TY - JOUR
T1 - Urinary potassium excretion and mortality risk in community-dwelling individuals with and without obesity
AU - Yeung, Stanley M. H.
AU - Nooteboom, Anne
AU - Hoorn, Ewout J.
AU - Rotmans, Joris I.
AU - Vogt, Liffert
AU - de Boer, Rudolf A.
AU - Gansevoort, Ron T.
AU - Navis, Gerjan
AU - Bakker, Stephan J. L.
AU - de Borst, Martin H.
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2022/9/2
Y1 - 2022/9/2
N2 - BACKGROUND: Potassium intake has been shown to be inversely associated with blood pressure and premature mortality. Previous studies have 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. OBJECTIVES: We investigated whether potassium intake, reflected by 24-h urinary excretion, is associated with all-cause mortality, and explored potential effect modification by obesity. METHODS: We performed a prospective cohort study in community-dwelling individuals. The association between urinary potassium excretion and all-cause mortality was investigated by using multivariable Cox regression. We performed multiplicative interaction analysis and subgroup analyses according to BMI and waist circumference. RESULTS: In 8533 individuals (50% male), the mean age was 50 ± 13 y, mean urinary potassium excretion was 71 ± 21 mmol/24 h, median BMI (in kg/m2) was 25.6 (IQR: 23.1, 28.4) and mean waist circumference was 89 ± 13 cm. During median follow-up of 18.4 (IQR: 13.5, 18.8) y, 1663 participants died. Low urinary potassium excretion (first compared with third sex-specific quintile) was associated with an increased mortality risk (fully adjusted HR: 1.38; 95% CI: 1.18, 1.61), P < 0.001, irrespective of body dimensions (HR range for all body dimensions: 1.36-1.70, all P < 0.05). High urinary potassium excretion (fifth compared with third quintile) was associated with increased mortality risk in participants with obesity (BMI ≥30; HR: 1.52; CI: 1.00, 2.30), but not in participants without obesity (BMI: <25; HR: 0.89; 95% CI: 0.62, 1.26; P-interaction = 0.001). CONCLUSIONS: 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.
AB - BACKGROUND: Potassium intake has been shown to be inversely associated with blood pressure and premature mortality. Previous studies have 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. OBJECTIVES: We investigated whether potassium intake, reflected by 24-h urinary excretion, is associated with all-cause mortality, and explored potential effect modification by obesity. METHODS: We performed a prospective cohort study in community-dwelling individuals. The association between urinary potassium excretion and all-cause mortality was investigated by using multivariable Cox regression. We performed multiplicative interaction analysis and subgroup analyses according to BMI and waist circumference. RESULTS: In 8533 individuals (50% male), the mean age was 50 ± 13 y, mean urinary potassium excretion was 71 ± 21 mmol/24 h, median BMI (in kg/m2) was 25.6 (IQR: 23.1, 28.4) and mean waist circumference was 89 ± 13 cm. During median follow-up of 18.4 (IQR: 13.5, 18.8) y, 1663 participants died. Low urinary potassium excretion (first compared with third sex-specific quintile) was associated with an increased mortality risk (fully adjusted HR: 1.38; 95% CI: 1.18, 1.61), P < 0.001, irrespective of body dimensions (HR range for all body dimensions: 1.36-1.70, all P < 0.05). High urinary potassium excretion (fifth compared with third quintile) was associated with increased mortality risk in participants with obesity (BMI ≥30; HR: 1.52; CI: 1.00, 2.30), but not in participants without obesity (BMI: <25; HR: 0.89; 95% CI: 0.62, 1.26; P-interaction = 0.001). CONCLUSIONS: 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.
KW - body dimension
KW - epidemiology
KW - general population
KW - mortality
KW - nutrition
KW - potassium intake
UR - http://www.scopus.com/inward/record.url?scp=85137138132&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ajcn/nqac137
DO - https://doi.org/10.1093/ajcn/nqac137
M3 - Article
C2 - 35580599
SN - 0002-9165
VL - 116
SP - 741
EP - 749
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 3
ER -