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1.
Ter Arkh ; 92(10): 4-8, 2020 Nov 24.
Artigo em Russo | MEDLINE | ID: mdl-33346472

RESUMO

Radioactive iodine, flying out of the destroyed reactor of the Chernobyl nuclear power plant, like a corona virus quickly spread throughout Europe. Iodine deficiency in the regions of Ukraine, Belarus and Russia adjacent to nuclear power plants became a factor in increased uptake of radioactive iodine by the thyroid gland in children and after 5 years led to an epidemic of thyroid cancer. Optimal iodine intake could become a kind of vaccination, which sharply reduces the risk of developing thyroid cancer, as has happened after the accident at the Fukushima nuclear power plant in Japan. Endemic goiter was eliminated 50 years ago, but returned to the country in the early 1990s after the collapse of iodized salt production and has not been eliminated to this day due to the lack of a legislative framework for mandatory salt iodization. The actual average consumption of iodine by residents of Russia is from 40 to 80 mcg per day, which is 23 times less than the recommended norm. Mild and moderate iodine deficiency was detected throughout the Russian Federation, and it is more typical for the the rural population. The iodine deficiency has the greatest negative effect on the psychomotor development of the child during the critical period the first 1000 days of life from the moment of conception to the end of the second year of life. According to WHO, over the past 20 years, iodine deficiency has been eliminated in 115 countries of the world, and the number of iodine-deficient countries has dropped to 25, but Russia is still among them. We believe that after the COVID-19 pandemic, it will no longer be necessary to prove the need for effective support for the prevention of both infectious and non-infectious diseases, and the declared preventive direction of Russian medicine will indeed become such.


Assuntos
Iodo , Neoplasias da Glândula Tireoide , Criança , Europa (Continente) , Humanos , Radioisótopos do Iodo , Pandemias , República de Belarus , Federação Russa/epidemiologia , Cloreto de Sódio na Dieta , Neoplasias da Glândula Tireoide/epidemiologia , Ucrânia
2.
Orv Hetil ; 161(50): 2107-2116, 2020 12 13.
Artigo em Húngaro | MEDLINE | ID: mdl-33310924

RESUMO

Összefoglaló. A szerzo a bevezetoben emlékeztet a több mint 50 évvel korábbi publikációjára (Orv Hetil. 1968; 109: 360-363) és annak utóéletére: az 1970-es években megállt a jódprevenció fejlodése. Ezt követoen ismerteti az utóbbi 50 év jódellátottságra vonatkozó fontosabb hazai eredményeit. A számszeru adatok szerint az iskolás gyermekek, várandós anyák, idosek és újszülöttek jódellátottságára, valamint az anyatej jódtartalmára vonatkozó sorozatvizsgálatok az ezredforduló elott egybehangzóan enyhe, illetve mérsékelt jódhiányra utaltak. Az utóbbi két évtizedben egyre többször váltak adekváttá az ugyanezen kategóriák jódellátottságát jelzo eredmények. A szabályozatlan jódozottsó-forgalom (fakultatív jódprevenció) ellenére, valószínuleg a sikeres felvilágosítási kampányok miatt, a lakosság jódellátottsága határozottan javult. Ezt a szituációt nevezik "silent" profilaxisnak. Ezzel a módszerrel nem lehet a jódhiányt teljesen felszámolni. A legnagyobb kockázatot a várandós anyák (közel felének!) hiányos jódpótlása jelenti az utódok agyfejlodésének veszélyeztetése miatt. A befejezésben az EUthyroid Consortium "Krakkói kiáltvány"-ának (2018) rövid ismertetése tartalmazza a teendoket. A kötelezo jódprevencióhoz a nem jódozott sót ki kell váltani jódozott sóval szinte minden élelmiszerben. A graviditás alatt megnövekedett igényt az élelmiszerekben lévo jód gyakran nem fedezi, ilyenkor több jódpótlásra van szükség. Az egészségügyi szerveknek meg kell valósítaniuk a jóddúsító program összehangolt, rendszeres monitorozását és kiértékelését a lakosság optimális jódellátottságának biztosításához. Orv Hetil. 2020; 161(50): 2107-2116. Summary. In the introduction, the author reminds the readers of his publication presented more than 50 years ago in the same journal ("Data to the present state of the goiter problem in Hungary", 1968) and of its afterlife: the development of iodine prevention stopped in the 1970s. Then the major Hungarian results are reviewed related to the iodine supply gained in the latter 50 years. Numerical data are presented showing mild or moderate iodine deficiency according to the results of a range of screening studies among schoolchildren, pregnant women, elderly people and newborns as well as by iodine content of breast milk before the millennium. In the same categories, the data indicating the level of iodine supply became increasingly adequate in the recent two decades. The iodine supply of the people improved markedly, in spite of unregulated iodized salt trade (facultative prevention), presumably because of the successful public-information campaigns. This situation is called "silent" prophylaxis. The total eradication of iodine deficiency is impossible with this method. The highest risk is the deficient iodine supply of pregnant women (almost the half!) due to the endangerment of the offspring's brain development. In the end, a brief review of the Krakow Declaration on Iodine of the EUthyroid Consortium comprises the round of the duties. To the mandatory iodine prevention, iodized salt should replace non-iodized salt in nearly all food productions. During pregnancy, the increased need for iodine is frequently not covered by food sources, more iodine supplement is needed. Health authorities should perform harmonized monitoring and evaluation of fortification programs at regular intervals to ensure optimal iodine supply to the population. Orv Hetil. 2020; 161(50): 2107-2116.


