본문 바로가기
KERD
논문KCI 등재

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)

  1. Annual Report on the Causes of Death Statistics, "Statistics Korea", Statistics Korea, ~ (2016)
  2. Ginsberg HN, "Insulin resistance and cardiovascular disease", J Clin Invest, 106, pp.453~458 (2000)[DOI]
  3. Reaven GM, "Insulin resistance, the insulin resistance syndrome, and cardiovascular disease", Panminerva Med, 47, pp.201~210 (2005)
  4. Paneni F, "Insulin resistance, diabetes, and cardiovascular risk", Curr Atheroscler Rep, 16, pp.419~ (2014)[DOI]
  5. 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]
  6. 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]
  7. Kuroda S, "Role of insulin resistance in the genesis of sodium sensitivity in essential hypertension", J Hum Hypertens, 13, pp.257~262 (1999)[DOI]
  8. 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]
  9. 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]
  10. 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]
  11. Townsend RR, "Salt intake and insulin sensitivity in healthy human volunteers", Clin Sci (Lond), 113, pp.141~148 (2007)[DOI]
  12. Raji A, "Insulin resistance in hypertensives: effect of salt sensitivity, renin status and sodium intake", J Hypertens, 19, pp.99~105 (2001)[DOI]
  13. Nakandakare ER, "Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients", Atherosclerosis, 200, pp.410~416 (2008)[DOI]
  14. Garg R, "Low-salt diet increases insulin resistance in healthy subjects", Metabolism, 60, pp.965~968 (2011)[DOI]
  15. Meland E, "Salt restriction: effects on lipids and insulin production in hypertensive patients", Scand J Clin Lab Invest, 57, pp.501~505 (1997)[DOI]
  16. 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]
  17. 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)
  18. 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]
  19. McLean RM, "Measuring population sodium intake: a review of methods", Nutrients, 6, pp.4651~4662 (2014)[DOI]
  20. Kim Y, "Cohort profile: the Korean Genome and Epidemiology Study (KoGES) consortium", Int J Epidemiol, 46, pp.1350~ (2017)[DOI]
  21. Kim J, "Development of a food frequency questionnaire in Koreans", Asia Pac J Clin Nutr, 12, pp.243~250 (2003)
  22. Ahn Y, "Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study", Eur J Clin Nutr, 61, pp.1435~1441 (2007)[DOI]
  23. 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]
  24. 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]
  25. O'Donnell M, "Urinary sodium and potassium excretion, mortality, and cardiovascular events", N Engl J Med, 371, pp.612~623 (2014)[DOI]
  26. O'Donnell MJ, "Urinary sodium and potassium excretion and risk of cardiovascular events", JAMA, 306, pp.2229~2238 (2011)
  27. 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]
  28. 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]
  29. 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]
  30. 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]
  31. 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]
  32. 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]
  33. 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]
  34. 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]
  35. Hall JE, "Control of sodium excretion by angiotensin II: intrarenal mechanisms and blood pressure regulation", Am J Physiol, 250, pp.960~972 (1986)
  36. 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]

관련 논문AI추천

The Association between Urinary Sodium Excretion and Metabolic Syndrome in Korean Adults from the 2010–2011 Korean National Health and Nutrition Examination Survey김정화, 서정은, 심경원, 안희정, 이상화, 이홍수, 전혜진, A Ri Byun대한가정의학회 · Korean Journal of Family Medicine2017 · 제38권 제4호한국 성인의 식이 나트륨칼륨비와 대사증후군의 관련성: 2013-2015 국민건강영양조사 자료를 이용하여이심열, 이유신대한임상건강증진학회 · Korean Journal of Health Promotion2020 · 제20권 제3호Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults노희경, 한영희, 허영란, 현태선, Choi Mi-Kyeong, Lee Yeon-Kyung한국영양학회 · Nutrition Research and Practice2023 · 제17권 제2호High Sodium Intake, as Assessed by Urinary Sodium Excretion, Is Associated with Nonalcoholic Fatty Liver Disease or Sarcopenia김혜순, 장병국, Han Eugene, Im Seung-Soon, Kim Mi Kyung, Kwon Taeg Kyu거트앤리버 소화기연관학회협의회 · Gut and Liver2023 · 제17권 제3호Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion한상엽, HyeongCheonPark, Joo-Hark Yi, Jung Gon Kim, Sang-Woong Han한국영양학회 · Nutrition Research and Practice2020 · 제14권 제1호Development and application of the sodium index to estimate and assess sodium intake for Korean adults노희경, 이연경, 최미경, 허영란, 현태선한국영양학회 · Nutrition Research and Practice2022 · 제16권 제3호

이 간행물의 다른 논문 (10건)