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钾状态与 2 型糖尿病、心血管疾病和死亡率的关系:前瞻性观察研究的荟萃分析。

Potassium status and the risk of type 2 diabetes, cardiovascular diseases, and mortality: a meta-analysis of prospective observational studies.

机构信息

School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.

The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, China.

出版信息

Crit Rev Food Sci Nutr. 2024;64(33):13212-13224. doi: 10.1080/10408398.2023.2262584. Epub 2023 Oct 3.

Abstract

Epidemiological evidence on the association between potassium and cardiometabolic outcomes remains controversial. This study aimed to examine associations of dietary intake and blood and urinary levels of potassium with risk of type 2 diabetes, cardiovascular disease (CVD), and mortality. Relevant prospective studies were retrieved through a comprehensive search of four electronic databases up to July 1, 2023. Random-effects models were used to pool the study-specific relative risks (RRs) and 95% confidence intervals (CIs). Fifty-six studies were included in this meta-analysis. A higher intake of potassium was significantly associated with a 16% lower risk of CVD (RR: 0.84, 95% CI: 0.78-0.90). Similar inverse associations were also observed between potassium intake and mortality. Each 1.0 g/d increment in potassium intake was associated with a decreased risk of CVD (RR: 0.85, 95% CI: 0.80-0.91) and all-cause mortality (RR: 0.93, 95% CI: 0.88-0.99). For blood and urinary potassium levels, higher level of blood potassium increased the risk of all-cause mortality by 23% (RR: 1.23, 95% CI: 1.11-1.36). The association of blood potassium levels with mortality was nonlinear (<0.001). However, urinary potassium levels were inversely associated with the risk of all-cause mortality (RR: 0.84, 95% CI: 0.76-0.93). Our findings support the benefits of moderate potassium consumption for primary prevention of chronic diseases and premature death.

摘要

关于钾与心脏代谢结局之间关联的流行病学证据仍然存在争议。本研究旨在探讨饮食摄入以及血液和尿液中钾水平与 2 型糖尿病、心血管疾病 (CVD) 和死亡风险之间的关系。通过对截至 2023 年 7 月 1 日的四个电子数据库进行全面检索,获取了相关的前瞻性研究。使用随机效应模型汇总了研究特定的相对风险 (RR) 和 95%置信区间 (CI)。本荟萃分析共纳入 56 项研究。钾摄入量较高与 CVD 风险降低 16%显著相关 (RR:0.84,95%CI:0.78-0.90)。钾摄入量与死亡率之间也观察到类似的负相关关系。钾摄入量每增加 1.0 g/d,CVD 风险降低 (RR:0.85,95%CI:0.80-0.91) 和全因死亡率降低 (RR:0.93,95%CI:0.88-0.99)。对于血液和尿液中的钾水平,较高的血钾水平使全因死亡率增加 23% (RR:1.23,95%CI:1.11-1.36)。血钾水平与死亡率之间的关系是非线性的 (<0.001)。然而,尿液中的钾水平与全因死亡率呈负相关 (RR:0.84,95%CI:0.76-0.93)。我们的研究结果支持适度摄入钾对慢性病和过早死亡的一级预防有益。

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