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Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study.

TitleSerum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2010
AuthorsChatterjee R, Yeh H-C, Shafi T, Selvin E, Anderson C, Pankow JS, Miller E, Brancati F
JournalArch Intern Med
Volume170
Issue19
Pagination1745-51
Date Published2010 Oct 25
ISSN1538-3679
KeywordsAged, Atherosclerosis, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Incidence, Insulin, Male, Middle Aged, Potassium, Potassium, Dietary, Prospective Studies, Risk Factors, Surveys and Questionnaires, Time Factors, United States
Abstract

BACKGROUND: Serum potassium levels affect insulin secretion by pancreatic ╬▓-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.

DOI10.1001/archinternmed.2010.362
Alternate JournalArch Intern Med
PubMed ID20975023
PubMed Central IDPMC3469719
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
T32-HL007180 / HL / NHLBI NIH HHS / United States
K23 DK083514 / DK / NIDDK NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
P30 DK079637 / DK / NIDDK NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
T32 HL007180 / HL / NHLBI NIH HHS / United States
5R01-DK56918-03 / DK / NIDDK NIH HHS / United States
K01 DK076595 / DK / NIDDK NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
P60 DK079637 / DK / NIDDK NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
K24 DK62222 / DK / NIDDK NIH HHS / United States
R21 DK080294 / DK / NIDDK NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
R01 DK056918 / DK / NIDDK NIH HHS / United States
K24 DK062222 / DK / NIDDK NIH HHS / United States