Sodium status is associated with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies

Kolahdouz‐Mohammadi, Roya; Soltani, Sepideh; Clayton, Zachary S.; Salehi‐Abargouei, Amin

doi:10.1007/s00394-021-02595-z

Cited by 17 publications

(15 citation statements)

References 83 publications

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“…Indeed, our findings are consistent with a recent meta-analysis of observational studies that showed individuals with diabetes had higher sodium status compared to individuals without diabetes [33]. The authors hypothesized that underlying mechanisms for this association might be linked with the notion that excessive salt intake (>2.3 g/d) may activate the aldose reductase-fructokinase pathway in the hypothalamus and liver [33]. This activation of the aldose reductase-fructokinase pathway may lead to increased endogenous production of fructose and enhanced leptin resistance, both of which are implicated in insulin resistance [34].…”

Section: Discussionsupporting

confidence: 92%

“…These dietary factors mainly include low nutritional quality, which more specifically consists of higher intakes of sodium, energy, fat, sugar, lower amounts of fiber, protein, essential vitamins and minerals. Indeed, our findings are consistent with a recent meta-analysis of observational studies that showed individuals with diabetes had higher sodium status compared to individuals without diabetes [33]. The authors hypothesized that underlying mechanisms for this association might be linked with the notion that excessive salt intake (>2.3 g/d) may activate the aldose reductase-fructokinase pathway in the hypothalamus and liver [33].…”

Section: Discussionsupporting

confidence: 91%

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Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

et al. 2021

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(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I2 = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I2 = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (pnonlinearity = 0.13, pdose-response < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

et al. 2021

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“…In one study, dietary sodium restriction resulted in a decreased insulin sensitivity in participants with type 2 diabetes,42 whereas in another study including non-diabetic participants, sodium restriction did not affect insulin sensitivity but impaired insulin secretion 43. However, higher sodium excretion was associated with a higher risk of type 2 diabetes in a meta-analysis of observational studies 44. Therefore, RAAS-dependent and independent effects of dietary sodium on glucose metabolism cannot be excluded.…”

Section: Discussionmentioning

confidence: 99%

“… 43 However, higher sodium excretion was associated with a higher risk of type 2 diabetes in a meta-analysis of observational studies. 44 Therefore, RAAS-dependent and independent effects of dietary sodium on glucose metabolism cannot be excluded.…”

Section: Discussionmentioning

confidence: 99%

Association of renin and aldosterone with glucose metabolism in a Western European population: the KORA F4/FF4 study

Then

Ritzel

Herder

et al. 2022

BMJ Open Diab Res Care

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IntroductionPrimary aldosteronism is associated with impaired glucose tolerance. Whether plasma aldosterone and/or renin concentrations are associated with type 2 diabetes and continuous measures of glucose metabolism in the general population is still under debate.Research design and methodsThe analyses included 2931 participants of the KORA F4 study at baseline and 2010 participants of the KORA FF4 study after a median follow-up of 6.5 years. The associations of active plasma renin and aldosterone concentrations with type 2 diabetes and continuous measures of glucose metabolism were assessed using logistic and linear regression models. Results were adjusted for sex, age, body mass index (BMI), estimated glomerular filtration rate, potassium, use of ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics and calcium channel blockers.ResultsCross-sectionally, renin was associated with type 2 diabetes (OR per SD: 1.25, 95% CI 1.10 to 1.43, p<0.001), fasting glucose, 2-hour glucose, insulin, proinsulin, HOMA-B (homeostasis model assessment of beta cell function) and HOMA-IR (homeostasis model assessment of insulin resistance) (all p values <0.001). Aldosterone was not associated with type 2 diabetes (OR: 1.04, 95% CI 0.91 to 1.19; p=0.547) but with insulin, proinsulin and HOMA-IR (all p values <0.001). The aldosterone–renin ratio was inversely associated with type 2 diabetes and several measures of glucose metabolism. Longitudinally, neither renin (OR: 1.12, 95% CI 0.92 to 1.36) nor aldosterone (OR: 0.91, 95% CI 0.74 to 1.11) were associated with incident type 2 diabetes. Renin was inversely associated with changes of insulin concentrations.ConclusionsIn the KORA F4/FF4 study, renin and aldosterone were not associated with incident type 2 diabetes and largely unrelated to changes of measures of glucose metabolism. Cross-sectionally, aldosterone was associated with surrogate parameters of insulin resistance. However, these associations were not independent of renin.

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“…Regarding sodium intake, patients with T2DM had substantially higher levels of sodium intake compared to non-diabetic controls. Furthermore, increased urinary sodium excretion was associated with a higher risk of developing T2DM [ 44 ]. A prospective study in Finland reported that the relationship between sodium intake and risk of T2DM based on 24-h urinary sodium excretion data showed that high levels of sodium intake, measured in the highest quartile of 24-h sodium excretion, significantly increased the risk of T2DM [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Dietary Habits and Type 2 Diabetes Mellitus in Yangon, Myanmar: A Case–Control Study

Ueno

Aung

Yuasa

et al. 2021

IJERPH

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In Myanmar, the escalating prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance among adults was recently reported, with the highest prevalence in the Yangon Region. The aim of the present study was to identify the risk factors in dietary habits and their relationship with T2DM in urban Myanmar residents. We conducted a case–control study recruiting 300 individuals aged 25–74 years living in the Yangon Region, consisting of 150 newly diagnosed cases attending a diabetes clinic, and 150 controls, who were community residents and free of diabetes. The case group had a significantly higher consumption of noodles, fish, beans, fermented food and pickles, dried food, topping seasonings, and non-dairy milk products than the control group, whereas they had a lower vegetable intake (more than three servings/day) and fruit intake (more than three servings/day) than the control group. Furthermore, the case group exhibited a higher frequency of some dietary behaviors than the control group, such as (1) having meals with family, (2) skipping breakfast, and (3) eating out. The final model showed that topping seasonings (adjusted odds ratio (aOR) 11.23, 95% confidence interval (CI) 3.08–40.90), more than three servings/day of vegetable intake (aOR 0.18, 95% CI 0.05–0.67), and having meals with family (aOR 2.23, 95% CI 1.05–4.71) were associated with diabetes. The study suggests that Myanmar’s characteristic dietary culture of topping their meals with salty seasonings and sauces and eating multiple dishes together as a family are risk factors associated with T2DM. Our findings may contribute recommendations and opportunities for the primary prevention of T2DM in urban Myanmar.

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Sodium status is associated with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies

Cited by 17 publications

References 83 publications

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

Association of renin and aldosterone with glucose metabolism in a Western European population: the KORA F4/FF4 study

Association between Dietary Habits and Type 2 Diabetes Mellitus in Yangon, Myanmar: A Case–Control Study

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