-term survival among people with hyperglycemia.
A total of 6208 people with hyperglycemia who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 were enrolled. Diabetes complications included congestive heart failure, coronary heart disease, angina, stroke, myocardial infarction, diabetic retinopathy, and nephropathy. Mortality was obtained from the National Death Index until 2015. Urinary nitrate was measured by ion chromatography coupled with electrospray tandem mass spectrometry, which was log-transformed and categorized into tertiles. Logistic regression models and Cox proportional hazards models were respectively performed to assess the association of urinary nitrate with the risk of diabetes complications and disease-specific mortalities.
After adjustment for potential confounders, including urinary perchlorate and thiocyanate, compared with the participants in the lowest tertile of nitrate, the participants in the highest tertile had lower risks of congestive heart failure (odds ratio [OR] 0.41; 95% CI, 0.27-0.60) and diabetic nephropathy (OR 0.50; 95% CI, 0.41-0.62). Meanwhile, during a total follow-up period of 41 463 person-years, the participants in the highest tertile had lower mortality risk of all-cause (hazard ratio [HR] 0.78; 95% CI, 0.62-0.97), cardiovascular disease (CVD) (HR 0.56; 95% CI, 0.37-0.84), and diabetes (HR 0.47; 95% CI, 0.24-0.90), which showed dose-dependent linear relationships (P for nonlinearity > 0.05). Moreover, no association between nitrate and cancer mortality was observed (HR 1.13; 95% CI, 0.71-1.80).
Higher urinary nitrate is associated with lower risk of congestive heart failure and diabetic nephropathy, and lower risk of all-cause, CVD, and diabetes mortalities. These findings indicate that inorganic nitrate supplementation can be considered as a supplementary treatment for people with hyperglycemia.
摘要：
背景：高血糖状态会破坏硝酸盐/亚硝酸盐和一氧化氮的代谢，和饮食中的硝酸盐摄入可以恢复一氧化氮的稳态。这项研究旨在检查尿中硝酸盐是否与高血糖患者的糖尿病并发症和长期生存有关。
方法：纳入2005年至2014年参加全国健康和营养调查的6208名高血糖患者。糖尿病并发症包括充血性心力衰竭，冠心病,心绞痛,中风,心肌梗塞,糖尿病视网膜病变，和肾病。死亡率从国家死亡指数中获得，直到2015年。通过离子色谱-电喷雾串联质谱法测定尿硝酸盐，对数变换并分类为三元。分别采用Logistic回归模型和cox比例风险模型评估尿硝酸盐与糖尿病并发症风险和疾病特异性死亡率的关系。
结果：在调整了潜在的混杂因素，包括尿高氯酸盐和硫氰酸盐，与硝酸盐含量最低的参与者相比，最高三分位数的参与者患充血性心力衰竭(奇数比[OR]=0.41,95CI:0.27~0.60)和糖尿病肾病(OR=0.50,95CI:0.41~0.62)的风险较低.同时,在总共41463人年的随访中，最高三分位数的参与者具有较低的全因死亡风险（危险比[HR]=0.78，95CI：0.62-0.97），心血管疾病（CVD）（HR=0.56，95CI：0.37-0.84）和糖尿病（HR=0.47，95CI：0.24-0.90），呈剂量依赖性线性关系(P为非线性>0.05)。此外，未观察到硝酸盐与癌症死亡率之间存在关联(HR=1.13,95CI:0.71~1.80).
结论：较高的尿硝酸盐与较低的充血性心力衰竭和糖尿病肾病风险相关，降低所有原因的风险，CVD,和糖尿病死亡率。这些发现表明，补充无机硝酸盐可被视为高血糖患者的补充治疗。
方法：纳入2005年至2014年参加全国健康和营养调查的6208名高血糖患者。糖尿病并发症包括充血性心力衰竭，冠心病,心绞痛,中风,心肌梗塞,糖尿病视网膜病变，和肾病。死亡率从国家死亡指数中获得，直到2015年。通过离子色谱-电喷雾串联质谱法测定尿硝酸盐，对数变换并分类为三元。分别采用Logistic回归模型和cox比例风险模型评估尿硝酸盐与糖尿病并发症风险和疾病特异性死亡率的关系。
结果：在调整了潜在的混杂因素，包括尿高氯酸盐和硫氰酸盐，与硝酸盐含量最低的参与者相比，最高三分位数的参与者患充血性心力衰竭(奇数比[OR]=0.41,95CI:0.27~0.60)和糖尿病肾病(OR=0.50,95CI:0.41~0.62)的风险较低.同时,在总共41463人年的随访中，最高三分位数的参与者具有较低的全因死亡风险（危险比[HR]=0.78，95CI：0.62-0.97），心血管疾病（CVD）（HR=0.56，95CI：0.37-0.84）和糖尿病（HR=0.47，95CI：0.24-0.90），呈剂量依赖性线性关系(P为非线性>0.05)。此外，未观察到硝酸盐与癌症死亡率之间存在关联(HR=1.13,95CI:0.71~1.80).
结论：较高的尿硝酸盐与较低的充血性心力衰竭和糖尿病肾病风险相关，降低所有原因的风险，CVD,和糖尿病死亡率。这些发现表明，补充无机硝酸盐可被视为高血糖患者的补充治疗。
