@article{79c589065fcc47d5bd4c51568d8f9904,
title = "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)",
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.",
keywords = "24-hour urinary potassium excretion, all-cause mortality, diet, food-frequency questionnaire, type 2 diabetes",
author = "Yeung, {Stanley MH} and Oosterwijk, {Milou M.} and Monique Poelstra and Gant, {Christina M.} and Rotmans, {Joris I.} and Hoorn, {Ewout J.} and Liffert Vogt and Gerjan Navis and Bakker, {Stephan JL} and {de Borst}, {Martin H.} and Laverman, {Gozewijn D.}",
note = "Funding Information: Author disclosures: GN reports an unpaid fiduciary role from the Health Council of The Netherlands and unpaid advisor to ZorgOnderzoek Nederland-Medische Wetenschappen (ZON-MW) governmental funding body for medical research. MHdB reports consulting fees from AstraZeneca and Vifor Pharma, outside the submitted work. GDL reports grants from Sanofi, grants from Novo Nordisk, personal fees from Lilly, grants and personal fees from AstraZeneca, grants and personal fees from Vifor Pharma, and grants and personal fees from Abbott, outside the submitted work. The other authors report no conflicts of interest. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This project is supported by the Dutch Kidney Foundation (K+onsortium) and a research grant from the Ziekenhuisgroep Twente Hospital. Funding Information: The authors{\textquoteright} responsibilities were as follows—SMHY, MMO, MP, GDL, MHdB, and SJLB: designed the research; SMHY, MMO, and MP: conducted the research; GDL, MHdB, and SJLB: provided essential materials; SMHY, MMO, and MP: analyzed data or performed statistical analysis; SMHY, MMO, MP, SJLB, MHdB, and GDL: wrote the manuscript; SMHY, MMO, MP, MHdB, and GDL: had primary responsibility for final content; SMHY, MMO, MP, CMG, JIR, EJH, LV, GN, SJLB, MHdB, and GDL: reviewed and edited the manuscript; and all authors: read and approved the final manuscript. The clinical trial data can be requested by any qualified researcher who engages in rigorous, independent scientific research, and will be provided following review and approval of a research proposal and statistical analysis plan and execution of a data-sharing agreement by the corresponding author. Data requests can be submitted by e-mail from 12 mo after publication of this report and data will be made accessible for 12 mo, with possible extensions considered. This project is supported by the Dutch Kidney Foundation (K+onsortium) and a research grant from the Ziekenhuisgroep Twente Hospital. Author disclosures: GN reports an unpaid fiduciary role from the Health Council of The Netherlands and unpaid advisor to ZorgOnderzoek Nederland-Medische Wetenschappen (ZON-MW) governmental funding body for medical research. MHdB reports consulting fees from AstraZeneca and Vifor Pharma, outside the submitted work. GDL reports grants from Sanofi, grants from Novo Nordisk, personal fees from Lilly, grants and personal fees from AstraZeneca, grants and personal fees from Vifor Pharma, and grants and personal fees from Abbott, outside the submitted work. The other authors report no conflicts of interest. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Supplemental Figures 1–3 and Supplemental Tables 1–7 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. SMHY and MMO are joint first authors. Publisher Copyright: {\textcopyright} 2022 American Society for Nutrition.",
year = "2022",
month = dec,
doi = "10.1093/jn/nxac215",
language = "English",
volume = "152",
pages = "2856--2864",
journal = "The Journal of Nutrition",
issn = "0022-3166",
publisher = "Oxford University Press",
number = "12",
}