Serum potassium level is associated with metabolic syndrome: A population-based study

ArticleinClinical nutrition (Edinburgh, Scotland) 33(3) · July 2013with19 Reads
Impact Factor: 4.48 · DOI: 10.1016/j.clnu.2013.07.010 · Source: PubMed
Abstract

Evidence has suggested that low serum potassium concentration or low dietary potassium intake can result in many metabolic disorders. Our objective was to evaluate the association between serum potassium level and risk of prevalent metabolic syndrome. We conducted a cross-sectional study in 10,341 participants aged 40 years or older. Metabolic syndrome was defined according to guidelines from the National Cholesterol Education Program with modification. The prevalence rate of metabolic syndrome was 51.7% in participants with hypokalemia and 37.7% in those with normokalemia. With the reduction of serum potassium quartiles, participants were tended to have higher level of triglycerides and uric acid, lower level of high-density lipoprotein cholesterol (HDL-C), larger waist circumference and more severe insulin resistance. Serum potassium level significantly decreased with the increasing number of metabolic syndrome components. Compared with subjects in the highest quartile of serum potassium level, multivariate adjusted odds ratios for prevalent metabolic syndrome in the lowest quartile was 1.48 (95% confidence interval, 1.16-1.87). Moreover, compared with subjects without central obesity, hypertriglyceridemia, low HDL-C and elevated fasting plasma glucose, those with each of these metabolic syndrome components have lower level of serum potassium after adjusted for age and sex. Low serum potassium level significantly associated with prevalence of metabolic syndrome in middle-aged and elderly Chinese.

    • "We also found an obvious downward curve in the nonlinear graph (p = 0.056 for nonlinearity, Figure 7), indicating a protective effect of adequate potassium intake on MetS. A study performed by Sun et al. [17] also indicated that serum potassium was associated with MetS. However, no research paper was found about the relationship between urinary sodium‐to‐potassium ratio and MetS. "
    [Show abstract] [Hide abstract] ABSTRACT: The objective of this study was to investigate the associations between potassium and obesity/metabolic syndrome. We identified eight relevant studies and applied meta-analysis, and nonlinear dose-response analysis to obtain the available evidence. The results of the pooled analysis and systematic review indicated that high potassium intake could not reduce the risk of obesity (pooled OR = 0.78; 95% CI: 0.61-1.01), while serum potassium and urinary sodium-to-potassium ratio was associated with obesity. Potassium intake was associated with metabolic syndrome (pooled OR = 0.75; 95% CI: 0.50-0.97). Nonlinear analysis also demonstrated a protective effect of adequate potassium intake on obesity and metabolic syndrome. Adequate intake of fruits and vegetables, which were the major sources of potassium, was highly recommended. However, additional pertinent studies are needed to examine the underlying mechanism.
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    • "Inhibition of pro-inflammatory events in vascular SMC, reduction of platelet aggregation and reduction of renal vascular resistance seem to mediate potassium favorable effects on blood pressure (Rice, 2011). Potassium intake and serum potassium levels have also been negatively associated with MetSyn prevalence (Lee, 2013;Sun, 2014). Lower serum potassium levels, and to a minor degree lower dietary potassium intake levels, have been associated with an increased risk of diabetes (Chatterjee, 2011;Lee, 2013). "
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    • "While this is the first study that demonstrates a correlation between potassium and histological severity of NAFLD, the literature reveals an association between potassium levels, insulin resistance and the metabolic syndrome. A large population-based study showed an inverse relationship between serum potassium level and prevalence of metabolic syndrome among a group of 10,341 Chinese adults [25]. Interestingly, that study also found that the prevalence rate of insulin resistance decreases with increased serum potassium quartiles (p<0.0001). "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group (4.4±0.42 mmoL/L vs. 4.8±0.21, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR ,0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.
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