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. 2021 Dec;24(17):5795-5804.
doi: 10.1017/S1368980021001452. Epub 2021 Apr 6.

Association between 24-h urinary sodium to potassium ratio and mild cognitive impairment in community-based general population

Zhongrong Wang  1 , Nanfang Li  1 , Mulalibieke Heizhati  1 , Lin Wang  1 , Mei Li  1 , Fengyu Pan  1 , Zhikang Yang  1 , Reyila Abudureyimu  1 , Jing Hong  1 , Le Sun  1 , Jing Li  1 , Wei Li  1
Affiliations

Association between 24-h urinary sodium to potassium ratio and mild cognitive impairment in community-based general population

Zhongrong Wang et al. Public Health Nutr. 2021 Dec.

Abstract

Objective: To explore the relationship between parameters of Na and K excretion using 24-h urine sample and mild cognitive impairment (MCI) in general population.

Design: This is a cross-sectional study.

Setting: Community-based general population in Emin China.

Participants: Totally, 1147 subjects aged ≥18 years were selected to complete the study, with a multistage proportional random sampling method. Cognitive status was assessed with Mini Mental State Examination (MMSE) questionnaire and timed 24-h urine specimens were collected. Finally, 561 participants aged ≥35 years with complete urine sample and MMSE data were included for the current analysis and divided into groups by tertiles of 24-h urinary sodium to potassium ratio (24-h UNa/K) as lowest (T1), middle (T2) and highest (T3) groups.

Results: The MMSE score was significantly lower in T3, compared with the T1 group (26·0 v. 25·0, P = 0·002), and the prevalent MCI was significantly higher in T3 than in T1 group (11·7 % v. 25·8 %, P < 0·001). In multiple linear regression, 24-UNa/K (β: -0·184, 95 % CI -0·319, -0·050, P = 0·007) was negatively associated with MMSE score. In multivariable logistic regression, compared with T1 group, 24-h UNa/K in the T2 and T3 groups showed 2·01 (95 % CI 1·03, 3·93, P = 0·041) and 3·38 (95 % CI 1·77, 6·44, P < 0·001) fold odds for presence of MCI, even after adjustment for confounders. More augmented results were demonstrated in sensitivity analysis by excluding individuals taking anti-hypertensive agents.

Conclusions: Higher 24-h UNa/K is in an independent association with prevalent MCI.

Keywords: Mild cognitive impairment; Urinary potassium; Urinary sodium; Urinary sodium to potassium ratio.

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Figures

Fig. 1
Fig. 1
Flowchart reporting analysis
Fig. 2
Fig. 2
Restricted cubic spline plots of 24-h UNa and mild cognitive impairment (MCI) after adjusted for age, gender, education attainment status, occupation, cigarette and alcohol consumption, BMI, estimated glomerular filtration rate (EGFR), 24-h urinary protein, systolic blood pressure (SBP), stroke, dyslipidaemia, diabetes mellitus and 24-h UK (a: in total population, b: population excluding for individuals undertaking anti-hypertensive drugs, c: population aged ≥45 years)
See this image and copyright information in PMC

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