Assuntos
Suplementos Nutricionais , Iodo/deficiência , Iodo/uso terapêutico , Cloreto de Sódio na Dieta/uso terapêutico , Humanos , Hungria
3.
PLoS One ; 15(11): e0242575, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33211758

RESUMO

Iodine is an essential micronutrient for cognitive development and growth. Optimal intakes are critical during pregnancy. We report the iodine status and thyroid function of pregnant women living in areas previously affected by severe iodine deficiency and in longstanding iodine sufficient areas in Java, Indonesia. This cross-sectional study was conducted in Magelang, Java, from July to November 2015, in four sub-districts; two previously affected by severe iodine deficiency (area 1) and two that were iodine-sufficient (area 2). Iodine intake was estimated using median urinary iodine concentration in spot samples and mean urinary iodine excretion in 3 x 24-hour samples, thyroid hormones (thyroid-stimulating hormone and free thyroxine) were measured in venous blood samples, and iodine content of household salt samples was estimated by titration. We recruited a total of 244 pregnant women, 123 in area 1 and 121 in area 2. Urinary iodine results suggested adequate habitual iodine intakes in both areas (median urinary iodine concentration in area 1: 222 µg/l (interquartile range 189, 276 µg/l), area 2: 264 µg/l (interquartile range 172, 284 µg/l), however, the risk of inadequate intakes increased with advancing trimester (Odds Ratio = 2.59 (95% CI 1.19-5.67) and 3.85 (95% CI 1.64-9.02) at second and third trimesters, respectively). Estimated prevalence of thyroid function disorders was generally low. Salt was iodized to approximately 40 ppm and foods rich in native iodine did not contribute significantly to dietary intakes. Adequately iodized salt continues to prevent iodine insufficiency in pregnant women living in areas previously affected by severe iodine deficiency in Java, Indonesia. Monitoring and surveillance, particularly in vulnerable groups, should be emphasized to ensure iodine sufficiency prevails.


Assuntos
Bócio/prevenção & controle , Iodo/deficiência , Complicações na Gravidez/prevenção & controle , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Estudos Transversais , Dieta , Feminino , Bócio/epidemiologia , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/epidemiologia , Hipotireoidismo/sangue , Hipotireoidismo/epidemiologia , Indonésia/epidemiologia , Iodo/administração & dosagem , Iodo/urina , Estado Nutricional , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , População Rural , Alimentos Marinhos , Tireotropina/sangue , Tiroxina/sangue , Adulto Jovem
4.
Am J Physiol Regul Integr Comp Physiol ; 319(6): R684-R689, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33052061

RESUMO

Social contact deficit is considered a stressful circumstance associated with various neural, hormonal, genetic, immune, and behavioral effects. A growing body of clinical and basic science evidence suggests that social isolation is linked to a higher risk of various neurological, cardiovascular, and metabolic diseases, including hypertension, diabetes mellitus, and obesity. However, the impact of the deficit of social interaction on kidney function is not well established. The Dahl salt-sensitive (SS) rat is a classical model of salt-induced hypertension and associated kidney injury. In this study, we investigated the effect of 30 days of social isolation (SI) on blood and urine electrolytes and metabolic, physiological, and behavioral parameters in adolescent male Dahl SS rats fed a normal 0.4% NaCl diet. SI rats demonstrated increased behavioral excitability compared with rats kept in groups. We also observed increased food consumption and a decrease in plasma leptin levels in the SI group without differences in water intake and weight gain compared with grouped animals. No changes in the level of blood and urine electrolytes, 24-h urine output, creatinine clearance, and albumin/creatinine ratio were identified between the SI and grouped rats. These findings indicate that 30 days of social isolation of adolescent Dahl SS rats affects metabolic parameters but has no apparent influence on kidney function.


Assuntos
Comportamento Animal , Metabolismo Energético , Rim/fisiopatologia , Isolamento Social , Fatores Etários , Animais , Biomarcadores/sangue , Biomarcadores/urina , Ingestão de Alimentos , Leptina/sangue , Masculino , Ratos Endogâmicos Dahl , Cloreto de Sódio na Dieta/administração & dosagem , Fatores de Tempo , Ganho de Peso
5.
Wei Sheng Yan Jiu ; 49(5): 749-754, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33070818

