目的 调查天津、上海两地青年男性在炎热和非炎热天气下的饮水、排尿行为及水合状态变化特征,分析水合状态的影响因素。方法 采用横断面研究方法,于2024年3、6、7、12月分别从上海、天津两地纳入289名18~35岁的男性;使用《24小时饮水-排尿记录表》连续记录3d饮水、排尿行为;使用带刻度尿液存储瓶收集并计量每次尿量;使用冰点渗透压测量仪检测3d晨尿及午后尿渗透压,判断脱水情况;使用生物电阻抗分析仪评估体成分。结果 研究对象总体饮水摄入量中位数为1415 ml,排尿量中位数为1040 ml,排尿次数中位数为6次,晨尿、午后尿渗透压中位数分别为977、918 mOsm/kg,研究对象晨尿、午后尿脱水率分别为84.1%和66.7%;根据调查期间平均室外气温（temperature,T）将两地数据统一分为T>28℃组（炎热）与T≤28℃组（非炎热）进行分析,相较于T≤28℃组,T>28℃组的研究对象饮水摄入量中位数更高（上海：Z = 6.49,P<0.01;天津：Z = 6.55, P<0.01）,排尿量（上海：Z =–5.85,P<0.01;天津：Z =–8.54,P<0.01）及排尿次数（上海：Z =–4.08,P<0.01;天津：Z =–12.76,P<0.01）更低,午后尿脱水率（上海：χ2 =5.99,P<0.05;天津：χ2 = 27.27,P<0.01）更高,而晨尿脱水率未见显著性差异;T>28℃组的研究对象细胞内水分偏低（上海：Z = 2.25,P<0.05;天津：Z = 2.37,P<0.05）,伴细胞外水分与细胞内水分比值（上海：t =–4.06,P<0.01;天津：t =–4.47,P<0.01）、细胞外水分比率（上海：t =–3.81,P<0.01;天津：t =–4.45,P<0.01）显著升高;Logistic回归分析显示,当T>28℃时,研究对象晨尿和午后尿脱水风险相比于T≤28℃分别增加1.6倍（OR = 2.59,95%CI：1.60~4.20）和4.1倍（OR = 5.13,95%CI：3.28~8.00）;饮水摄入量>2000 ml时,研究对象的晨尿脱水风险较饮水摄入量为1700~2000 ml降低50%（OR = 0.50,95%CI：0.25~0.98）;较高的汤的摄入比例使午后尿脱水风险降低（OR = 1.24,95%CI：1.02~1.50）,而其余种类液体摄入比例对脱水影响不显著。结论 此次调查对象普遍存在饮水摄入不足及脱水现象;在炎热天气下,脱水风险显著增高;增加饮水摄入量,显著降低脱水风险。
Abstract
Objective To investigate the characteristics of fluid intake, urine output and hydration status among young males from Tianjin and Shanghai in different seasons, and to analyze the influencing factors. Methods A total of 289 male subjects aged 18-35 years were recruited from Shanghai and Tianjin during the surveys conducted in March, June, July, and December in 2024.Information on daily fluid intake and urination behaviors was recorded using a 24-hour drinking and urination questionnaire over three consecutive days. Urine samples were collected and volumetrically measured using graduated urine collection bottles. Hydration status was measured by using freezing point osmometry to test the osmolality of morning and afternoon urines for three days. The body composition was tested with a bioelectrical impedance analyzer (BIA). Results The median values for total fluid intake (TFI), urine volume, and urine frequency were 1415 ml, 1040 ml, and 6 times, respectively. The median urine osmolality values were 977 mOsm/kg (morning) and 918 mOsm/kg (afternoon), corresponding to dehydration prevalence of 84.1% (morning) and 66.7% (afternoon). Based on the average outdoor temperature(T) measured during the survey period, participants from the two cities were divided into two groups: T≤28℃ and T>28℃.Compared with the T≤28℃ group, the T>28℃ group had higher TFI (Shanghai: Z=6.49, P<0.01; Tianjin: Z = 6.55, P<0.01), lower urine volume (Shanghai: Z =–5.85, P<0.01; Tianjin: Z =–8.54, P<0.01) and frequency (Shanghai: Z =–4.08, P<0.01; Tianjin: Z =–12.76, P<0.01), and higher afternoon urine dehydration prevalence (Shanghai: χ2 =5.99, P<0.05; Tianjin: χ2=27.27, P<0.01). No significant differences were observed in morning urine dehydration prevalence between different temperature groups. There were no significant differences in total body water (TBW) and extracellular water (ECW) between different temperature groups, while the T>28°C group had lower intracellular water (ICW) (Shanghai: Z=2.25, P<0.05; Tianjin: Z=2.37, P<0.05) and higher ECW/ICW (Shanghai: t=–4.06, P<0.01; Tianjin: t=–4.47, P<0.01) and ECW/TBW (Shanghai: t =–3.81, P<0.01; Tianjin: t =–4.45, P<0.01). Logistic regression analysis revealed that exposure to the ambient temperatures higher than 28℃ was significantly associated with higher risk of dehydration for both morning urine (OR = 2.59, 95%CI: 1.60-4.20) and afternoon urine (OR = 5.13, 95%CI: 3.28-8.00). TFI more than 2000ml reduced the risk of dehydration for morning urine (OR=0.50, 95%CI: 0.25-0.98). Higher proportion of soup intake reduced the risk of dehydration for afternoon urine (OR =1.24, 95%CI: 1.02-1.50). The proportion of other types of liquid intake had no significant impact on the risk of dehydration. Conclusion Young males in Tianjin and Shanghai commonly exhibit inadequate water consumption and a high dehydration incidence. Higher outdoor temperatures increase the risk of dehydration. Daily water intake exceeding 2000 ml decreases the risk of dehydration.
关键词
饮水 /
水合状态 /
脱水 /
尿液渗透压
Key words
fluid intake /
hydration status /
dehydration /
urine osmolality
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