Yeung Stanley M H, Oosterwijk Milou M, Poelstra Monique, Gant Christina M, Rotmans Joris I, Hoorn Ewout J, Vogt Liffert, Navis Gerjan, Bakker Stephan J L, de Borst Martin H, Laverman Gozewijn D
Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente Hospital, Almelo and Hengelo, The Netherlands.
J Nutr. 2023 Jan 14;152(12):2856-2864. doi: 10.1093/jn/nxac215.
Low 24-h urinary potassium excretion, reflecting low potassium intake, is associated with premature mortality in the general population.
To determine whether urinary potassium excretion is associated with all-cause mortality in patients with type 2 diabetes.
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.
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).
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.
24小时尿钾排泄量低反映钾摄入量低，与普通人群的过早死亡有关。
确定尿钾排泄量与2型糖尿病患者的全因死亡率是否相关。
我们在特温特糖尿病与生活方式队列（DIALECT）中的654例2型糖尿病患者中进行了一项前瞻性队列研究。在多变量Cox回归模型中，分析了按性别划分的24小时尿钾排泄三分位数与全因死亡率之间的关系。医院的门诊项目使用市政死亡登记处的连续监测系统，以确保掌握患者状态（存活或死亡）的最新信息。使用食物频率问卷（FFQ）研究尿钾排泄量与食品之间的关联。
男性基线时的尿钾排泄量为84±25 mmol/d，女性为65±22 mmol/d，对应的估计钾摄入量分别为4250±1270 mg/d和3300±875 mg/d。在中位随访5.2（四分位间距：2.7 - 7.9）年期间，96名参与者死亡。在完全调整模型中，与处于按性别划分的最高三分位数的患者相比，处于按性别划分的最低三分位数的患者全因死亡风险更高（风险比：2.09；95%置信区间：1.06，4.10；P = 0.03）。与处于按性别划分的最高三分位数的患者相比，处于按性别划分的最低三分位数的患者食用的水果、蔬菜、乳制品、咖啡和土豆制品较少（所有P < 0.05）。
低钾摄入量与荷兰2型糖尿病患者的全因死亡风险较高相关。需要进行干预研究以确定补钾是否能提高2型糖尿病患者的寿命。该试验已在荷兰试验注册库注册，试验代码为NTR 5855。