RESUMO

OBJECTIVE: To evaluate the effects of comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods among catering units. METHODS: The total of 36 catering units were selected randomly and divided into intervention group A, B and control group in August of 2015. Health education was initiated in the intervention group A, including the training of knowledge on salt reduction for managers, cooks and service personnel of catering units every month; distribution of special salt control spoon for cooks; the arrangement of environment of salt reduction in catering units. And health education and labeling less salt foods was provided to the intervention group B, The control group C did not actively provide any intervention. The cook records the quantity of low-salt dishes sold, salt collection and the number of persons per meal in according to the requirements. Questionnaire survey and physical examination were performed to evaluate the effects of comprehensive intervention measures among catering units in the three groups of staffs in the catering units in a baseline study and an evaluation survey six months after the intervention. RESULTS: Compared with group C, the knowledge, attitude and behavior of salt reduction was significantly improved in intervention group A and B(P<0. 05). The behavior towards salt reduction improved much better in group B than in group A(P<0. 05), and using salt spoon when cooking and recommending less salt food to customer improved 32. 1%(χ~2=51. 72, P<0. 05)and 24. 2%(χ~2=30. 01, P<0. 05)separately. The proportion of sales of low salt dishes in the unit canteen has increased steadily, reaching 16. 8% while the proportion of sales has dropped to 9. 2% in the hotel by the end of the intervention period(χ~2=44. 66, P<0. 05). CONCLUSION: The level of knowledge of reducing salt was improved by health education, and labeling less salt foods can promote reducing salt related behavior. The effect of comprehensive intervention measures for salt reduction in unit canteen is better than in the hotel. It was suggested that comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods should be used together in the catering units.


Assuntos
Educação em Saúde , Cloreto de Sódio na Dieta , Humanos , Refeições , Inquéritos e Questionários
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1141-1145, 2020 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-33115202

RESUMO

In 2016, the median of 24-hour urinary sodium, sodium-to-potassium ratio, and sodium intake per capita of residents in Jiaodong area of Shandong Province were 161.7 (IQR:120.5, 218.9) mmol/d, 3.4 (IQR: 2.4, 5.0) and 9.5 (IQR:7.1, 12.8) g/d, all were lower than that of 2011[193.3(IQR:149.2,243.3)mmol/d, 4.5(IQR:3.3,5.9), 11.3(IQR:8.7, 14.2)g/d] (P<0.05); the median of 24-hour urinary potassium was 47.2 (IQR:34.4, 66.5) mmol/d, higher than that of 2011[42.9(IQR:33.6,56.0)] (P<0.05); the proportion of salt intake per capita per day exceeding 5 g (89.9%) was lower than that in 2011 (90.0%). The results of the generalized linear regression model showed that the 24-hour urinary sodium was positively correlated with systolic and diastolic blood pressure [ß values were 0.04 (95%CI: 0.00, 0.07), 0.03 (95%CI 0.01, 0.05), respectively], and the sodium-to-potassium ratio was positively correlated with diastolic blood pressure [ß(95%CI): 0.78 (0.09, 1.47)].


Assuntos
Hipertensão , Cloreto de Sódio na Dieta , Pressão Sanguínea , Comportamento Alimentar , Humanos , Hipertensão/prevenção & controle
7.
Am J Physiol Renal Physiol ; 319(5): F729-F745, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32985236

RESUMO

Chronic kidney disease (CKD) causes salt-sensitive hypertension that is often resistant to treatment and contributes to the progression of kidney injury and cardiovascular disease. A better understanding of the mechanisms contributing to salt-sensitive hypertension in CKD is essential to improve these outcomes. This review critically explores these mechanisms by focusing on how CKD affects distal nephron Na+ reabsorption. CKD causes glomerulotubular imbalance with reduced proximal Na+ reabsorption and increased distal Na+ delivery and reabsorption. Aldosterone secretion further contributes to distal Na+ reabsorption in CKD and is not only mediated by renin and K+ but also by metabolic acidosis, endothelin-1, and vasopressin. CKD also activates the intrarenal renin-angiotensin system, generating intratubular angiotensin II to promote distal Na+ reabsorption. High dietary Na+ intake in CKD contributes to Na+ retention by aldosterone-independent activation of the mineralocorticoid receptor mediated through Rac1. High dietary Na+ also produces an inflammatory response mediated by T helper 17 cells and cytokines increasing distal Na+ transport. CKD is often accompanied by proteinuria, which contains plasmin capable of activating the epithelial Na+ channel. Thus, CKD causes both local and systemic changes that together promote distal nephron Na+ reabsorption and salt-sensitive hypertension. Future studies should address remaining knowledge gaps, including the relative contribution of each mechanism, the influence of sex, differences between stages and etiologies of CKD, and the clinical relevance of experimentally identified mechanisms. Several pathways offer opportunities for intervention, including with dietary Na+ reduction, distal diuretics, renin-angiotensin system inhibitors, mineralocorticoid receptor antagonists, and K+ or H+ binders.


Assuntos
Hipertensão/metabolismo , Receptores de Mineralocorticoides/metabolismo , Insuficiência Renal Crônica/metabolismo , Sais/metabolismo , Cloreto de Sódio na Dieta/metabolismo , Animais , Humanos , Sódio/metabolismo
8.
BMC Public Health ; 20(1): 1475, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993606

RESUMO

BACKGROUND: In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan's disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. METHODS: We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan's National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017-2040, we modelled the three diseases using the data for 1990-2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. RESULTS: In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. CONCLUSIONS: The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs.


