Evaluation of Random Urine Sodium and Potassium Compensated by Creatinine as Possible Alternative Markers for 24 Hours Urinary Sodium and Potassium Excretion

Sodium and potassium intake was assessed on the basis of its respective excretion levels in 24 hr urine samples. However, owing to the inconvenience of collection, we evaluated random spot urine for alternative sodium and potassium excretion markers. We included 250 patients who submitted 24 hr- and spot urine for clinical tests. However, 22 patients who showed 24 hr urine creatinine excretion levels <500 mg/day were excluded, because these samples possibly resulted from incomplete urine collection. Moreover, 24 patients were excluded because of their use of diuretics during the urine collection period. We observed significant correlations between 24 hr urine sodium excretion and both the sodium/creatinine (r=0.34, P<0.0001) and the sodium/specific gravity unit (SGU) ratios (r=0.19, P=0.007) in random urine samples. Similarly, 24 hr urine potassium excretion and both the spot urine potassium/creatinine (r=0.47, P<0.0001) and potassium/SGU ratios (r=0.28, P<0.0001) were significantly correlated. Although the estimated sodium/creatinine and potassium/creatinine ratios showed a significant correlation with 24 hr urine sodium and potassium excretion, respectively, further studies are required to develop a spot urine test for individualized monitoring of sodium and potassium excretion.

Estimating 24-Hour Urine Sodium Level with Spot Urine Sodium and Creatinine

The 24-hr urine sodium excretion level was estimated based on the spot urine sodium, and the efficacy of the formula was validated to determine the status of low salt intake or =100 mEq/day using the estimated amount> or =100 mEq/day was 84.3%, 87.6%, and 84.8%, respectively. In conclusion, the three equations used to estimate the 24-hr urine sodium content were useful to determine the status of low salt intake.

Estimation of Daily Salt Intake through a 24-Hour Urine Collection in Pohang, Korea

There is an established relationship between a high salt diet and public health problems, especially hypertension and cardiovascular disease. We estimated daily salt intake in a group of adults and assessed its association with related variables in Pohang, Korea. We conducted a cross-sectional survey in 2013 with 242 adults. Urine was collected for 24 hr to estimate daily salt intake, and questionnaires about salt preference were administered. The mean daily salt intake was 9.9+/-4.6 g. There was no difference in salt intake between high systolic blood pressure (SBP) participants and normal SBP participants (10.5+/-4.7 g/d vs. 9.6+/-4.3 g/d, P=0.339), but high diastolic blood pressure (DBP) participants reported more salt intake than normal DBP participants (10.4+/-4.9 g/d vs. 9.7+/-4.1 g/d, P=0.049). Salt intake and body mass index demonstrated a positive correlation (P=0.001). A preference for Korean soup or stew was associated with high salt intake (P=0.038). Dietary salt intake in Korean adults is still higher than the recommendation from the World Health Organization. More efforts should be made to reduce the salt consumption of Korean adults.

Development and Evaluation of Validity of Short Dish Frequency Questionnaire (DFQ) for Estimation of Habitual Sodium Intake for Korean Adults / 대한지역사회영양학회지

The aim of this study was to develop various types of a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and to evaluate the validity of a 125 item dish frequency questionnaire (DFQ 125) with the DFQ 70, DFQ 36 and DFQ 15. For the DFQ 125, one hundred and twenty five dish items were selected based on the information of sodium content of a one serving size, consumption frequency and dish items that contributed most to the variation of sodium intake. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. The sodium intake estimated with DFQ 125 was 5775.0 +/- 3636.3mg, 12.6% higher than that estimated with a 24 hr urine analysis (5009.7 +/- 1541.9mg) and significant correlation was observed between them (r = 0.3315, p < 0.001). When sodium content in broth leftover was subtracted from the total intake, the actual sodium intakes was decreased to 5309.6 +/- 3076.6mg, which was 3.2% higher than that with a 24-hr urine analysis. Overall, 56% of subjects in the lowest quintile of sodium intake computed with DFQ 125 were also in the lowest of adjacent quintile while categorization into the opposite quintile were 4.9%. DFQ 70 was developed from DFQ 125 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. The sodium intake estimated with DFQ 70 (5026.6 +/- 3107.1mg) showed only 0.2% difference from that estimated with a 24-hr urine analysis, significant correlation with it (r = 0.3199, p < 0.001) and higher proportion of subjects to be classified into the same or adjacent quintile. The sodium intake estimated with DFQ 36 or DFQ 15 was also significancy correlated with that estimated with a 24-hr urine analysis (r = 0.3441, p < 0.001; r = 0.321, p < 0.001 respectively) and more. The proportion of subjects was classified into the same or adjacent quintile. However, the actual sodium intake estimated with DFQ 36 or DFQ 15 were 3534.0 +/- 1804.6mg and 2508.0 +/- 1261.5mg, respectively, 31.3% or 51.3% less than that estimated with a 24-hr urine analysis. It seems the DFQ 125 with subtraction of sodium content in broth leftover or DFQ 70 can be used quantitatively to estimate sodium intake of adults. DFQ 36 or DFQ 15 can be used as a screening tool or to assess the changes of sodium intake after nutrition education.

