The association between urinary and dietary potassium and diabetic microvascular complications: insights from UK Biobank data
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Potassium plays an important role in glucose metabolism and blood vessel. However, there is a lack of systematic research on the intake of potassium and diabetic microvascular complications. The aim of this study was to explore whether inadequate potassium intake increases the risk of developing diabetic microvascular complications, diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy using the UK Biobank database.
Methods
This study included 22,395 subjects with type 2 diabetes mellitus at baseline. Urinary potassium and creatinine were measured by potentiometry and photometric assay respectively. Dietary potassium intake was measured using the 24-hour dietary recall method. The occurrence of microvascular complications was determined using ICD-10 codes from cumulative hospitalization records and death records in the national death registry. Cox proportional hazards models were used to explore the relationship between urinary potassium-to-creatinine ratio, dietary potassium, and overall and individual microvascular complications, generating hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
Compared with the minimum potassium-to-creatinine ratio group, the highest potassium-to-creatinine ratio group had a significantly lower risk of diabetic microvascular complications (HR, 0.70 [95% CI 0.63–0.78]; P for trend < 0.001) and diabetic nephropathy (HR, 0.54 [95% CI 0.47–0.61]; P for trend < 0.001). The group with the highest dietary potassium had a significantly lower risk of diabetic nephropathy (HR, 0.48 [95% CI 0.29–0.80], P for trend = 0.005) than the minimum dietary potassium group. The restricted cubic spline results showed a non-linear relationship between urinary potassium-to-creatinine ratio and overall microvascular complications and diabetic nephropathy, with nonlinear P values of 0.009 and < 0.001, respectively, and a generally declining trend.
Conclusions
The urinary potassium-to-creatinine ratio was significantly negatively associated with overall diabetic microvascular complications and diabetic nephropathy.
Potassium plays an important role in glucose metabolism and blood vessel. However, there is a lack of systematic research on the intake of potassium and diabetic microvascular complications. The aim of this study was to explore whether inadequate potassium intake increases the risk of developing diabetic microvascular complications, diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy using the UK Biobank database.
Methods
This study included 22,395 subjects with type 2 diabetes mellitus at baseline. Urinary potassium and creatinine were measured by potentiometry and photometric assay respectively. Dietary potassium intake was measured using the 24-hour dietary recall method. The occurrence of microvascular complications was determined using ICD-10 codes from cumulative hospitalization records and death records in the national death registry. Cox proportional hazards models were used to explore the relationship between urinary potassium-to-creatinine ratio, dietary potassium, and overall and individual microvascular complications, generating hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
Compared with the minimum potassium-to-creatinine ratio group, the highest potassium-to-creatinine ratio group had a significantly lower risk of diabetic microvascular complications (HR, 0.70 [95% CI 0.63–0.78]; P for trend < 0.001) and diabetic nephropathy (HR, 0.54 [95% CI 0.47–0.61]; P for trend < 0.001). The group with the highest dietary potassium had a significantly lower risk of diabetic nephropathy (HR, 0.48 [95% CI 0.29–0.80], P for trend = 0.005) than the minimum dietary potassium group. The restricted cubic spline results showed a non-linear relationship between urinary potassium-to-creatinine ratio and overall microvascular complications and diabetic nephropathy, with nonlinear P values of 0.009 and < 0.001, respectively, and a generally declining trend.
Conclusions
The urinary potassium-to-creatinine ratio was significantly negatively associated with overall diabetic microvascular complications and diabetic nephropathy.
Date Issued
2025-07-01
Date Acceptance
2025-05-29
Citation
Nutrition Journal, 2025, 24
ISSN
1475-2891
Publisher
BMC
Journal / Book Title
Nutrition Journal
Volume
24
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40597135
PII: 10.1186/s12937-025-01161-1
Subjects
Science & Technology
Life Sciences & Biomedicine
Nutrition & Dietetics
Potassium
Diabetic microvascular complications
UK Biobank
SODIUM
HYPERTENSION
RETINOPATHY
NEUROPATHY
RISK
Publication Status
Published
Coverage Spatial
England
Article Number
101
Date Publish Online
2025-07-01