Abstract
ObjectiveTo clarify the relationship between serum, dietary, and urinary potassium and the risk of type 2 diabetes mellitus (T2DM).Materials and MethodsWe searched PubMed and EMBASE through January 6, 2017 for studies reporting risk estimates on the association of potassium measurements and the risk of T2DM. The summary risk estimates were obtained through a random-effects model. Dose-response analysis was conducted.ResultsEight studies involving 5,053 cases and 119,993 individuals were included. A trend toward significance was found in the highest versus lowest meta-analysis on serum potassium and T2DM risk (RR = 0.79; 95% CI 0.60–1.04); moreover, the RR per 1 mmol/L increase in serum potassium was 0.83 (95% CI 0.73–0.95). A non-significant association of dietary potassium and T2DM risk was detected (RR for the highest versus lowest category: 0.93; 95% CI 0.81–1.06; RR for every 1000mg increase per day: 1.00, 95% CI 0.96–1.05). A similar non-significant association was found for urinary potassium and T2DM risk (RR for the highest versus lowest category: 0.83; 95% CI 0.39–1.75; RR per 10 mmol increase: 1.00; 95% CI 0.95–1.05). Evidence of a linear association between serum, dietary, and urinary potassium and the risk of T2DM was found (all Pnon-linearity > 0.05).ConclusionsLow serum potassium increases the risk of T2DM in a linear dose-response manner; nevertheless, neither dietary potassium nor urinary potassium shows any association with the risk of T2DM. However, these findings should be interpreted with caution due to limited studies.
Highlights
According to the pooled data of the International Diabetes Federation from 219 countries and territories, diagnosed diabetes reached 381.8 million cases in 2013 and is projected to reach 591.9 million by 2035 [1]
A trend toward significance was found in the highest versus lowest metaanalysis on serum potassium and type 2 diabetes mellitus (T2DM) risk (RR = 0.79; 95% confidence intervals (CIs) 0.60–1.04); the RR per 1 mmol/L increase in serum potassium was 0.83
A similar non-significant association was found for urinary potassium and T2DM risk (RR for the highest versus lowest category: 0.83; 95% CI 0.39–1.75; RR per 10 mmol increase: 1.00; 95% CI 0.95–1.05)
Summary
According to the pooled data of the International Diabetes Federation from 219 countries and territories, diagnosed diabetes reached 381.8 million cases in 2013 and is projected to reach 591.9 million by 2035 [1]. Some large scale epidemiological studies have explored the association between serum, dietary, and urinary potassium and the risk of T2DM [9,10,11,12,13,14]. Several studies have suggested that higher serum potassium levels are related to a lower risk of T2DM [10, 13,14,15]. Several studies regarding dietary and urinary potassium showed that low potassium intake was related to an increased risk of T2DM [12, 16], while other studies found non-significant results [10, 11, 14, 17]. The nature of the dose-response association between potassium measurements and T2DM risk remains unknown
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