title: Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population.
abstract: Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa). We examined the association of UNawith mortality in a cohort of type 2 diabetes (T2D) patients.
  
  
  
  Patients were followed for all-cause death and cardiovascular death. Baseline UNawas measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition of UNato a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI) index.
  
  
  
  Participants (n= 1,439) were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded. UNaindependently predicted all-cause and cardiovascular mortality. An increase of one standard deviation of UNawas associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality. UNaimproved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%,P= 0.04 and rIDI = 4.6%,P= 0.02, resp.).
  
  
  
  In T2D, UNawas an independent predictor of mortality (low concentration is associated with increased risk) and improved modestly its prediction in addition to traditional risk factors.
authors.affiliation: CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France; Université de Poitiers, UFR Médecine Pharmacie, CIC1402, Poitiers, France; Inserm, CIC1402, Poitiers, France.
authors.forename: Pierre-Jean
authors.identifier: 0000-0003-1862-4252
authors.initials: PJ
authors.lastname: Saulnier
authors.affiliation: CHU Poitiers, Pole DUNE, Poitiers, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Gand
authors.affiliation: CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France; Université de Poitiers, UFR Médecine Pharmacie, CIC1402, Poitiers, France; Inserm, CIC1402, Poitiers, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ragot
authors.affiliation: Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France; Université Paris 6 Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France.
authors.forename: Lise
authors.initials: L
authors.lastname: Bankir
authors.affiliation: CHU Poitiers, Pole DUNE, Poitiers, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Piguel
authors.affiliation: Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France; Université Paris 6 Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France; Université Paris 7 Denis Diderot, UMRS1138, Centre de Recherche des Cordeliers, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Fumeron
authors.affiliation: CHU Bordeaux, Service d'Endocrinologie, Diabétologie, Maladies Métaboliques et Nutrition, Bordeaux, France.
authors.forename: Vincent
authors.identifier: 0000-0002-5175-6479
authors.initials: V
authors.lastname: Rigalleau
authors.affiliation: CHU Tours, Service de Néphrologie, Tours, France; Université de Tours, Faculté de Médecine, Tours, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Halimi
authors.affiliation: CHU Poitiers, Pole DUNE, Poitiers, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Marechaud
authors.affiliation: Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France; Université Paris 6 Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France; Université Paris 7 Denis Diderot, UMRS1138, Centre de Recherche des Cordeliers, Paris, France; CHU Bordeaux, Service d'Endocrinologie, Diabétologie, Maladies Métaboliques et Nutrition, Bordeaux, France.
authors.forename: Ronan
authors.initials: R
authors.lastname: Roussel
authors.affiliation: CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France; Université de Poitiers, UFR Médecine Pharmacie, CIC1402, Poitiers, France; Inserm, CIC1402, Poitiers, France; CHU Poitiers, Pole DUNE, Poitiers, France; Inserm, U1082, Poitiers, France.
authors.forename: Samy
authors.initials: S
authors.lastname: Hadjadj
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000652:urine; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012964:Sodium / Q000652:urine*; D015996:Survival Rate; D016482:Urinalysis
chemical_list: D015415:Biomarkers; D012964:Sodium