Urinary Potassium Excretion and Mortality Risk in Community-Dwelling Individuals with and without obesity release_syumdsbuojgsbbknk7mnducp3q

by Stanley Yeung, Anne Nooteboom, Ewout Hoorn, Joris Rotmans, Liffert Vogt, Rudolf de Boer, Ron Gansevoort, gerjan navis, Stephan Bakker, Martin De Borst

Published in American Journal of Clinical Nutrition by Oxford University Press (OUP).

2022   Volume 116, Issue 3, p741-749

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> Potassium intake has been shown to be inversely associated with blood pressure and premature mortality. Previous studies suggested that the association between potassium intake and blood pressure is modified by obesity, but whether obesity similarly influences the association between potassium intake and mortality is unclear. </jats:sec> <jats:sec> <jats:title>Objectives</jats:title> To investigate whether potassium intake, reflected by 24-hour urinary excretion, is associated with all-cause mortality, and to explore potential effect modification by obesity. </jats:sec> <jats:sec> <jats:title>Methods</jats:title> We performed a prospective cohort study in community-dwelling individuals. The association between urinary potassium excretion and all-cause mortality was investigated by multivariable Cox regression. We performed multiplicative interaction analysis and subgroup analyses according to BMI and waist circumference. </jats:sec> <jats:sec> <jats:title>Results</jats:title> In 8,533 individuals (50% male) mean age was 50 ± 13 years, mean urinary potassium excretion was 71±21 mmol/24 hrs, median BMI was 25.6 (IQR 23.1–28.4) kg/m2 and mean waist circumference was 89±13 cm. During follow-up of 18.4 [IQR 13.5–18.8] years, 1,663 participants died. Low urinary potassium excretion (1st vs. 3rd sex-specific quintile) was associated with an increased mortality risk (fully adjusted HR 1.38 [95% CI 1.18, 1.61], P &amp;lt; 0.001, irrespective of body dimensions (Range of HR for all body dimensions 1.36 to 1.70, all P &amp;lt; 0.05). High urinary potassium excretion (5th vs. 3rd quintile) was associated with increased mortality risk in participants with obesity (BMI ≥30 kg/m2; HR 1.52 [1.00, 2.30]), but not in participants without obesity (BMI &amp;lt;25 kg/m2; HR 0.89 [0.62, 1.26]) (P-interaction = 0.001). </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> Low potassium intake was associated with increased mortality risk in community-dwelling individuals. In individuals with obesity, high potassium intake was also associated with increased mortality risk. </jats:sec>
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