Baseline Demographic, Clinical and Laboratory Parameters Related with 24 Hour Urinary Sodium Excretion in Newly Diagnosed Patients with Type 2 Diabetes

Abstract Background: It has been well documented that left ventricular hypertrophy (LVH) is highly associated with incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake has been observed related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.Methods: A total of 1356 patients with T2DM were recruited. Urinary sodium was measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. LVH was assessed by echocardiography. The associations between urinary sodium excretion and the risk factors for cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines.Results: Urinary sodium excretion levels was positively associated with cardiometabolic risk factors, including systolic blood pressure (P<0.001), body mass index (P<0.001), waist circumference (P<0.001) and LVMI (P<0.001). In multivariable logistic regression analyses, increased urinary sodium excretion were significantly associated with increased risks of LVH [OR (95% CI), 1.47 (1.02-2.10); P=0.037] and CVD [OR (95% CI), 2.08 (1.20-3.61); P=0.009], after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted restricted cubic spline analyses of the association between urinary sodium excretion and LVMI showed a significant association (P=0.002) and provided no evidence of a nonlinear association (P=0.135).Conclusions: This study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake is valuable in the prevention of diabetic cardiovascular complications.

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URINARY SODIUM EXCRETION PREDICTS ARTERIAL STIFFNESS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS: A 6-YEAR FOLLOW-UP STUDY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61590-8 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1590

Author(s):

C. Thomopoulos ◽

K. Tsioufis ◽

E. Andrikou ◽

D. Syrseloudis ◽

D. Tsiachris ◽

...

Keyword(s):

Arterial Stiffness ◽

Sodium Excretion ◽

Urinary Sodium Excretion ◽

Urinary Sodium ◽

Newly Diagnosed ◽

Hypertensive Patients ◽

Follow Up Study

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Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in People With Type 2 Diabetes Mellitus: A Cross-Sectional Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.728493 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jianfang Liu ◽

Xiaoyu Yang ◽

Peizhen Zhang ◽

Dan Guo ◽

Bingyan Xu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Sodium Excretion ◽

Ventricular Hypertrophy ◽

Sodium Intake ◽

Urinary Sodium Excretion ◽

Left Ventricular ◽

Urinary Sodium ◽

Cross Sectional

BackgroundIt has been well documented that left ventricular hypertrophy (LVH) is highly associated with the incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake was closely related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes mellitus (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.MethodsThis cross-sectional analysis included baseline data from 1,556 individuals with T2DM enrolled in the NanFang Prospective Diabetes Study (NFPDS). Urinary sodium excretion levels were measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. Left ventricular dimensions were assessed by echocardiography. The associations between urinary sodium excretion and the risks of cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines (RCS).ResultsUrinary sodium excretion levels were positively associated with cardiometabolic risk factors, including systolic blood pressure, body mass index, waist circumference and LVMI (All P<0.001). Odds ratios of the highest quartile of urinary sodium excretion compared with the lowest quartile were 1.80 (95% CI, 1.28-2.54; P=0.001) for LVH and 1.77 (95% CI, 1.06-2.94; P=0.028) for CVD, after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted RCS analysis of the association between urinary sodium excretion and LVMI showed a significant association (P=0.001) and lacked evidence of a nonlinear association (P=0.406).ConclusionThis study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake may be valuable for the prevention of diabetic cardiovascular complications.

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Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.772073 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yan Huang ◽

Wenhui Liu ◽

Jianfang Liu ◽

Dan Guo ◽

Peizhen Zhang ◽

...

Keyword(s):

Regression Analysis ◽

Kidney Disease ◽

Sodium Excretion ◽

Diabetic Kidney Disease ◽

Urinary Sodium Excretion ◽

Cross Sectional Study ◽

Urinary Sodium ◽

Sectional Study ◽

Cross Sectional

BackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe performed a cross-sectional study of 1545 patients with T2DM over aged 20 years old from January 2018 to December 2020. Urinary sodium excretion was measured by 24-hour urine samples in inpatients and morning fasting urine samples in outpatients. The associations between urinary sodium excretion and the risks of DKD were examined using stepwise regression analysis, logistic regression analysis and multivariable-adjusted restricted cubic splines (RCS).ResultsRegression analysis showed that urinary sodium was independently associated with urinary albumin to creatinine ratio (UACR) level (P = 0.006) and the risks of DKD (P = 0.042). In multivariable-adjusted RCS analysis, urinary sodium excretion was significantly associated with UACR in all patients (P = 0.008), and exhibited a J-shaped relationship. Logistic regression analysis showed that increased urinary sodium excretion was significantly associated with increased risks of DKD [OR (95% CI); 1.56 (1.07-2.27); P = 0.020]. However, the relationships between urinary sodium excretion and the risks of DKD and albuminuria showed no significance, after further adjustment for HOMA-IR and ba-PWV (brachial-ankle pulse wave velocity) (Both P > 0.05).ConclusionsHigher urinary sodium excretion level was associated with increased risks of DKD among patients with T2DM, dependent of vascular sclerosis and insulin resistance.

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