title: Potassium and glucose measures in older adults: the Cardiovascular Health Study.
abstract: BACKGROUND
  We sought to determine the impacts of serum and dietary potassium measures on glucose metabolism and diabetes risk in older adults.
  
  
  METHODS
  Among participants of the Cardiovascular Health Study, a community-based cohort of older American adults, we examined a) cross-sectional associations between potassium and measures of insulin sensitivity and secretion estimated from oral glucose tolerance tests and b) longitudinal associations of serum and dietary potassium with diabetes risk.
  
  
  RESULTS
  Among 4,754 participants aged ≥65 years at baseline, there were 445 cases of incident diabetes during a median follow-up of 12 years. In multivariate models, baseline serum and dietary potassium were both associated with lower insulin sensitivity and greater insulin secretion. Compared with those with a serum potassium ≥4.5 mEq/L, participants with a serum potassium <4.0mEq/L had an adjusted mean difference in Matsuda insulin sensitivity index of -0.18 (-0.39, 0.02). Compared with those in the highest quartile, participants in the lowest quartile of dietary potassium intake had a corresponding adjusted mean difference in Matsuda insulin sensitivity index of -0.61 (-0.94, -0.29). In multivariate models, neither serum nor dietary potassium intake was associated with long-term diabetes risk.
  
  
  CONCLUSIONS
  Although we did not identify serum and dietary potassium as risk factors for incident diabetes in older adults, results from cross-sectional analyses suggest that both may be associated with increased insulin resistance. This relationship with insulin resistance needs to be confirmed, and its importance on diabetes risk, cardiovascular risk, and conditions specific to older adults should be determined as well.
authors.affiliation: Department of Medicine, Duke University, Durham, North Carolina. ranee.chatterjee@duke.edu.
authors.forename: Ranee
authors.initials: R
authors.lastname: Chatterjee
authors.affiliation: Department of Biostatistics, Collaborative Studies Coordinating Center.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Biggs
authors.affiliation: Department of Medicine, and Department of Epidemiology, University of Washington, Seattle.
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Brancati
authors.affiliation: Department of Medicine, Duke University, Durham, North Carolina.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.affiliation: Kaiser Permanente of Georgia and Department of Medicine, Emory University School of Medicine, Atlanta.
authors.forename: Joshua
authors.initials: J
authors.lastname: Barzilay
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Boston Veterans Affairs Healthcare System, Massachusetts.
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.affiliation: Department of Medicine, University of California, San Diego and Veterans Affairs San Diego Healthcare System.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
authors.affiliation: Department of Medicine, and Department of Epidemiology, University of Washington, Seattle.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
authors.affiliation: Department of Medicine, Duke University, Durham, North Carolina.
authors.forename: David
authors.initials: D
authors.lastname: Edelman
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood*; D017419:Potassium, Dietary / Q000008:administration & dosage; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D007328:Insulin; D017419:Potassium, Dietary; D011188:Potassium
keywords: Glucose metabolism; Older adults.; Potassium