Assuntos
Doença Crônica/tendências , Pessoas com Deficiência/estatística & dados numéricos , Promoção da Saúde/organização & administração , Anos de Vida Ajustados por Qualidade de Vida , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Doenças Cardiovasculares/epidemiologia , Dieta/estatística & dados numéricos , Previsões , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco , Cloreto de Sódio na Dieta/administração & dosagem
9.
PLoS One ; 15(9): e0235749, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931497

RESUMO

BACKGROUND: Although assessing nutrient intake through dietary surveys is desirable, it can be effort- and time-intensive. We aimed to develop a brief screening method for determining sodium intake in order to raise public awareness regarding the Dietary Reference Intakes for Japanese (DRI-J) 2020. METHODS: Using data from the 2015 National Health and Nutrition Survey, we compared dietary behaviours obtained from a self-administered questionnaire according to sodium intake, which was assessed from one-day dietary records by a semi-weighed method. Participants were divided into 4 groups based on the reference values of sodium (salt equivalent) shown in the DRI-J. We also randomly divided the participants into development and validation groups, and used logistic regression analysis to identify predictive factors for sex-specific DRI-J (<7.5 g/day in men and <6.5 g/day in women) and above-average intakes (≥10 g/day in men and women). RESULTS: Among the 6,172 Japanese individuals aged ≥20 years old, participants with lower sodium intake were found to use nutrition labels and had a lower frequency of eating out than those with higher intakes (P for difference < .001). Our final model for predicting sodium intake included adjusted sex, age, dietary behaviours, and consumption of mainly processed foods. In the development group, areas under the receiver operating characteristics curves were 0.747 and 0.741 for adherence to sex-specific DRI-J and above-average intake, respectively. The corresponding values in the validation group were 0.734 and 0.730, respectively. CONCLUSIONS: This method could easily identify sodium intake using dietary behaviours and specific food consumption, and is expected to be widely useful for health and nutrition education in Japan.


Assuntos
Dieta , Cloreto de Sódio na Dieta , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Ingestão de Alimentos , Feminino , Preferências Alimentares , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Inquéritos Nutricionais , Cloreto de Sódio na Dieta/metabolismo , Adulto Jovem
10.
Nat Commun ; 11(1): 4368, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32868758

RESUMO

Increased extracellular sodium activates Th17 cells, which provide protection from bacterial and fungal infections. Whilst high salt diets have been shown to worsen autoimmune disease, the immunological consequences of clinical salt depletion are unknown. Here, we investigate immunity in patients with inherited salt-losing tubulopathies (SLT). Forty-seven genotyped SLT patients (with Bartter, Gitelman or EAST Syndromes) are recruited. Clinical features of dysregulated immunity are recorded with a standardised questionnaire and immunological investigations of IL-17 responsiveness undertaken. The effects of altering extracellular ionic concentrations on immune responses are then assessed. Patients are hypokalaemic and hypomagnesaemic, with reduced interstitial sodium stores determined by 23Na-magnetic resonance imaging. SLT patients report increased mucosal infections and allergic disease compared to age-matched controls. Aligned with their clinical phenotype, SLT patients have an increased ratio of Th2:Th17 cells. SLT Th17 and Tc17 polarisation is reduced in vitro, yet STAT1 and STAT3 phosphorylation and calcium flux following T cell activation are unaffected. In control cells, the addition of extracellular sodium (+40 mM), potassium (+2 mM), or magnesium (+1 mM) reduces Th2:Th17 ratio and augments Th17 polarisation. Our results thus show that the ionic environment typical in SLT impairs IL-17 immunity, but the intracellular pathways that mediate salt-driven Th17 polarisation are intact and in vitro IL-17 responses can be reinvigorated by increasing extracellular sodium concentration. Whether better correction of extracellular ions can rescue the immunophenotype in vivo in SLT patients remains unknown.


Assuntos
Síndromes de Imunodeficiência/etiologia , Interleucina-17/metabolismo , Túbulos Renais Distais/patologia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Animais , Pré-Escolar , Doença Crônica , Estudos de Coortes , Feminino , Doenças Genéticas Inatas , Humanos , Magnésio/metabolismo , Masculino , Pessoa de Meia-Idade , Potássio/metabolismo , Sais/metabolismo , Sais/uso terapêutico , Sódio/metabolismo , Cloreto de Sódio/metabolismo , Cloreto de Sódio na Dieta/uso terapêutico , Células Th17/metabolismo , Células Th2/metabolismo , Adulto Jovem
11.
Best Pract Res Clin Endocrinol Metab ; 34(4): 101430, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32792134

RESUMO

Iodine intake is essential for the production of thyroid hormone. Iodine deficiency remains a public health problem in many regions around the world. Iodine deficiency can present as a spectrum of disorders depending on the degree of severity. Pregnant and lactating women are particularly vulnerable to iodine deficiency disorders because of their increased iodine requirements. Severe maternal iodine deficiency has been associated with cretinism or impaired neurodevelopment in children as well as obstetric complications. Universal salt iodization has been shown to prevent these disorders in severely iodine deficient areas. Recently, observational studies have demonstrated an association between mild-to-moderate iodine deficiency and poorer cognitive outcomes in children. In this review, we describe the iodine requirements for pregnant and lactating women, how population iodine status can be assessed, the effects of maternal iodine deficiency and excess, and current data regarding efficacy of iodine supplementation for women who are pregnant or lactating.


