背景:点尿液收集为更繁琐的24小时尿液收集提供了一种方便的替代方法。然而,广泛认可的估计模型,如田中和国际贸易,没有充分适应在一般中国人群中的广泛使用。
目的:本研究旨在评估Tanaka和INTERSALT校准模型的精度,除了浙江省当地制定的模式,预测中国人群24小时尿钠(24-hUNa)排泄。
方法:该研究包括1,424名参与者,18至69岁,他提供了全面的24小时尿液和空腹早晨尿液样本。研究人员根据从田中获得的估计值评估了测量的24-hUNa的准确性,Intersalt,和浙江模特。这项评估是在人口和个人两个层面进行的,采用一系列统计技术,包括偏见分析,相关系数,类内相关系数(ICC),接收机工作特性(ROC)曲线,Bland-Altman阴谋,以及相对和绝对差计算,和错误分类率。
结果:测得的平均24-hUNa排泄为165.7±71.5mmol/24小时。值得注意的是,田中调整模型的估计值和实测值之间存在显著偏差(-11.7mmol,95%置信区间(CI):-16.7,-6.7mmol/24小时),表明有统计学上的显著差异。相比之下,INTERSALT调整模型的偏差(0.6mmol,95%CI:-4.2,5.4mmol/24小时)和浙江模型(0.2mmol,95%CI:-4.6,5.0mmol/24小时)无统计学意义。模型的相关系数分别为0.303、0.398和0.391,INTERSALT调整模型和浙江模型在人口水平上表现优异。
结论:三种评估模型可能是有效的,评估人群尿钠水平的低负担替代方法。然而,为了提高个人预测的准确性和可靠性,进一步的重复测量是必要的,以最大限度地减少测量误差和增加估计的有效性。
BACKGROUND: Spot urine collection offers a convenient alternative to the more cumbersome 24-hour urine collection. However, the widely recognized estimation models, such as Tanaka and INTERSALT, have not been adequately adapted for widespread use in the general Chinese population.
OBJECTIVE: This study was designed to evaluate the precision of the Tanaka and INTERSALT calibration models, alongside a locally-Zhejiang Province formulated model, in predicting 24-hour urinary sodium (24-hUNa) excretion among the Chinese population.
METHODS: The study comprised 1,424 participants, aged 18 to 69 years, who provided both comprehensive 24-hour urine and fasting morning urine samples. The researchers assessed the accuracy of the measured 24-hUNa against the estimates obtained from the Tanaka, INTERSALT, and Zhejiang models. This evaluation was conducted at both population and individual levels, employing a range of statistical techniques, including bias analysis, correlation coefficients, intraclass correlation coefficients (ICC), receiver operating characteristic (ROC) curves, Bland-Altman plots, as well as relative and absolute difference calculations, and misclassification rates.
RESULTS: The measured average 24-hUNa excretion was found to be 165.7 ± 71.5 mmol/24-hour. Notably, there was a significant deviation between the estimated and measured values for the Tanaka-adjusted model (-11.7 mmol, 95% Confidence Interval (CI): -16.7, -6.7 mmol/24-hour), indicating a statistically significant difference. In contrast, the deviations for the INTERSALT-adjusted model (0.6 mmol, 95% CI: -4.2, 5.4 mmol/24-hour) and the Zhejiang model (0.2 mmol, 95% CI: -4.6, 5.0 mmol/24-hour) were not significant. The correlation coefficients for the models were 0.303, 0.398, and 0.391, respectively, with the INTERSALT-adjusted and Zhejiang models showing superior performance at the population level.
CONCLUSIONS: The three evaluation models may serve as effective, low-burden alternatives for assessing urinary sodium levels in the population. However, to enhance the accuracy and reliability of predictions at the individual level, further repeated measurements are necessary to minimize measurement errors and augment the validity of the estimations.