Potassium Measurements And Risk Of Type 2 Diabetes: A Dose-response Meta-analysis Of Prospective Cohort Studies

Objective:To clarify the relationship between serum,dietary,and urinary potassium and the risk of type 2 diabetes mellitus（T2DM）.Methods:We 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.Results:Eight 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%CI0.95-1.05）.Evidence of a linear association between serum,dietary,and urinary potassium and the risk of T2DM was found(all P_{non-linearity}>0.05).Conclusions:Low 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.