Can Methods Based on Spot Urine Samples Be Used to Estimate Average Population 24 H Sodium Excretion? Results from the Isfahan Salt Study

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2019 Sep 25

PMID 31547894

Citations 5

Authors

Noushin Mohammadifard

Hamidreza Marateb

Marjan Mansourian

Alireza Khosravi

Zahra Abdollahi

Norman Rc Campbell

Jacqui Webster

Kristina Petersen

Nizal Sarrafzadegan

Affiliations

Soon will be listed here.

Abstract

Objective: To assess agreement between established methods of estimating salt intake from spot urine collections and 24 h urinary Na (24hUNa) and then to develop a valid formula that can be used in the Iranian population to estimate salt intake from spot urine samples.

Design: A validation study. Three spot urine samples were collected (fasting second-void morning; afternoon; evening) on the same day as a 24 h urine collection. We estimated 24hUNa from spot specimens using the Kawasaki, Tanaka and INTERSALT equations. Two new formulas were developed, the Iran formula 1 (Iran 1) and Iran formula 2 (Iran 2), based on our population characteristics.

Setting: Iranian adults recruited in 2014-2015.

Participants: Healthy volunteer adults aged ≥18 years.

Results: With all three spot urine specimens, predicted population 24hUNa was underestimated based on the INTERSALT equation (-469 to -708 mg/d; all P < 0·05) and conversely overestimation occurred with the Kawasaki equation (926 to 1080 mg/d; all P < 0·01). The Tanaka equation produced comparable estimates to measured 24hUNa (-151 to 86 mg/d; all P > 0·49). The newly derived formulas, Iran 1 and Iran 2, showed less mean bias than the established equations (Iran 1: 43 to 80 mg/d, all P > 0·55; Iran 2: 22 to 90 mg/d, all P > 0·50).

Conclusions: In this Iranian sample, the Tanaka equation and newly derived formulas produced group-level estimates comparable to measured 24hUNa. The newly developed formulas showed less mean bias than established equations; however, they need to be tested for generalization in a larger sample.

Citing Articles

Mean population salt intake in Iran: A systematic review and meta-analysis.

Pourkhajoei S, Yazdi-Feyzabadi V, Amiresmaeili M, Nakhaee N, Goudarzi R Health Sci Rep. 2022; 5(6):e855.

PMID: 36226320 PMC: 9531774. DOI: 10.1002/hsr2.855.

Estimating 24-Hour Urinary Excretion of Sodium and Potassium Is More Reliable from 24-Hour Urine Than Spot Urine Sample in a Feeding Study of US Older Postmenopausal Women.

Tinker L, Huang Y, Johnson K, Carbone L, Snetselaar L, Van Horn L Curr Dev Nutr. 2021; 5(11):nzab125.

PMID: 34761160 PMC: 8575727. DOI: 10.1093/cdn/nzab125.

Dietary sodium estimation methods: accuracy and limitations of old and new methods in individuals at high cardiovascular risk.

Tsirimiagkou C, Karatzi K, Basdeki E, Argyris A, Papaioannou T, Yannakoulia M Public Health Nutr. 2021; 25(4):866-878.

PMID: 34693901 PMC: 9991764. DOI: 10.1017/S1368980021004390.

Salt intake and blood pressure in Iranian children and adolescents: a population-based study.

Emamian M, Ebrahimi H, Hashemi H, Fotouhi A BMC Cardiovasc Disord. 2021; 21(1):62.

PMID: 33530964 PMC: 7851910. DOI: 10.1186/s12872-021-01876-z.

Further evidence that methods based on spot urine samples should not be used to examine sodium-disease relationships from the Science of Salt: A regularly updated systematic review of salt and health outcomes (November 2018 to August 2019).

Petersen K, Malta D, Rae S, Dash S, Webster J, McLean R J Clin Hypertens (Greenwich). 2020; 22(10):1741-1753.

PMID: 32964622 PMC: 8029798. DOI: 10.1111/jch.13958.

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