Assuntos
Suplementos Nutricionais , Iodo/administração & dosagem , Iodo/sangue , Estado Nutricional , Complicações na Gravidez/prevenção & controle , Criança , Hipotireoidismo Congênito/prevenção & controle , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/prevenção & controle , Iodo/deficiência , Lactação/efeitos dos fármacos , Lactação/fisiologia , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/normas , Gravidez , Complicações na Gravidez/sangue , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/normas , Cloreto de Sódio na Dieta/administração & dosagem , Hormônios Tireóideos/metabolismo , Fatores de Tempo
12.
Biochim Biophys Acta Mol Basis Dis ; 1866(11): 165907, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32738302

RESUMO

High salt diet (HSD), considered a public health problem worldwide, is associated with chronic degenerative diseases including renal diseases. However, little is known about the effects of HSD on renal function independently of the development of hypertension. To address the hypothesis that HSD induces renal injuries even without changes in blood pressure, BALB/c mice were fed for 7 days with chow with a high salt content (0.3-8%). Blood pressure did not change and there was a decrease in cortical (Na+ + K+)ATPase and NHE3 exchanger and an increase in renal fractional excretion of sodium. Positive correlations between Na+ intake or urinary sodium excretion with proteinuria were found. HSD did not change glomerular function and structure, but induced tubule-interstitial injury measured by an increase in collagen deposition, interstitial space and γ-GT activity, a marker of tubular injury. These effects were associated with a decrease in cortical albumin reabsorption and megalin expression. Similarly, the addition of NaCl 20 mM to the incubation medium of LLC-PK1 cells reduced megalin expression and albumin endocytosis indicating that HSD could have a direct effect on proximal tubule cells. Furthermore, tubule-interstitial injury was associated with pro-inflammatory and pro-fibrotic phenotypes with an increase in Th1 and Th17 phenotypes and a decrease in Tregs followed by increases in IL-6, -17, -10, TNF-α, IFN-γ and TGF-ß. Our results reveal a complex network involved in renal injuries induced by HSD independently of changes in blood pressure. These findings strengthen the importance of restriction of salt intake for the general population even for salt-resistant individuals.


Assuntos
Hipertensão/metabolismo , Inflamação/metabolismo , Cloreto de Sódio na Dieta/efeitos adversos , Animais , Pressão Sanguínea/efeitos dos fármacos , Endocitose/efeitos dos fármacos , Imunofluorescência , Hipertensão/induzido quimicamente , Immunoblotting , Imuno-Histoquímica , Inflamação/induzido quimicamente , Interferon gama/metabolismo , Interleucina-10/metabolismo , Interleucina-17/metabolismo , Interleucina-6/metabolismo , Túbulos Renais Proximais/efeitos dos fármacos , Túbulos Renais Proximais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Microscopia Eletrônica de Transmissão , Suínos , Linfócitos T/efeitos dos fármacos , Linfócitos T/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
13.
Artigo em Inglês | MEDLINE | ID: mdl-32784844

RESUMO

In Saudi Arabia, data regarding salt-related knowledge and practices are still lacking. This cross-sectional study aimed to investigate salt-related knowledge and practices and associated factors in Saudi adults. Data on the following variables were collected from 467 participants living in Madinah or Jeddah via face-to-face interviews: demographics, anthropometrics (height and weight), blood pressure (assessed using a digital sphygmomanometer), salt-related knowledge, and practices related to salt intake. Salt-related knowledge and practices were limited among the study participants; however, they were not correlated (rs = 0.10). Multiple linear regression analysis revealed that salt-related practices were negatively associated with sodium intake and positively associated with body mass index (BMI) (p < 0.001 and p = 0.001, respectively), whereas salt-related knowledge was not associated with sodium intake, blood pressure, or BMI. Salt-related knowledge is limited and not linked to practices related to salt intake in Saudi adults. Interventions are needed to increase the accessibility of low-sodium food options and improve practices limiting sodium intake to prevent the occurrence of salt-related diseases among adults in Saudi Arabia.


Assuntos
Comportamento Alimentar , Cloreto de Sódio na Dieta , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Arábia Saudita
14.
Am J Physiol Renal Physiol ; 319(4): F647-F653, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32799674

RESUMO

It has been shown that cyclooxygenase (COX)-2-dependent activation of renal (pro)renin receptor (PRR) contributes to angiotensin II (ANG II)-induced hypertension. However, less is known about the involvement of this mechanism in ANG II-independent hypertension. The goal of the present study was to test whether or not COX-2-dependent upregulation of PRR serves as a universal mechanism contributing to ANG II-dependent and -independent hypertension. Here, we examined the association between renal COX-2 and PRR during deoxycorticosterone acetate (DOCA)-salt hypertension in rats. By immunoblot analysis and immunofluorescence, renal protein expression of PRR was remarkably upregulated by DOCA-salt treatment. Surprisingly, this upregulation of renal PRR expression was unaffected by a COX-2 inhibitor, celecoxib. To address the role of renal PRR to the pathogenesis of DOCA-salt hypertension, a decoy PRR inhibitor, PRO20, was infused to the renal medulla of uninephrectomized Sprague-Dawley rats for 14 days. Radiotelemetry demonstrated effective attenuation of DOCA-salt hypertension by intramedullary infusion of a PRR inhibitor, PRO20. In parallel, DOCA-salt-induced hypertrophy in the heart and kidney as well as proteinuria were improved, accompanied with blunted polydipsia and polyuria. In contrast, intravenous infusion of PRO20 was less effective in attenuating DOCA-salt hypertension and cardiorenal injury. Together, these results suggest that COX-2-independent activation of renal PRR contributes to DOCA-salt hypertension.


