Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh

• Type of Material: Article
• Authors: Abu Mohd Naser, Emory University; Mahbubur Rahman, Bangladesh Icddr B; Leanne Unicomb, Bangladesh Icddr B; Solaiman Doza, Bangladesh Icddr B; Shahjada Selim, Bangabandhu Sheikh Mujib Medical University; Monjila Chaity, Carle Foundation Hospital; Stephen P. Luby, Stanford University; Shuchi Anand, Stanford University; Lisa Staimez, Emory University; Thomas Clasen, Emory University; Unjali Gujral, Emory University; Matthew Gribble, Emory University; Kabayam Venkat Narayan, Emory University
• Language: English
• Date: 2020-09-15
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.119.014978
• Title of Journal or Parent Work: JOURNAL OF THE AMERICAN HEART ASSOCIATION
• Volume: 9
• Issue: 18
• Start Page: e014978
• End Page: e014978
• Grant/Funding Information: This research was funded by Wellcome Trust, UK, Our Planet, Our Health Award (Grant 106871/Z/15/Z). Dr Gribble's effort was supported in part by funding from the National Institute of Environmental Health Sciences (P30 ES019776).
• Keywords: BLOOD-PRESSURE; HIGH-SALT INTAKE; metabolic syndrome; LEFT-VENTRICULAR HYPERTROPHY; sodium intake; Science & Technology; DIETARY-SODIUM; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; TOTAL CHOLESTEROL; 24-hour urine sodium; cardiometabolic biomarkers; diabetes mellitus; proteinuria; RENAL HEMODYNAMICS; Life Sciences & Biomedicine; URINE ALBUMIN EXCRETION; CARDIOVASCULAR-DISEASE; ESSENTIAL-HYPERTENSION; urine sodium; INSULIN-RESISTANCE
• Research Categories: Health Sciences, Nutrition; Health Sciences, Medicine and Surgery

Abstract

BACKGROUND: We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. METHODS AND RESULTS: A total of 1191 participants’ data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24-hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein, blood pressure, and 24-hour urine protein were measured at the fifth visit. Participants’ mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant-, household-, and community-level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08–1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73–11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04–2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24–3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45–6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34–3.71) times higher prevalence of large waist circumference. CONCLUSIONS: Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.