Low serum potassium levels and risk of type 2 diabetes: the Toranomon Hospital Health Management Center Study 1 (TOPICS 1)
Low serum potassium levels and risk of type 2 diabetes: the Toranomon Hospital Health Management Center Study 1 (TOPICS 1)
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DOI：
10.1007/s00125-010-2029-9
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发表时间：
2011-04-01
期刊：
影响因子：
8.2
通讯作者：
Sone, H.
中科院分区：
文献类型：
--
作者：
Heianza, Y.;Hara, S.;Sone, H.
有证据表明，低血清钾浓度会减少胰岛素分泌，导致葡萄糖不耐受，而利尿剂引起的低钾血症会增加高血压患者患糖尿病的风险。然而，尚无前瞻性研究在由未服用抗高血压药物的亚洲个体组成的健康队列中调查血清钾与 2 型糖尿病发展之间的关联。本研究旨在调查低血清钾是否与表面健康的日本男性患 2 型糖尿病的风险增加相关。我们对 4,409 名没有糖尿病史、没有使用抗高血压药物、肾功能不全或肝功能不全的日本男性进行了随访（平均 +/- SD 年龄，48.4 +/- 8.4 岁）。 Cox比例风险回归用于估计糖尿病发病的HR（空腹血糖水平千分之一7.0 mmol/l，HbA(1c)千分之一欧元千分之6.5%或自我报告），包括血清钾浓度作为分类变量或连续变量。在5年的随访期间，250人患上了2型糖尿病。与最高三分位数（4.2-5.4 mmol/l）相比，在调整已知预测因子后（HR 1.57 [95% CI，1.15-2.15]），血清钾的最低三分位数（2.8-3.9 mmol/l）与糖尿病的发展独立相关。基线血清钾水平每降低 0.5 mmol/l，患糖尿病的风险就会增加 45% (12-87%)。 对于表面健康的日本男性，轻度至中度低血清钾水平，在正常范围内且没有明显的低钾血症，可以预测 2 型糖尿病。
Evidence has suggested that low serum potassium concentrations decrease insulin secretion, leading to glucose intolerance, and that hypokalaemia induced by diuretics increases the risk for diabetes in hypertensive individuals. However, no prospective study has investigated the association between serum potassium and the development of type 2 diabetes in a healthy cohort comprised of Asian individuals not being administered antihypertensive medications. This study aimed to investigate whether low serum potassium is associated with increased risk of type 2 diabetes in apparently healthy Japanese men.We followed 4,409 Japanese men with no history of diabetes, use of antihypertensives, renal dysfunction or liver dysfunction (mean +/- SD age, 48.4 +/- 8.4 years). Cox proportional hazards regression was used to estimate HRs for incident diabetes (fasting plasma glucose level a parts per thousand yen7.0 mmol/l, HbA(1c) a parts per thousand yenaEuro parts per thousand 6.5% or self-reported) including serum potassium concentration as either a categorical or a continuous variable.During a 5 year follow-up, 250 individuals developed type 2 diabetes. The lowest tertile of serum potassium (2.8-3.9 mmol/l) was independently associated with the development of diabetes after adjustment for known predictors (HR 1.57 [95% CI, 1.15-2.15]) compared with the highest tertile (4.2-5.4 mmol/l). Every 0.5 mmol/l lower increment in the baseline serum potassium level was associated with a 45% (12-87%) increased risk of diabetes.Mild to moderately low serum potassium levels, within the normal range and without frank hypokalaemia, could be predictive of type 2 diabetes in apparently healthy Japanese men.