Dietary sodium and potassium and risk of diabetes: A prospective study using data from the China Health and Nutrition Survey

Dietary sodium and potassium intakes are well-known risk factors for cardiovascular outcomes. However, the associations between dietary sodium and potassium and diabetes are still controversial. Our study aimed to examine whether dietary sodium, potassium and the sodium–potassium ratio are associated with the risk of diabetes, based on a large sample of Chinese adults. The study data were from the 2004–2009 China Health and Nutrition Survey (CHNS), and 5867 participants were eligible for analysis. Sodium and potassium intakes were estimated based on three consecutive 24-h recalls at an individual level combined with a food inventory at a household level performed over the same 3-day period. Diabetes was defined as fasting glucose ≥7.0mmol/L (≥126mg/dL), HbA1c ≥6.5% or use of antidiabetic drugs. Over a mean follow-up of 4.7 years, there were 611 (10.4%) incident cases of diabetes. Participants in the higher quartiles (Q3 and Q4) of sodium intake had significantly higher risks of diabetes than those with the lowest sodium intake [Q3, RR: 1.41, 95% CI: 1.06–1.86 and Q4, RR: 1.35, 95% CI: 1.02–1.80; P