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Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study.
Arch Intern Med 2010; 170(19):1745-51AI

Abstract

BACKGROUND

Serum potassium levels affect insulin secretion by pancreatic β-cells, and hypokalemia associated with diuretic use has been associated with dysglycemia. We hypothesized that adults with lower serum potassium levels and lower dietary potassium intake are at higher risk for incident diabetes mellitus (DM), independent of diuretic use.

METHODS

We analyzed data from 12 209 participants from the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing prospective cohort study, beginning in 1986, with 9 years of in-person follow-up and 17 years of telephone follow-up. Using multivariate Cox proportional hazard models, we estimated the hazard ratio (HR) of incident DM associated with baseline serum potassium levels.

RESULTS

During 9 years of in-person follow-up, 1475 participants developed incident DM. In multivariate analyses, we found an inverse association between serum potassium and risk of incident DM. Compared with those with a high-normal serum potassium level (5.0-5.5 mEq/L), adults with serum potassium levels lower than 4.0 mEq/L, 4.0 to lower than 4.5 mEq/L, and 4.5 to lower than 5.0 mEq/L had an adjusted HR (95% confidence interval [CI]) of incident DM of 1.64 (95% CI, 1.29-2.08), 1.64 (95% CI, 1.34-2.01), and 1.39 (95% CI, 1.14-1.71), respectively. An increased risk persisted during an additional 8 years of telephone follow-up based on self-report with HRs of 1.2 to 1.3 for those with a serum potassium level lower than 5.0 mEq/L. Dietary potassium intake was significantly associated with risk of incident DM in unadjusted models but not in multivariate models.

CONCLUSIONS

Serum potassium level is an independent predictor of incident DM in this cohort. Further study is needed to determine if modification of serum potassium could reduce the subsequent risk of DM.

Authors+Show Affiliations

Departments of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20975023

Citation

Chatterjee, Ranee, et al. "Serum and Dietary Potassium and Risk of Incident Type 2 Diabetes Mellitus: the Atherosclerosis Risk in Communities (ARIC) Study." Archives of Internal Medicine, vol. 170, no. 19, 2010, pp. 1745-51.
Chatterjee R, Yeh HC, Shafi T, et al. Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study. Arch Intern Med. 2010;170(19):1745-51.
Chatterjee, R., Yeh, H. C., Shafi, T., Selvin, E., Anderson, C., Pankow, J. S., ... Brancati, F. (2010). Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study. Archives of Internal Medicine, 170(19), pp. 1745-51. doi:10.1001/archinternmed.2010.362.
Chatterjee R, et al. Serum and Dietary Potassium and Risk of Incident Type 2 Diabetes Mellitus: the Atherosclerosis Risk in Communities (ARIC) Study. Arch Intern Med. 2010 Oct 25;170(19):1745-51. PubMed PMID: 20975023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study. AU - Chatterjee,Ranee, AU - Yeh,Hsin-Chieh, AU - Shafi,Tariq, AU - Selvin,Elizabeth, AU - Anderson,Cheryl, AU - Pankow,James S, AU - Miller,Edgar, AU - Brancati,Frederick, PY - 2010/10/27/entrez PY - 2010/10/27/pubmed PY - 2010/11/10/medline SP - 1745 EP - 51 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 170 IS - 19 N2 - BACKGROUND: Serum potassium levels affect insulin secretion by pancreatic β-cells, and hypokalemia associated with diuretic use has been associated with dysglycemia. We hypothesized that adults with lower serum potassium levels and lower dietary potassium intake are at higher risk for incident diabetes mellitus (DM), independent of diuretic use. METHODS: We analyzed data from 12 209 participants from the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing prospective cohort study, beginning in 1986, with 9 years of in-person follow-up and 17 years of telephone follow-up. Using multivariate Cox proportional hazard models, we estimated the hazard ratio (HR) of incident DM associated with baseline serum potassium levels. RESULTS: During 9 years of in-person follow-up, 1475 participants developed incident DM. In multivariate analyses, we found an inverse association between serum potassium and risk of incident DM. Compared with those with a high-normal serum potassium level (5.0-5.5 mEq/L), adults with serum potassium levels lower than 4.0 mEq/L, 4.0 to lower than 4.5 mEq/L, and 4.5 to lower than 5.0 mEq/L had an adjusted HR (95% confidence interval [CI]) of incident DM of 1.64 (95% CI, 1.29-2.08), 1.64 (95% CI, 1.34-2.01), and 1.39 (95% CI, 1.14-1.71), respectively. An increased risk persisted during an additional 8 years of telephone follow-up based on self-report with HRs of 1.2 to 1.3 for those with a serum potassium level lower than 5.0 mEq/L. Dietary potassium intake was significantly associated with risk of incident DM in unadjusted models but not in multivariate models. CONCLUSIONS: Serum potassium level is an independent predictor of incident DM in this cohort. Further study is needed to determine if modification of serum potassium could reduce the subsequent risk of DM. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/20975023/Serum_and_dietary_potassium_and_risk_of_incident_type_2_diabetes_mellitus:_The_Atherosclerosis_Risk_in_Communities__ARIC__study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinternmed.2010.362 DB - PRIME DP - Unbound Medicine ER -