High Dietary Sodium Intake Assessed by Estimated 24-h Urinary Sodium Excretion Is Associated with NAFLD and Hepatic Fibrosis

Although high sodium intake is associated with obesity and hypertension, few studies have investigated the relationship between sodium intake and non-alcoholic fatty liver disease (NAFLD). We evaluated the association between sodium intake assessed by estimated 24-h urinary sodium excretion and NAFL...

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Published in:PloS one 2015-11, Vol.10 (11), p.e0143222-e0143222
Main Authors: Huh, Ji Hye, Lee, Kyong Joo, Lim, Jung Soo, Lee, Mi Young, Park, Hong Jun, Kim, Moon Young, Kim, Jae Woo, Chung, Choon Hee, Shin, Jang Yel, Kim, Hyun-Soo, Kwon, Sang Ok, Baik, Soon Koo
Format: Article
Language:English
Subjects:
Adipose Tissue - diagnostic imaging
Adult
Aged
Aged, 80 and over
Alanine Transaminase - metabolism
Body fat
Body Mass Index
Cardiovascular disease
Care and treatment
Complications and side effects
Confidence intervals
Data processing
Development and progression
Diabetes
Diet
Dietary intake
Endocrinology
Excretion
Family medical history
Fatty liver
Female
Fibrosis
Gastroenterology
Health care
Hepatitis
Hepatology
Humans
Hypertension
Insulin resistance
Internal medicine
Liver
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - pathology
Liver diseases
Male
Mathematical models
Metabolic disorders
Metabolic syndrome
Middle Aged
Non-alcoholic Fatty Liver Disease - complications
Non-alcoholic Fatty Liver Disease - diagnosis
Non-alcoholic Fatty Liver Disease - epidemiology
Nutrition
Nutrition Surveys
Obesity
Odds Ratio
Patient outcomes
Population
Prediction models
Prevalence
Preventive medicine
Radiography
Republic of Korea
Risk Factors
Salt
Severity of Illness Index
Sodium
Sodium - urine
Sodium, Dietary
Steatosis
Studies
Urine
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Summary:Although high sodium intake is associated with obesity and hypertension, few studies have investigated the relationship between sodium intake and non-alcoholic fatty liver disease (NAFLD). We evaluated the association between sodium intake assessed by estimated 24-h urinary sodium excretion and NAFLD in healthy Koreans. We analyzed data from 27,433 participants in the Korea National Health and Nutrition Examination Surveys (2008-2010). The total amount of sodium excretion in 24-h urine was estimated using Tanaka's equations from spot urine specimens. Subjects were defined as having NAFLD when they had high scores in previously validated NAFLD prediction models such as the hepatic steatosis index (HSI) and fatty liver index (FLI). BARD scores and FIB-4 were used to define advanced fibrosis in subjects with NAFLD. The participants were classified into three groups according to estimated 24-h urinary excretion tertiles. The prevalence of NAFLD as assessed by both FLI and HSI was significantly higher in the highest estimated 24-h urinary sodium excretion tertile group. Even after adjustment for confounding factors including body fat and hypertension, the association between higher estimated 24-h urinary sodium excretion and NAFLD remained significant (Odds ratios (OR) 1.39, 95% confidence interval (CI) 1.26-1.55, in HSI; OR 1.75, CI 1.39-2.20, in FLI, both P < 0.001). Further, subjects with hepatic fibrosis as assessed by BARD score and FIB-4 in NAFLD patients had higher estimated 24-h urinary sodium values. High sodium intake was independently associated with an increased risk of NAFLD and advanced liver fibrosis.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0143222