An association of urinary sodium-potassium ratio with insulin resistance among Korean adults

Park, Yeong Mi; Kwock, Chang Keun; Park, Sung Yong; Eicher‐Miller, Heather A.; Yang, Yoon Jung

doi:10.4162/nrp.2018.12.5.443

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…In rats, a high-salt diet may promote insulin resistance [47]. In humans, insulin resistance was independently and positively associated with a higher sodium intake [48,49]. The results of our cross-sectional study are in agreement with the hypothesis that a higher sodium intake, possibly via an effect on insulin resistance, promotes the development of NAFLD.…”

Section: Discussionsupporting

confidence: 89%

Higher Sodium Intake Assessed by 24 Hour Urinary Sodium Excretion Is Associated with Non-Alcoholic Fatty Liver Disease: The PREVEND Cohort Study

Berg

Gruppen

Blokzijl

et al. 2019

JCM

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A higher sodium intake is conceivably associated with insulin resistant conditions like obesity, but associations of non-alcoholic fatty liver disease (NAFLD) with a higher sodium intake determined by 24 hours (24 h) urine collections are still unclear. Dietary sodium intake was measured by sodium excretion in two complete consecutive 24 h urine collections in 6132 participants of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort. Fatty Liver Index (FLI) ≥60 and Hepatic Steatosis Index (HSI) >36 were used as proxies of suspected NAFLD. 1936 (31.6%) participants had an FLI ≥60, coinciding with the increased prevalence of type 2 diabetes (T2D), metabolic syndrome, hypertension and history of cardiovascular disease. Sodium intake was higher in participants with an FLI ≥60 (163.63 ± 61.81 mmol/24 h vs. 136.76 ± 50.90 mmol/24 h, p < 0.001), with increasing incidence in ascending quartile categories of sodium intake (p < 0.001). Multivariably, an FLI ≥60 was positively associated with a higher sodium intake when taking account for T2D, a positive cardiovascular history, hypertension, alcohol intake, smoking and medication use (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.44–1.64, p < 0.001). Additional adjustment for the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) diminished this association (OR 1.30, 95% CI 1.21–1.41, p < 0.001). HSI >36 showed similar results. Associations remained essentially unaltered after adjustment for body surface area or waist/hip ratio. In conclusion, suspected NAFLD is a feature of higher sodium intake. Insulin resistance-related processes may contribute to the association of NAFLD with sodium intake.

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Section: Discussionsupporting

confidence: 89%

Higher Sodium Intake Assessed by 24 Hour Urinary Sodium Excretion Is Associated with Non-Alcoholic Fatty Liver Disease: The PREVEND Cohort Study

Berg

Gruppen

Blokzijl

et al. 2019

JCM

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“…A cohort study of the general Chinese population reported that a higher dietary Na:K ratio was associated with a higher risk of diabetes (11) , which is consistent with the results of our study. The study involving Korean population suggested that a high Na:K ratio is related to high insulin resistance and low insulin sensitivity (39) . A previous study has reported that the association between urinary Na:K ratio and DBP was stronger in a group with a higher homoeostasis model assessment of insulin resistance than with a lower homoeostasis model assessment of insulin resistance (40) .…”

Section: Discussionmentioning

confidence: 99%

Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003–2017

Okada

Matsumoto

et al. 2020

Br J Nutr

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Few studies have reported association between sodium-to-potassium (Na-K) ratio and risk factors related to cardiovascular diseases (CVDs) among the general population in Asian countries. This study aimed to investigate the dietary sodium-to-potassium (Na-K) ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48,800 Japanese participants (19,386 men and 29,414 women) aged ≥20 years, registered in the 2003–2017 National Health and Nutrition Survey. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of hypertension, high glycated haemoglobin A1c (HbA1c) levels, hypercholesterolaemia, low serum levels of high-density lipoprotein (HDL) cholesterol, and high non-HDL cholesterol levels according to Na-K ratio, were estimated using logistic regression models. Dietary Na-K ratio decreased for both men and women from 2003 to 2017. Higher Na-K ratio and higher hypertension prevalence was observed (multivariate OR [fifth vs. first quintiles] = 1.27, 95% CI: 1.15, 1.40; P for trend <0.001 for men and 1.12, 95% CI: 1.01, 1.23; P for trend = 0.007 for women). Higher Na-K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR = 1.56, 95% CI: 1.24, 1.96). Prevalence of low HDL cholesterol levels was increased with higher Na-K ratio (P for trend = 0.002 for men and <0.001 for women). No significant associations were found between Na-K ratio and hypercholesterolaemia in men or high non-HDL cholesterol levels in both men and women. Our findings suggest that dietary Na-K ratio is associated with several CVD risk factors among Japanese adults.

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“…Higher potassium intake was associated with enhanced bone mineral density, probably by neutralizing acid load and consequently reducing calcium loss from the bone [20,22,23]. Lower potassium intake was associated with lower insulin sensitivity [21,24].…”

Section: Introductionmentioning

confidence: 93%

“…As a result, the World Health Organization recommends an increase in potassium intake from food for reducing blood pressure and the risks of cardiovascular disease and stroke in adults [19]. Dietary potassium intake may also have a beneficial effect on bone health and insulin sensitivity [20,21]. Higher potassium intake was associated with enhanced bone mineral density, probably by neutralizing acid load and consequently reducing calcium loss from the bone [20,22,23].…”

Section: Introductionmentioning

confidence: 99%

Potassium intake, skeletal muscle mass, and effect modification by sex: data from the 2008–2011 KNHANES

Lee

et al. 2020

Nutr J

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Background: A loss of muscle mass may be influenced by multiple factors. Insulin sensitivity and metabolic acidosis are associated with muscle wasting and may be improved with potassium intake. This study evaluated the association between dietary potassium intake and skeletal muscle mass. Methods: We performed a cross-sectional study with data obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2011). Participant's daily food intake was assessed using a 24-h recall method. Appendicular skeletal muscle mass (ASM) was calculated as the sum of muscle mass in both arms and legs, measured using dual energy X-ray absorptiometry. The skeletal muscle index (SMI) was calculated as ASM divided by height 2 (kg/m 2). Low muscle mass was defined as a SMI < 7.0 kg/m 2 for men and < 5.4 kg/m 2 for women. Results: Data from 16,558 participants (age ≥ 19 years) were analyzed. Participants were categorized into quintiles according to their potassium intake. Sex-specific differences were found in the association between potassium intake and muscle mass (P Interaction < 0.001). In men, higher potassium intake was associated with lower odds for low muscle mass; the fully adjusted odds ratios (95% confidence intervals) were 0.78 (0.60-1.03), 0.71 (0.54-0.93), 0.68 (0.51-0.90), and 0.71 (0.51-0.98) for the top four quintiles (referenced against the lowest quintile), respectively. However, this association was attenuated in women after adjusting for total energy intake. Higher potassium intakes were also associated with a greater SMI. Conclusions: Higher dietary potassium intake decreased the odds of low muscle mass in men but not in women.

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An association of urinary sodium-potassium ratio with insulin resistance among Korean adults

Cited by 10 publications

References 35 publications

Higher Sodium Intake Assessed by 24 Hour Urinary Sodium Excretion Is Associated with Non-Alcoholic Fatty Liver Disease: The PREVEND Cohort Study

Higher Sodium Intake Assessed by 24 Hour Urinary Sodium Excretion Is Associated with Non-Alcoholic Fatty Liver Disease: The PREVEND Cohort Study

Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003–2017

Potassium intake, skeletal muscle mass, and effect modification by sex: data from the 2008–2011 KNHANES

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