Sodium Intakes of Korean Adults with 24-hour Urine Analysis and Dish Frequency Questionnaire and Comparison of Sodium Intakes According to the Regional Area and Dish Group / 대한지역사회영양학회지

This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 552 adults (male: 267, female: 285), aged 20-59yr residing in the metropolitan area (N = 200), Chungcheng-Do (N = 117), Jeolla-Do (N = 117), and Gueongsang-Do provinces (N = 118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95).The mean age and BMI of the subjects were 39.0+/-11.7 y and 23.1+/-2.9 kg/m2, respectively. The mean systolic and diastolic blood pressure was 119.5+/-15.4 mmHg, and 77.1+/-11.1 mmHg, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure(SBP > or = 140 mmHg or DBP > or = 90 mmHg) measurements in the present study. Salt intake of the subject estimated with 24-hr sodium excretion was 12.7 g/d (male : 13.4 g/d, female : 12.1 g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7 g/d (male : 16.2 g/d, female : 13.4 g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (I1571.4mg), soup and stew (1260.5 mg), fish and shellfish (706.3 mg) and noodle and ramyeon (644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do (17.0 g/d), second highest Chungcheong-Do (16.4 g/d) and the lowest in the metropolitan area (13.0 g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chuncheong-Do revealed the highest sodium intake with kimchi and ofJeolla-Do the higher sodium intake with the main dish (meat, fish and beans). The highest salt percentage of kimchi (3.0+/-0.8%) and soybean paste (14.5 +/-5.1%) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi (1.6 +/-0.5%) and soybean paste (7.4 +/-1.6%) with the lowest salt percentage. Men were observed as having more salty kimchi (2.4 +/-0.1%) than women (2.1 +/-0.1%).

A Change of Adrenal Androgen and Cortisol in Kawasaki Disease

PURPOSE: Endocrine and immune systems are connected and interdependent. Adrenal glands play an important role in this network and control the balance between serum levels of dehydroepiandrosterone sulfate(DHEAS) and cortisol. These steroids have an antagonistic effect on the T cell progression into Th1 and Th2 cells and on the induction of correlated interleukins. Therefore we evaluated the role of adrenal androgen and cortisol as immune modulators in Kawasaki disease(KD) with changes of T cell immunity. METHODS: From April to August in 2001, we examined serum DHEAS and 24 hour urine free cortisol(F) before administration of immunoglobulin and steroids by radioimmunoassay in 14 KD patients. It's clinical severity was determined by Harada score and coronary lesion. RESULTS:The age of the patient group ranged from 4 months to 4 years; its average age was 2.3 years. Three patients(21.4%) were below 1 year, 2(14.3%) between 1 and 2 years, 5(35.7%) between 2 and 3 years, 4(28.6%) between 3 and 4 years of age. Male to female ratio was 1:1.3. DHEAS was significantly decreased in patients(11.1+/-6.0 ng/dL) more than controls(81.6+/-13.3 ng/dL)(P<0.05). Twenty-four hour urine free cortisol was significantly increased in patients(36.9+/-21.9 ng/dL) more than controls(13.6+/-5.5 ng/dL)(P<0.05). Ratio of DHEAS/F was decreased remarkably in patients(0.33+/-0.20) more than controls(6.65+/-2.56)(P=0.016). There was no difference between ratio of DHEAS/F and Harada score, but its ratio was very low in patients with coronary aneurysm. CONCLUSION: These data demonstrate that there are changes of DHEAS and cortisol in acute stage of KD and the dis-equilibrium between two steroids may be relevant in the T cell immune response induction of Kawasaki disease. These changes support the use of DHEAS/F ratio as one of the predictive factors of coronary arteries complication.