Assuntos
Pressão Sanguínea , Ciclo-Oxigenase 2/metabolismo , Acetato de Desoxicorticosterona , Hipertensão/enzimologia , Rim/enzimologia , Receptores de Superfície Celular/metabolismo , Cloreto de Sódio na Dieta , Animais , Cardiomegalia/induzido quimicamente , Cardiomegalia/enzimologia , Cardiomegalia/fisiopatologia , Modelos Animais de Doenças , Ativação Enzimática , Hipertensão/induzido quimicamente , Hipertensão/fisiopatologia , Rim/fisiopatologia , Masculino , Proteinúria/induzido quimicamente , Proteinúria/enzimologia , Proteinúria/fisiopatologia , Ratos Sprague-Dawley , Transdução de Sinais
15.
Am J Physiol Heart Circ Physiol ; 319(3): H571-H581, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32734815

RESUMO

Salt intake may alter blood pressure (BP) regulation, but no study has investigated the impact of salt reduction versus salt loading on morning blood pressure surge (MBPS) and sympathetic neural control in premenopausal women with a history of normal pregnancy. Nine healthy women (42 ± 3 yr; mean ± SD) were given a low-salt diet (LS; 50 mEq sodium/day) and high-salt diet (HS; 250 mEq sodium/day) for 1 wk each (~2 mo apart with the order randomized), while water intake was ad libitum. Ambulatory BP at 24 h was measured, and the percent change in blood volume (BV) was calculated following LS and HS. MBPS was defined as the morning systolic BP (averaged for 2 h after wake-up) minus the lowest nocturnal systolic BP. Beat-by-beat BP, heart rate, and muscle sympathetic nerve activity (MSNA) were measured during supine rest. Signal averaging was used to characterize changes in beat-by-beat mean arterial pressure and total vascular conductance following spontaneous MSNA bursts to assess sympathetic vascular transduction. Ambulatory BP and MBPS (32 ± 7 vs. 26 ± 12 mmHg, P = 0.208) did not differ between LS and HS. From LS to HS, BV increased by 4.3 ± 3.7% (P = 0.008). MSNA (30 ± 20 vs. 18 ± 13 bursts/100 heartbeats, P = 0.005) was higher, whereas sympathetic vascular transduction was lower in LS than HS (both, P < 0.01). Changes in MSNA from LS to HS were correlated to percent changes in BV (r = -0.673; P = 0.047). Thus, salt intake affects sympathetic neural control but not MBPS in premenopausal women with a history of normal pregnancy. The underlying mechanisms remain unknown; however, alterations in sympathetic vascular transduction may, in part, contribute.NEW & NOTEWORTHY This is the first study to demonstrate that MBPS and ambulatory BP were not affected by salt intake despite a significant change in sympathetic outflow in healthy premenopausal women with a history of normal pregnancy. This may be due to compensatory adaptations in MSNA and sympathetic vascular transduction during salt reduction versus salt loading.


Assuntos
Pressão Sanguínea , Sistema Cardiovascular/inervação , Ritmo Circadiano , Dieta Hipossódica , Músculo Esquelético/inervação , Cloreto de Sódio na Dieta/administração & dosagem , Sistema Nervoso Simpático/fisiologia , Adaptação Fisiológica , Adulto , Estudos Cross-Over , Feminino , Frequência Cardíaca , Humanos , Pessoa de Meia-Idade , Paridade , Gravidez , Pré-Menopausa , Estudos Prospectivos , Distribuição Aleatória , Fatores de Tempo
16.
Am J Physiol Renal Physiol ; 319(4): F624-F635, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32830539

RESUMO

Recently, we reported a mutation in γ-adducin (ADD3) was associated with an impaired myogenic response of the afferent arteriole and hypertension-induced chronic kidney disease (CKD) in fawn hooded hypertensive (FHH) rats. However, the mechanisms by which altered renal blood flow (RBF) autoregulation promotes hypertension-induced renal injury remain to be determined. The present study compared the time course of changes in renal hemodynamics and the progression of CKD during the development of DOCA-salt hypertension in FHH 1BN congenic rats [wild-type (WT)] with an intact myogenic response versus FHH 1BN Add3KO (Add3KO) rats, which have impaired myogenic response. RBF was well autoregulated in WT rats but not in Add3KO rats. Glomerular capillary pressure rose by 6 versus 14 mmHg in WT versus Add3KO rats when blood pressure increased from 100 to 150 mmHg. After 1 wk of hypertension, glomerular filtration rate increased by 38% and glomerular nephrin expression decreased by 20% in Add3KO rats. Neither were altered in WT rats. Proteinuria doubled in WT rats versus a sixfold increase in Add3KO rats. The degree of renal injury was greater in Add3KO than WT rats after 3 wk of hypertension. RBF, glomerular filtration rate, and glomerular capillary pressure were lower by 20%, 28%, and 19% in Add3KO rats than in WT rats, which was associated with glomerular matrix expansion and loss of capillary filtration area. The results indicated that impaired RBF autoregulation and eutrophic remodeling of preglomerular arterioles increase the transmission of pressure to glomeruli, which induces podocyte loss and accelerates the progression of CKD in hypertensive Add3KO rats.


