In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_1 ( 2015-03-10)
Abstract:
Introduction: National efforts toward reducing population sodium intake necessitate developing a feasible and valid monitoring method, especially for the distribution tails given about 90% of the US population consumes more sodium than recommended. Objective: We developed and tested the validity of a statistical approach using one or two timed-spot urines to estimate population distribution of usual 24-hour sodium excretion. Methods: A convenience sample of 407 adults, 18-39 years of age, (54% female, 48% black) collected urine for a 24-hour period, placing each void in a separate container. Of these, 133 repeated the procedure 4-11 days later. Four timed-spot specimens (morning, afternoon, evening, and overnight) were selected from each 24-hour collection. We developed gender-specific equations using Fuller’s error-in-the-equation measurement error model to calibrate total sodium excreted in each of the one-spot (e.g., morning) and combined two-spot (e.g., morning + afternoon) urines to 24-hour sodium excretion. The calibrated sodium excretions were used to estimate the population distribution of usual 24-hour sodium excretion. Participants were then randomly assigned to modeling (n=160) or validation (n=247) groups to examine the bias in estimated population percentiles. Results: Median bias in predicting the 5 th , 25 th , 50 th , 75 th , and 95 th population percentiles of usual 24-hour sodium excretion with one-spot urine ranged from -367 to 284 mg (-7.7 to 12.2% of the observed usual excretions) for men and -604 to 486 mg (-14.6 to 23.7%) for women, and with two-spot urines from -338 to 263 mg (-6.9 to 10.4%) and -166 to 153 mg (-4.1 to 8.1%), respectively. Four of the six two-spot urine combinations produced no significant bias in predicting selected percentiles. Conclusions: Our approach to estimate the population distribution of usual 24-hour sodium excretion using calibrated spot urine sodium accounted for day-to-day variation and covariance between measurement errors, and produced percentile estimates with relatively low biases across low to high sodium levels. This may provide a low-burden, low-cost alternative to 24-hour collections in monitoring population sodium intake among healthy young adults and merits further investigation in other population subgroups.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.131.suppl_1.p328
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2015
detail.hit.zdb_id:
1466401-X
