社区居住的肥胖个体和非肥胖个体的尿钾排泄与死亡风险。

Urinary potassium excretion and mortality risk in community-dwelling individuals with and without obesity.

机构信息

Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

Am J Clin Nutr. 2022 Sep 2;116(3):741-749. doi: 10.1093/ajcn/nqac137.

DOI:10.1093/ajcn/nqac137

PMID:35580599

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9437991/

Abstract

BACKGROUND

Potassium intake has been shown to be inversely associated with blood pressure and premature mortality. Previous studies have suggested that the association between potassium intake and blood pressure is modified by obesity, but whether obesity similarly influences the association between potassium intake and mortality is unclear.

OBJECTIVES

We investigated whether potassium intake, reflected by 24-h urinary excretion, is associated with all-cause mortality, and explored potential effect modification by obesity.

METHODS

We performed a prospective cohort study in community-dwelling individuals. The association between urinary potassium excretion and all-cause mortality was investigated by using multivariable Cox regression. We performed multiplicative interaction analysis and subgroup analyses according to BMI and waist circumference.

RESULTS

In 8533 individuals (50% male), the mean age was 50 ± 13 y, mean urinary potassium excretion was 71 ± 21 mmol/24 h, median BMI (in kg/m2) was 25.6 (IQR: 23.1, 28.4) and mean waist circumference was 89 ± 13 cm. During median follow-up of 18.4 (IQR: 13.5, 18.8) y, 1663 participants died. Low urinary potassium excretion (first compared with third sex-specific quintile) was associated with an increased mortality risk (fully adjusted HR: 1.38; 95% CI: 1.18, 1.61), P < 0.001, irrespective of body dimensions (HR range for all body dimensions: 1.36-1.70, all P < 0.05). High urinary potassium excretion (fifth compared with third quintile) was associated with increased mortality risk in participants with obesity (BMI ≥30; HR: 1.52; CI: 1.00, 2.30), but not in participants without obesity (BMI: <25; HR: 0.89; 95% CI: 0.62, 1.26; P-interaction = 0.001).

CONCLUSIONS

Low potassium intake was associated with increased mortality risk in community-dwelling individuals. In individuals with obesity, high potassium intake was also associated with increased mortality risk.

摘要

背景

钾的摄入量与血压和过早死亡呈负相关。先前的研究表明，钾摄入量与血压之间的关联受肥胖的影响，但肥胖是否同样影响钾摄入量与死亡率之间的关联尚不清楚。

目的

我们研究了 24 小时尿排泄反映的钾摄入量与全因死亡率之间的关系，并探讨了肥胖的潜在效应修饰作用。

方法

我们在社区居住的个体中进行了一项前瞻性队列研究。使用多变量 Cox 回归分析尿钾排泄与全因死亡率之间的关系。我们根据 BMI 和腰围进行了乘法交互作用分析和亚组分析。

结果

在 8533 名个体（50%为男性）中，平均年龄为 50±13 岁，平均尿钾排泄量为 71±21mmol/24h，中位数 BMI（kg/m2）为 25.6（IQR：23.1，28.4），平均腰围为 89±13cm。在中位数为 18.4（IQR：13.5，18.8）年的随访期间，有 1663 名参与者死亡。低尿钾排泄（与各性别特异五分位中第三分位相比）与死亡率升高相关（完全调整的 HR：1.38；95%CI：1.18，1.61），P<0.001，与身体尺寸无关（所有身体尺寸的 HR 范围：1.36-1.70，所有 P<0.05）。高尿钾排泄（与五分位中第三分位相比）与肥胖参与者（BMI≥30）的死亡率升高相关（HR：1.52；CI：1.00，2.30），但与非肥胖参与者（BMI：<25）无关（HR：0.89；95%CI：0.62，1.26；P 交互作用=0.001）。