Assuntos
Pressão Sanguínea , Taxa de Filtração Glomerular , Hipertensão/complicações , Glomérulos Renais/irrigação sanguínea , Proteinúria/etiologia , Circulação Renal , Insuficiência Renal Crônica/etiologia , Animais , Arteríolas/metabolismo , Arteríolas/fisiopatologia , Proteínas de Ligação a Calmodulina/genética , Proteínas de Ligação a Calmodulina/metabolismo , Acetato de Desoxicorticosterona , Modelos Animais de Doenças , Progressão da Doença , Homeostase , Hipertensão/genética , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Masculino , Desenvolvimento Muscular , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/fisiopatologia , Proteinúria/genética , Proteinúria/metabolismo , Proteinúria/fisiopatologia , Ratos Transgênicos , Insuficiência Renal Crônica/genética , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/fisiopatologia , Cloreto de Sódio na Dieta , Remodelação Vascular
17.
Am J Med ; 133(12): 1471-1478.e4, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32603788

RESUMO

BACKGROUND: Guidelines recommend increased salt intake as a first-line recommendation in the management of symptomatic orthostatic hypotension and recurrent syncope. There have been no systematic reviews of this intervention. We sought to summarize the evidence for increased salt intake in patients with orthostatic intolerance syndromes. METHODS: We conducted a systematic review and meta-analysis of studies in PubMed, EMBASE, and CINAHL. Interventional studies that increased salt intake in individuals with orthostatic intolerance syndromes were included. Primary outcome measures included incidence of falls and injuries, and rates of syncope and presyncope. Secondary outcome measures included other orthostatic intolerance symptoms, blood pressure, and heart rate. RESULTS: A total of 14 studies were eligible, including participants with orthostatic hypotension, syncope, postural orthostatic tachycardia syndrome, and idiopathic orthostatic tachycardia (n = 391). Mean age was 35.6 (± 15) years. All studies were small and short-term (<60 mins-90 days). No study reported on the effect of increased salt intake on falls or injuries. Meta-analysis demonstrated that during head-up tilt, mean time to presyncope with salt intake increased by 1.57 minutes (95% confidence interval [CI], 1.26-1.88), mean systolic blood pressure increased by 12.27 mm Hg (95% CI, 10.86-13.68), and mean heart rate decreased by -3.97 beats per minute (95% CI, -4.08 to -3.86), compared with control. Increased salt increased supine blood pressure by 1.03 mm Hg (95% CI, 0.81 to 1.25). Increased salt intake resulted in an improvement or resolution of symptoms in 62.3% (95% CI, 51.6 to 72.6) of participants in short-term follow-up studies (mean follow-up of 44.3 days, 6 studies; n=91). Methodological quality of studies were low with high statistical heterogeneity in all meta-analyses. CONCLUSIONS: Our meta-analysis provides low-quality evidence of a short-term improvement in orthostatic intolerance with increased salt intake. There were no clinical trials demonstrating the efficacy and safety of increased salt intake on long-term clinical outcomes. Overall, there is a paucity of clinical trial evidence to support a cornerstone recommendation in the management of orthostatic intolerance syndromes.


Assuntos
Intolerância Ortostática/dietoterapia , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Humanos , Pessoa de Meia-Idade , Adulto Jovem
18.
PLoS One ; 15(7): e0235514, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645031

RESUMO

INTRODUCTION: Cardiovascular diseases (CVDs) represent the main cause of death among non-communicable diseases (NCDs) in Brazil, and they have a high economic impact on health systems. Most populations around the world, including Brazilians, consume excessive sodium, which increases blood pressure and the risk of CVDs. OBJECTIVE: To model the estimated deaths and costs associated with CVDs, which are mediated by increased blood pressure attributable to excessive sodium consumption in adults from the perspective of the Brazilian public health system in 2017. METHODS: We employed two macrosimulation methods, using top-down approaches and based on the same relative risks. The models estimated the mortality and costs-of-illness attributable to excessive sodium intake and mediated by hypertension for adults aged over 30 years in 2017. Direct healthcare cost data (inpatient care, outpatient care and medications) were extracted from the Ministry of Health information systems and official records. RESULTS: In 2017, an estimated 46,651 deaths from CVDs could have been prevented if the average sodium consumption had been reduced to 2 g/day in Brazil. Premature deaths related to excessive sodium consumption caused 575,172 Years of Life Lost and US$ 752.7 million in productivity losses to the economy. In the same year, the National Health System's costs of hospitalizations, outpatient care and medication for hypertension attributable to excessive sodium consumption totaled US$192.1 million. The main causes of death and costs associated with CVDs were coronary heart disease and stroke, followed by hypertensive disease, heart failure and aortic aneurysm. CONCLUSION: Excessive sodium consumption is estimated to account for 15% of deaths by CVDs and to 14% of the inpatient and outpatient costs associated with CVD. It also has high societal costs in terms of premature deaths. CVDs are a leading cause of disease and economic burden on the global, regional and country levels. As a largely preventable and treatable conditions, CVDs require the strengthening of cost-effective policies, supported by evidence, including modeling studies, to reduce the costs relating to illness borne by the Brazilian public health system and society.


