Abstract P140: Serum Chloride Predicts Mortality Risk in Type 2 Diabetes - Analysis of 91,159 Patients From the West of Scotland

Abstract

Objective: Low serum chloride (Cl - ) is associated with increased risk of death in those with heart failure, hypertension or chronic kidney disease. We sought to investigate the association of serum Cl - with risk of cause-specific death in adults with type 2 diabetes mellitus (T2DM). Methods: Data was available for 91,159 adults from the West of Scotland with T2DM from NHS Greater Glasgow and Clyde Safe Haven with 10 years follow up. Two groups were created: serum Cl - <100 and Cl - ≥100 mmol/L. Cox-PH models, adjusted for age, sex and serum sodium (Na + ), were used to assess the association between serum Cl - and risk of death (all-cause mortality, vascular death, death from myocardial infarction (MI), death from heart failure, death from stroke, death from cancer). Results: There were 13,459 patients with serum Cl - <100 mmol/L; 53% were male with median age 62.5 (IQR 50.9-73.1) years and median Na+ 136 (133-138) mmol/L. There were 77,757 patients with serum Cl - ≥100 mmol/L; 53% were male with median age 61.2 (IQR 50.2-71.4) years and median Na + 139 (IQR 138-141) mmol/L. Serum Cl - <100 mmol/L was associated with an 44% increased risk of all-cause mortality (N=20,304, HR 1.44[95% CI 1.38-1.49]; p <0.0001), independent of serum Na + (Figure). The increased mortality risk of serum Cl - <100 mmol/L was observed for cardiovascular mortality (N=6,323, 1.41[1.31-1.51]; p <0.0001); death from MI (N=1,986, 1.42[1.25-1.60]; p <0.0001); stroke (N=1,590, 1.24[1.08-1.42]; p 0.003); heart failure (N=200, 1.38[0.95-2.0]; p 0.09) and cancer (N=5,577, 1.12[1.04-1.21]; p 0.003). Conclusions: Serum chloride <100 mmol/L was associated with increased risk of death in adults with type 2 diabetes mellitus.