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

Summary: New Iran-specific formulas (Iran 1 & 2) estimate 24h urinary sodium with less bias than existing equations. #SaltIntake #PublicHealth

Mohammadifard N¹ ; Marateb H² ; Mansourian M³ ; Khosravi A^{4, 5} ; Abdollahi Z⁶ ; Campbell NRC⁷ ; Webster J⁸ ; Petersen K⁹ ; Sarrafzadegan N^{1, 10}
Source: Public Health Nutrition Published:2020

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. © 2019 The Authors.