Serum potassium is a predictor of incident diabetes in African Americans with normal aldosterone: the Jackson Heart Study ,

Chatterjee, Ranee; Davenport, Clemontina A.; Svetkey, Laura P.; Batch, Bryan C.; Lin, Pao Hwa; Vasan, Ramachandran S.; Fox, Ervin R.; Harman, Jane; Yeh, Hsin Chieh; Selvin, Elizabeth; Correa, Adolfo; Butler, Kenneth R.; Edelman, David

doi:10.3945/ajcn.116.143255

Cited by 13 publications

(22 citation statements)

References 32 publications

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“…We found that participants tolerated the study medication well and had high adherence on the basis of pill count as well as 24-h urinary potassium measures, which strongly correlate with potassium intake (14). However, we also found that, compared with placebo, the intervention did not increase serum potassium significantly and did not achieve a theoretical target of $4.1 mEq/L, which, in a cohort study in African Americans, has been associated with a lower risk of diabetes (9). Despite the minimal effect on serum potassium, we did find trends to suggest that potassium supplementation may have favorable effects on glucose metabolism.…”

Section: Discussioncontrasting

confidence: 40%

“…These expensive tests are not feasible to perform in clinical practice; however, on the basis of previous studies, serum potassium in the low end of the normal range (3.5-3.9 mEq/L; normal range typically being 3.5-5.5 mEq/L) can serve as a proxy measure of relative potassium deficiency. This concentration of serum potassium, 3.4-3.9 mEq/L, is the range of potassium that was most clearly associated with an increased diabetes risk in the cohort studies described above (5)(6)(7)(8)(9). A concentration ,4.1 mEq/L was found to be associated with a higher risk of diabetes in an African-American cohort on the basis of our analyses of the Jackson Heart Study data (9).…”

Section: Introductionmentioning

confidence: 74%

“…Several lines of evidence point to low potassium as a risk factor for type 2 diabetes, including pharmacologic studies (1), studies of human physiology (2)(3)(4), and epidemiologic studies (5)(6)(7)(8)(9). African Americans have a higher prevalence of both diabetes and prediabetes (10,11), and potassium homeostasis may contribute to these disparities.…”

Section: Introductionmentioning

confidence: 99%

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Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Chatterjee

Slentz

Davenport

et al. 2017

The American Journal of Clinical Nutrition

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Background: Low potassium has been identified both as a risk factor for type 2 diabetes and as a mediator of the racial disparity in diabetes risk. Low potassium could be a potentially modifiable risk factor, particularly for African Americans. Objective: We sought to determine the effects of potassium chloride (KCl) supplements, at a commonly prescribed dose, on measures of potassium and glucose metabolism. Design: Among African-American adults with prediabetes, we conducted a double-blinded pilot randomized controlled trial that compared the effects of 40 mEq K/d as KCl supplements with a matching placebo, taken for 3 mo, on measures of potassium and glucose metabolism, with measures collected from frequently sampled oral-glucose-tolerance tests (OGTTs). Results: Twenty-seven of 29 recruited participants completed the trial. Participants had high adherence to the study medication (92% by pill count). Participants in both groups gained weight, with an overall mean 6 SD weight gain of 1.24 6 2.03 kg. In comparison with participants who received placebo, urine potassium but not serum potassium increased significantly among participants randomly assigned to receive KCl (P = 0.005 and 0.258, respectively). At the end of the study, participants taking KCl had stable or improved fasting glucose, with a mean 6 SD change in fasting glucose of 21.1 6 8.4 mg/dL compared with an increase of 6.1 6 7.6 mg/dL in those who received placebo (P = 0.03 for comparison between arms). There were no significant differences in glucose or insulin measures during the OGTT between the 2 groups, but there was a trend for improved insulin sensitivity in potassium-treated participants. Conclusions: In this pilot trial, KCl at a dose of 40 mEq/d did not increase serum potassium significantly. However, despite weight gain, KCl prevented worsening of fasting glucose. Further studies in larger sample sizes, as well as with interventions to increase serum potassium more than was achieved with our intervention, are indicated to definitively test this potentially safe and inexpensive approach to reducing diabetes risk. This trial was registered at clinicaltrials.gov as NCT02236598.

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Section: Discussioncontrasting

confidence: 40%

Section: Introductionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Chatterjee

Slentz

Davenport

et al. 2017

The American Journal of Clinical Nutrition

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“…However, this inverse association has not been observed in other studies [ 9 , 11 ] regarding the association of serum potassium with the risk of T2DM. Similarly, several studies regarding dietary and urinary potassium showed that low potassium intake was related to an increased risk of T2DM [ 12 , 16 ], while other studies found non-significant results [ 10 , 11 , 14 , 17 ]. Moreover, the nature of the dose-response association between potassium measurements and T2DM risk remains unknown.…”

Section: Introductionmentioning

confidence: 95%

“…However, the relationship between potassium measurements and T2DM risk still remains controversial. Several studies have suggested that higher serum potassium levels are related to a lower risk of T2DM [ 10 , 13 – 15 ]. However, this inverse association has not been observed in other studies [ 9 , 11 ] regarding the association of serum potassium with the risk of T2DM.…”

Section: Introductionmentioning

confidence: 99%

Potassium measurements and risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies

Yang

Zhong

et al. 2017

Oncotarget

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ObjectiveTo clarify the relationship between serum, dietary, and urinary potassium and the risk of type 2 diabetes mellitus (T2DM).Materials and MethodsWe searched PubMed and EMBASE through January 6, 2017 for studies reporting risk estimates on the association of potassium measurements and the risk of T2DM. The summary risk estimates were obtained through a random-effects model. Dose-response analysis was conducted.ResultsEight studies involving 5,053 cases and 119,993 individuals were included. A trend toward significance was found in the highest versus lowest meta-analysis on serum potassium and T2DM risk (RR = 0.79; 95% CI 0.60–1.04); moreover, the RR per 1 mmol/L increase in serum potassium was 0.83 (95% CI 0.73–0.95). A non-significant association of dietary potassium and T2DM risk was detected (RR for the highest versus lowest category: 0.93; 95% CI 0.81–1.06; RR for every 1000mg increase per day: 1.00, 95% CI 0.96–1.05). A similar non-significant association was found for urinary potassium and T2DM risk (RR for the highest versus lowest category: 0.83; 95% CI 0.39–1.75; RR per 10 mmol increase: 1.00; 95% CI 0.95–1.05). Evidence of a linear association between serum, dietary, and urinary potassium and the risk of T2DM was found (all Pnon-linearity > 0.05).ConclusionsLow serum potassium increases the risk of T2DM in a linear dose-response manner; nevertheless, neither dietary potassium nor urinary potassium shows any association with the risk of T2DM. However, these findings should be interpreted with caution due to limited studies.

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Dietary Potassium and Magnesium Intake with Risk of Type 2 Diabetes Mellitus Among Rural China: the Henan Rural Cohort Study

Li,

Wang

et al. 2023

Biol Trace Elem Res

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Serum potassium is a predictor of incident diabetes in African Americans with normal aldosterone: the Jackson Heart Study ,

Cited by 13 publications

References 32 publications

Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Potassium measurements and risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies

Dietary Potassium and Magnesium Intake with Risk of Type 2 Diabetes Mellitus Among Rural China: the Henan Rural Cohort Study

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