Serum sodium level is inversely associated with new-onset diabetes in hypertensive patients

Abstract

Background: Serum sodium level is associated with cardiovascular and endocrine health. Though decreased serum sodium is considered to be associated with reduced hypertension risk, some studies also found that it may increase the risk of diabetes. This study aimed to investigate the association of serum sodium with new-onset diabetes in hypertensive patients.

Methods: Based on the annual health examinations from 2011 to 2016 in Dongguan City, Guangdong, China, hypertensive patients without diabetes at baseline were selected. Logistic regression and restricted cubic spline were used to evaluate the association between serum sodium level and new-onset diabetes. Subgroup analysis was also conducted.

Results: A total of 4438 hypertensive patients with a mean age of 58.65 years were included, of whom 48.9% were male. During a median follow-up of 35.1 months, 617 (13.9%) of the subjects developed new-onset diabetes. Per 1-SD (3.39 mmol/L) increment of serum sodium was associated with a 14% lower risk of new-onset diabetes (odds ratio = 0.86; 95% CI: 0.78, 0.97; p = 0.01). The lowest quartile of serum sodium was associated with the lowest diabetes risk. The restricted cubic spline showed a linear inverse relationship (nonlinear p = 0.72). Across all the subgroups, the inverse association was consistent (p for interaction >0.05).

Conclusion: An inverse association of serum sodium with new-onset diabetes in hypertensive patients was observed.

Keywords: hypertension; new-onset diabetes; serum sodium; 新发糖尿病; 血清钠; 高血压.

FIGURE 1

The study flow chart

FIGURE 2

Restricted cubic spline analyses of new‐onset diabetes by serum sodium concentration. OR, odds ratio; CI, confidence interval. (Restricted cubic spline analyses were adjusted for age, gender, smoking, diastolic blood pressure, waist circumference, body mass index, fasting blood glucose, triglyceride, low‐density lipoprotein cholesterol, total cholesterol)