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Oh, Kim, Jun, and Lee: Associations between 24-hour Urine Sodium Excretion Level and Obesity-related Metabolic Risk Factors
Research Article

Korean Journal of Community Nutrition 2015; 20(6): 460-467.

Published online: 31 December 2015

DOI: https://doi.org/10.5720/kjcn.2015.20.6.460

Associations between 24-hour Urine Sodium Excretion Level and Obesity-related Metabolic Risk Factors

Hyun Woo Oh1, Hyun Jung Kim2, Dae Won Jun1, Seung Min Lee2

1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

2Department of Food and Nutrition, Sungshin Women's University, Seoul, Korea.

Corresponding author: Seung Min Lee. Department of Food and Nutrition, Sungshin Women's University, 55, Dobong-ro76gagil, Gangbuk-gu, Seoul 01133, Korea. Tel: (02) 920-7671, Fax: (02) 920-2076, smlee@sungshin.ac.kr

Received 12 October 2015       Revised 13 December 2015       Accepted 24 December 2015

Copyright © 2015 The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults.

Methods

A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (<110 mEq/day, 110~180 mEq/day, >180 mEq/day).

Results

After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group.

Conclusions

The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.

Keywords: sodium intake, obesity, 24-hour urine sodium excretion

Figures and Tables

Fig. 1

Mean numbers1) of metabolic syndrome risk factors according to according to 24-hour sodium excretion levels

1) Adjusted for age(years), sex, smoking(no smoking, previous smoking. current smoking), drinking(no drinking, 1~4 times/month, >=5 times/month), physical activity(rarely, 1~2 times/week, >=3 times/week), energy intake (kcal/day)
Different alphabet letters represent significant difference (p < 0.05) by Tukey-Kramer's multiple comparison test
kjcn-20-460-g001
Table 1

Comparison of obesity and obesity-related metabolic indices between obese and non-obese groups

kjcn-20-460-i001

1) BMI: body mass index

2) Mean±SE

3) ALT: alanine transferase

4) AST: aspartate transferase

5) GGT: glutamyl transferase

6) CT: computed tomography

**: p < 0.01, ***: p < 0.001

Table 2

Comparison of obesity and obesity-related metabolic indices according to 24-hour urine sodium excretion levels

kjcn-20-460-i002

1) BMI: body mass index

2) Mean ±SE

3) Adjusted for age (years), sex, smoking (no smoking, previous smoking. current smoking), drinking (no drinking, 1~4 times/month, >=5 times/month), physical activity (rarely, 1~2 times/week, >=3 times/week), energy intake (kcal/day)

4) CT: computed tomography

5) ALT: alanine transferase

6) AST: aspartate transferase

7) GGT: glutamyl transferase

8) HOMA-IR: homeostasis model assessment of insulin resistance

ab: Different alphabet letters within a row represent significant difference (p < 0.05) by Tukey-Kramer's multiple comparison test.

Table 3

Spearman correlation coefficient between obesity-related indices and 24-hour urine sodium excretion levels

kjcn-20-460-i003

1) BMI: body mass index

2) Adjusted for age (years) and energy intake (kcal/day)

3) CT: computed tomography

4) HOMA-IR: homeostasis model assessment of insulin resistance

**: p < 0.01, ***: p < 0.001 by partial Spearman correlation analysis

Table 4

Odds radios of metabolic syndrome risk factors and metabolic syndrome according to 24-hour sodium excretion levels

kjcn-20-460-i004

1) Adjusted for age(years), sex, smoking (no smoking, previous smoking. current smoking), drinking(no drinking, 1~4 times/month, >=5 times/month), physical activity(rarely, 1~2 times/week, >=3 times/week), energy intake (kcal/day)

2) MS : Metabolic syndrome

*: p < 0.05, **: p < 0.01, ***: p < 0.001

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