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

• 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
• Journal Title: JOURNAL OF THE AMERICAN HEART ASSOCIATION
• Volume: Volume 9, Number 18
• Publisher: WILEY | 2020-09-15, Pages e014978-e014978
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1161/JAHA.119.014978
• Subjects: Health Sciences, Nutrition; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; 24-hour urine sodium; cardiometabolic biomarkers; diabetes mellitus; metabolic syndrome; proteinuria; sodium intake; urine sodium; HIGH-SALT INTAKE; LEFT-VENTRICULAR HYPERTROPHY; URINE ALBUMIN EXCRETION; BLOOD-PRESSURE; CARDIOVASCULAR-DISEASE; DIETARY-SODIUM; ESSENTIAL-HYPERTENSION; RENAL HEMODYNAMICS; INSULIN-RESISTANCE; TOTAL CHOLESTEROL

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.