ArticleDiabetes care2026
Multiple 24-Hour Urinary Sodium and Potassium Excretions and Type 2 Diabetes Incidence.
Siwei Zhu, Xinyuan Zhang, Rikuta Hamaya, Yanping Li, Yiwen Zhang, Qi Sun, Gary C Curhan, Eric B Rimm, Walter C Willett, Frank B Hu and 1 more
Abstract read
In one paragraphArticle in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 · The recordCorrections and comments
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5 · Who and what moneyAuthors and funding
11 authors.
Xinyuan ZhangChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Rikuta HamayaDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Yiwen ZhangDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Gary C CurhanChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Eric B RimmDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Walter C WillettDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Frank B HuDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Funding
University of Hawaii Cancer Center CCSGP30CA071789 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI Pallav Pokhrel · 1996 to 2026
$56.2MValidity of Diet and Activity Measures in WomenP01CA055075 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI RIMM, ERIC B · 1991 to 2009
$41.8MLife Course Cancer Epidemiology Cohort in WomenU01CA176726 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ELIASSEN, A. HEATHER, WILLETT, WALTER C. · 2018 to 2025
$22.4MLong Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3MIntegrating lifecourse approaches, biologic and digital phenotypes in support of heart and lung disease epidemiologic researchU01HL145386 · NHLBI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI CHAVARRO, JORGE EDUARDO, MANSON, JOANN ELISABETH · 2019 to 2025
$17.8MCancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0MLife Course Cancer Epidemiology Cohort in WomenUM1CA176726 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2013 to 2017
$15.7MRISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8MDietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6MCancer Epidemiology Cohort in Male Health ProfessionalsUM1CA167552 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2012 to 2016
$11.5MDIETARY PATTERNS AND RISK OF CARDIOVASCULAR DISEASER01HL060712 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HU, FRANK B, QI, QIBIN · 1998 to 2021
$8.0MPollutant-related diabetes in the Nurses' Health Study IIR01ES021372 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI GRANDJEAN, PHILIPPE ADAM, SUN, QI · 2013 to 2017
$2.9MCenters for Disease Control and Prevention's National Program of Cancer RegistriesEnd Results (SEER) ProgramNCI NIH HHS CA055075NCI NIH HHS CA071789NCI NIH HHS CA167552NCI NIH HHS CA176726NCI NIH HHS CA186107NCI NIH HHS P01 CA055075NCI NIH HHS P30 CA071789NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA176726NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA176726NCI NIH HHS UM1 CA186107NHLBI NIH HHS HL145386NHLBI NIH HHS HL34594NHLBI NIH HHS HL35464NHLBI NIH HHS HL60712NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL060712NHLBI NIH HHS U01 HL145386NIDDK NIH HHS DK082486NIDDK NIH HHS DK091417NIDDK NIH HHS K24 DK091417NIDDK NIH HHS R01 DK059583NIDDK NIH HHS R01 DK082486NIEHS NIH HHS R01 ES021372NIH DK059583NIH ES021372NIH HHS CA055075NIH HHS CA071789NIH HHS CA167552NIH HHS CA176726NIH HHS CA186107NIH HHS DK059583NIH HHS DK082486NIH HHS DK091417NIH HHS ES021372NIH HHS HL145386NIH HHS HL34594NIH HHS HL35464NIH HHS HL60712
6 · The paper itselfAbstract
objectiveHigh sodium and low potassium intake, well-established dietary risk factors for hypertension, may induce insulin resistance and increase the risk of type 2 diabetes. However, previous research based on self-reported intakes is inconclusive. We examined the association of sodium and potassium intake, assessed by multiple 24-h urine samples, with subsequent risk of developing type 2 diabetes. RESEARCH DESIGN AND
methodsWe included 3,173 adults without major chronic diseases from three prospective cohorts. Sodium and potassium excretions were assessed using two to four 24-h urine collections per participant. We used Cox proportional hazards models to estimate hazard ratios (HR) for type 2 diabetes, adjusting for major confounding factors, including total energy intake and BMI.
resultsAmong 3,173 participants (mean age 62.2 ± 10.0 years, 69% women), diabetes developed in 161 over a median of 13.6 years. Risk of diabetes was 2.66 (95% CI 1.57-4.51) times higher in participants in the highest versus the lowest quartile of sodium excretion. Each 1,000 mg/day increase in sodium excretion was associated with a 32% (HR 1.32; 95% CI 1.16-1.52) higher risk of diabetes, whereas potassium excretion was not associated with diabetes risk (HR 0.87; 95% CI 0.69-1.11). Each unit increase in the sodium-to-potassium ratio was associated with a 26% higher risk of diabetes (95% CI 1.10-1.45).
conclusionsHigher sodium intake and a higher sodium-to-potassium ratio were associated with a higher risk of type 2 diabetes. Although these findings suggest that adopting a low-sodium diet may reduce diabetes risk, the associations may partly reflect residual confounding despite comprehensive covariate adjustment.
Indexed as
Diabetes Mellitus, Type 2PotassiumSodiumAgedFemaleHumansIncidenceMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk FactorsPotassiumSodium
Identifiers
PMID42454990
PMCPMC13493326
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