An association of urinary sodium-potassium ratio with insulin resistance among Korean adults
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
BACKGROUND/OBJECTIVES: This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS: Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40-69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS: HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION: The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.
Abstract
BACKGROUND/OBJECTIVES: This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS: Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40-69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS: HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION: The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.
참고문헌 (36)
- Annual Report on the Causes of Death Statistics, "Statistics Korea", Statistics Korea, ~ (2016)
- Ginsberg HN, "Insulin resistance and cardiovascular disease", J Clin Invest, 106, pp.453~458 (2000)[DOI]
- Reaven GM, "Insulin resistance, the insulin resistance syndrome, and cardiovascular disease", Panminerva Med, 47, pp.201~210 (2005)
- Paneni F, "Insulin resistance, diabetes, and cardiovascular risk", Curr Atheroscler Rep, 16, pp.419~ (2014)[DOI]
- Patel TP, "Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes", Heart Fail Rev, 21, pp.11~23 (2016)[DOI]
- Ames RP, "The effect of sodium supplementation on glucose tolerance and insulin concentrations in patients with hypertension and diabetes mellitus", Am J Hypertens, 14, pp.653~659 (2001)[DOI]
- Kuroda S, "Role of insulin resistance in the genesis of sodium sensitivity in essential hypertension", J Hum Hypertens, 13, pp.257~262 (1999)[DOI]
- Dziwura J, "The associations between G972R polymorphism of the IRS-1 gene, insulin resistance, salt sensitivity and non-dipper hypertension", Hypertens Res, 34, pp.1082~1086 (2011)[DOI]
- Wan Z, "Involvement of NLRP3 inflammasome in the impacts of sodium and potassium on insulin resistance in normotensive Asians", Br J Nutr, 119, pp.228~237 (2018)[DOI]
- Chatterjee R, "Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial", Am J Clin Nutr, 106, pp.1431~1438 (2017)[DOI]
- Townsend RR, "Salt intake and insulin sensitivity in healthy human volunteers", Clin Sci (Lond), 113, pp.141~148 (2007)[DOI]
- Raji A, "Insulin resistance in hypertensives: effect of salt sensitivity, renin status and sodium intake", J Hypertens, 19, pp.99~105 (2001)[DOI]
- Nakandakare ER, "Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients", Atherosclerosis, 200, pp.410~416 (2008)[DOI]
- Garg R, "Low-salt diet increases insulin resistance in healthy subjects", Metabolism, 60, pp.965~968 (2011)[DOI]
- Meland E, "Salt restriction: effects on lipids and insulin production in hypertensive patients", Scand J Clin Lab Invest, 57, pp.501~505 (1997)[DOI]
- Foo M, "Effect of salt-loading on blood pressure, insulin sensitivity and limb blood flow in normal subjects", Clin Sci (Lond), 95, pp.157~164 (1998)[DOI]
- Ministry of Health and Welfare (KR), "Korea Health Statistics 2014: Korea National Health and Nutrition Examination Survey (KNHANES VI-2)", Korea Centers for Disease Control and Prevention, ~ (2015)
- Iwahori T, "Time to consider use of the sodium-to-potassium ratio for practical sodium reduction and potassium increase", Nutrients, 9, pp.700~ (2017)[DOI]
- McLean RM, "Measuring population sodium intake: a review of methods", Nutrients, 6, pp.4651~4662 (2014)[DOI]
- Kim Y, "Cohort profile: the Korean Genome and Epidemiology Study (KoGES) consortium", Int J Epidemiol, 46, pp.1350~ (2017)[DOI]
- Kim J, "Development of a food frequency questionnaire in Koreans", Asia Pac J Clin Nutr, 12, pp.243~250 (2003)
- Ahn Y, "Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study", Eur J Clin Nutr, 61, pp.1435~1441 (2007)[DOI]
- Park YM, "Interaction between single nucleotide polymorphism and urinary sodium, potassium, and sodium-potassium ratio on the risk of hypertension in Korean adults", Nutrients, 9, pp.235~ (2017)[DOI]
- Tanaka T, "A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen", J Hum Hypertens, 16, pp.97~103 (2002)[DOI]
- O'Donnell M, "Urinary sodium and potassium excretion, mortality, and cardiovascular events", N Engl J Med, 371, pp.612~623 (2014)[DOI]
- O'Donnell MJ, "Urinary sodium and potassium excretion and risk of cardiovascular events", JAMA, 306, pp.2229~2238 (2011)
- Khaw KT, "Blood pressure and urinary sodium in men and women: the Norfolk Cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk)", Am J Clin Nutr, 80, pp.1397~1403 (2004)[DOI]
- Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)[DOI]
- Katz A, "Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans", J Clin Endocrinol Metab, 85, pp.2402~2410 (2000)[DOI]
- Chun YH, "Association of urinary sodium excretion with insulin resistance in Korean adolescents: results from the Korea National Health and Nutrition Examination Survey 2009-2010", Medicine (Baltimore), 95, pp.e3447~ (2016)[DOI]
- Kim YM, "Association of sodium intake with insulin resistance in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey 2010", J Pediatr Endocrinol Metab, 31, pp.117~125 (2018)[DOI]
- Fonseca-Alaniz MH, "High dietary sodium intake increases white adipose tissue mass and plasma leptin in rats", Obesity (Silver Spring), 15, pp.2200~2208 (2007)[DOI]
- Lopes KL, "Perinatal salt restriction: a new pathway to programming adiposity indices in adult female Wistar rats", Life Sci, 82, pp.728~732 (2008)[DOI]
- Fonseca-Alaniz MH, "High sodium intake enhances insulin-stimulated glucose uptake in rat epididymal adipose tissue", Obesity (Silver Spring), 16, pp.1186~1192 (2008)[DOI]
- Hall JE, "Control of sodium excretion by angiotensin II: intrarenal mechanisms and blood pressure regulation", Am J Physiol, 250, pp.960~972 (1986)
- Wasada T, "Adenosine triphosphate-sensitive potassium (KATP) channel activity is coupled with insulin resistance in obesity and type 2 diabetes mellitus", Intern Med, 41, pp.84~90 (2002)[DOI]