Assuntos
Efeitos Psicossociais da Doença , Cardiopatias/epidemiologia , Modelos Teóricos , Recomendações Nutricionais , Cloreto de Sódio na Dieta/efeitos adversos , Brasil , Feminino , Fidelidade a Diretrizes , Cardiopatias/economia , Cardiopatias/etiologia , Cardiopatias/mortalidade , Humanos , Masculino , Cloreto de Sódio na Dieta/normas , Organização Mundial da Saúde
19.
Am Heart J ; 226: 198-205, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32615357

RESUMO

BACKGROUND: High sodium intake has been considered as the leading dietary risk factor for deaths and disability-adjusted life-years among older adults. High-quality randomized trials to evaluate the effects of practical sodium reduction strategies are needed. METHODS: The study is a cluster randomized trial with a 2 × 2 factorial design conducted in 48 senior residential facilities in northern China. These facilities are randomly assigned (1:1:1:1) to 1 of 4 groups: stepwise salt supply control (SSSC) in which 5%-10% of the study salt supply in the institutional kitchens will be reduced every 3 months, replacing normal salt with salt substitute (SS); SSSC only; SS only; or neither SSSC nor SS. The interventions last for 2 years with follow-up every 6 months. The primary outcome is the change in systolic blood pressure from baseline to 24 months. Secondary outcomes include the incidence of hyperkalemia, hyponatremia, cardiovascular events, and death. CURRENT STATUS: The study has recruited and randomized 48 senior residential facilities with 1,606 participants. Mean age at baseline was 71 years, and 76% are male. Both types of salt intervention were initiated in the study facilities between January and April 2018. CONCLUSION: The study is well placed to define the effects of 2 practical and scalable sodium reduction strategies for blood pressure reduction and will provide important new data about safety of these strategies among older adults in China.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Dieta Hipossódica/métodos , Aromatizantes/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Cloreto de Sódio na Dieta/farmacologia , Idoso , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Masculino
20.
J Sex Med ; 17(7): 1280-1287, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32624131

RESUMO

BACKGROUND: High salt intake is a risk factor for hypertension, which can potentially lead to erectile dysfunction (ED); however, the underlying pathological mechanisms remain unclear. AIM: To investigate whether erectile function is directly impaired by high salt intake and whether selective inhibition of mineralocorticoid receptor (MR) could provide protection from ED. METHODS: 6-week-old male Dahl salt-sensitive rats were randomly divided into 3 groups: normal diet (0.3% NaCl; control, n = 8), high-salt diet (8% NaCl; HS, n = 8), and high-salt diet plus eplerenone (HS + EPL, n = 11). HS + EPL rats were orally administered daily doses of EPL (75 mg/kg) for 6 weeks; control and HS rats received purified water on the same schedule. OUTCOMES: At the end of the study period, erectile function was evaluated by measuring intracavernosal pressure and mean arterial pressure after cavernous nerve stimulation. Serum levels of asymmetric dimethylarginine and L-arginine were determined using ultraperformance liquid chromatography-tandem mass spectrometry. Quantitative PCR was used to assess the expression of MR, inflammation, and oxidative stress markers (nicotinamide adenine dinucleotide phosphate oxidase-1/4, p22phox, interleukin-6, and superoxide dismutase-1), and protein arginine N-methyltransferase-1. RESULTS: The intracavernosal pressure/mean arterial pressure ratio was significantly lower, whereas systolic blood pressure, MR expression, serum asymmetric dimethylarginine levels, oxidative stress, and levels of inflammatory biomarkers were significantly higher in HS rats than in control rats (P < .05). EPL administration significantly improved each of these parameters except systolic blood pressure and MR expression. No significant intergroup differences were observed for L-arginine and superoxide dismutase-1 levels. CLINICAL TRANSLATION: Our results provide a rationale for the need of salt restriction and the use of selective MR inhibitors in prophylaxis or treatment of ED in men consuming a high-salt diet. STRENGTHS & LIMITATIONS: We are the first to report that the adverse impact of high salt intake on erectile function is mediated via MR activation, independent of its effect on blood pressure. A major limitation of this study is that responses of salt-resistant rats were not studied. CONCLUSIONS: High salt intake directly impaired erectile function in Dahl salt-sensitive rats, whereas selective MR inhibition ameliorated this effect. Kishimoto T, Kataoka T, Yamamoto Y, et al. High Salt Intake Impairs Erectile Function in Salt-Sensitive Rats Through Mineralocorticoid Receptor Pathway Beyond Its Effect on Blood Pressure. J Sex Med 2020;17:1280-1287.


Assuntos
Disfunção Erétil , Hipertensão , Animais , Pressão Sanguínea , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/tratamento farmacológico , Masculino , Ratos , Ratos Endogâmicos Dahl , Receptores de Mineralocorticoides , Cloreto de Sódio , Cloreto de Sódio na Dieta/efeitos adversos
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