Abstract
PurposeLow-grade inflammation and a diet high in salt are both established risk factors for cardiovascular disease. High potassium (K+) intake was found to counter increase in blood pressure due to high salt intake and may potentially also have protective anti-inflammatory effects. To better understand these interactions under normal physiological conditions, we investigated the relationships between 22 inflammatory mediators with 24-h urinary K+ in young healthy adults stratified by low, medium and high salt intake (salt tertiles). We stratified by ethnicity due to potential salt sensitivity in black populations.MethodsIn 991 healthy black (N = 457) and white (N = 534) adults, aged 20–30 years, with complete data for 24-h urinary sodium and K+, we analysed blood samples for 22 inflammatory mediators.ResultsWe found no differences in inflammatory mediators between low-, mid- and high-sodium tertiles in either the black or white groups. In multivariable-adjusted regression analyses in white adults, we found only in the lowest salt tertile that K+ associated negatively with pro-inflammatory mediators, namely interferon gamma, interleukin (IL) -7, IL-12, IL-17A, IL-23 and tumour necrosis factor alpha (all p ≤ 0.046). In the black population, we found no independent associations between K+ and any inflammatory mediator.ConclusionIn healthy white adults, 24-h urinary K+ associated independently and negatively with specific pro-inflammatory mediators, but only in those with a daily salt intake less than 6.31 g, suggesting K+ to play a protective, anti-inflammatory role in a low-sodium environment. No similar associations were found in young healthy black adults.
Highlights
K+ Potassium Granulocyte– macrophage colony-stimulating factor (GM-CSF) Granulocyte–macrophage colony-stimulating factor IFN-γ Interferon gamma IL-1 β Interleukin 1 beta interleukin 2 (IL-2) Interleukin 2 IL-4 Interleukin 4 interleukin 5 (IL-5) Interleukin 5 interleukin 6 (IL-6) Interleukin 6 interleukin 7 (IL-7) Interleukin 7 interleukin 8 (IL-8) Interleukin 8 interleukin 10 (IL-10) Interleukin 10 interleukin 12 (IL-12) Interleukin interleukin 13 (IL-13) Interleukin interleukin 17A (IL-17A) Interleukin 17A interleukin 21 (IL-21) Interleukin 21 interleukin 23 (IL-23) Interleukin 23 ITAC Interferon-inducible T-cell alpha chemoattractant MIP-1α Macrophage inflammatory protein 1-alpha MIP-1β Macrophage inflammatory protein 1-beta
In T1, we found negative correlations between K + and interferon gamma (IFN-γ), IL-1β, IL-5, IL-6, IL-7, IL-8, IL-12, IL-17A, IL-21, IL-23, macrophage inflammatory protein 3-alpha (MIP-3α) and tumour necrosis factor alpha (TNF-α)
With partial correlations, we found in the highest N a+ tertile (T3) positive correlations between K + and both ITAC and IL-5, and negative correlations in the lowest tertile (T1) with ITAC/IL-4 and ITAC/IL-5 (Online Resource Fig. S2)
Summary
Inflammation is involved in the development of cardiovascular disease [1,2,3]. a diet high in salt (Na+) is another well-known risk factor for cardiovascular diseases, including hypertension [4]. As high K + intake has a beneficial effect on blood pressure [14], as well as cardiovascular events and mortality [13], an additional mechanism of K+ may be its anti-inflammatory properties [15] This notion is supported by a study indicating that K + supplementation inhibited interleukin (IL) -17A production in human T lymphocytes that were induced by a salt load [5]. The cardiovascular risk in black populations may be further increased based on their more pro-inflammatory profile when compared to white adults [17] To better understand these potential mechanisms involved in the development of cardiovascular disease, we performed a hypothesis-generating work by investigating whether a detailed range of 22 pro- and anti-inflammatory mediators are associated with 24-h urinary K + in young black and white adults. Variables included in backward stepwise multiple regression models were: K+, age, socio-economic status, AEE, waist circumference, total cholesterol, eGFR, cotinine, GGT, glucose and sex. Multiple regression analyses displayed the last model in which potassium remained
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