Low Urinary Potassium Excretion Is Associated with Higher Risk of All-Cause Mortality in Patients with Type 2 Diabetes: Results of the Dutch Diabetes and Lifestyle Cohort Twente (DIALECT)

Stanley MH Yeung, Milou M. Oosterwijk*, Monique Poelstra, Christina M. Gant, Joris I. Rotmans, Ewout J. Hoorn, Liffert Vogt, Gerjan Navis, Stephan JL Bakker, Martin H. de Borst, Gozewijn D. Laverman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
65 Downloads (Pure)

Abstract

Background: Low 24-h urinary potassium excretion, reflecting low potassium intake, is associated with premature mortality in the general population.

Objectives: To determine whether urinary potassium excretion is associated with all-cause mortality in patients with type 2 diabetes.

Methods: We performed a prospective cohort study in 654 patients with type 2 diabetes in the Diabetes and Lifestyle Cohort Twente (DIALECT). Sex-specific tertiles of 24-h urinary potassium excretion were analyzed in a multivariable Cox regression model with all-cause mortality. The outpatient program of the hospital uses a continuous surveillance system by the municipal registry of death to ensure up-to-date information on the patient's status (alive or deceased). FFQs were used to study associations between urinary potassium excretion and food products.

Results: Urinary potassium excretion at baseline was 84 ± 25 mmol/d in males and 65 ± 22 mmol/d in females, corresponding to estimated potassium intakes of 4250 ± 1270 mg/d and 3300 ± 875 mg/d. During a median follow-up of 5.2 (IQR: 2.7−7.9] y, 96 participants died. In a fully adjusted model, patients in the lowest sex-specific tertile had a higher risk of all-cause mortality, compared with patients in the highest sex-specific tertile (HR: 2.09; 95% CI: 1.06, 4.10; P = 0.03). Patients in the lowest sex-specific tertile consumed fewer fruits and vegetables, dairy, coffee, and potato products compared with patients in the highest sex-specific tertile (all P < 0.05).

Conclusions: Low potassium intake is associated with a higher risk of all-cause mortality in Dutch patients with type 2 diabetes. Intervention studies are needed to determine whether potassium supplementation improves longevity in patients with type 2 diabetes. This trial was registered in the Dutch Trial Register as NTR trial code 5855.

Original languageEnglish
Pages (from-to)2856-2864
Number of pages9
JournalThe Journal of Nutrition
Volume152
Issue number12
DOIs
Publication statusPublished - Dec-2022

Keywords

  • 24-hour urinary potassium excretion
  • all-cause mortality
  • diet
  • food-frequency questionnaire
  • type 2 diabetes

Cite this