The Impact of 24 h Urinary Potassium Excretion on High-Density Lipoprotein Cholesterol and Chronic Disease Risk in Chinese Adults: A Health Promotion Study.

Background: Research into the pivotal role of potassium in chronic diseases and their comorbidities remains scarce. Our aim is to elucidate the relationship between potassium and chronic diseases, including comorbid conditions, and to provide evidence-based recommendations for potassium intake in patients.

Methods: This study is anchored in a representative, population-based survey conducted in Zhejiang Province, China, in 2017, encompassing participants aged 18 to 69 years. Data collection included questionnaire responses, physical measurements, and biological samples, obtained through a multistage cluster random sampling method. A subset of 1496 participants provided complete 24 h urine samples.

Results: The median age of the participants was 48.0 years (interquartile range [IQR] 24.0), with 51.1% being female, and hypertension was identified in more than one third (35.6%) of the participants. The prevalence of diabetes was approximately 9.0%, dyslipidemia was found in 34.2%, and microalbuminuria in 8.8%. The 24 h urinary excretion levels were 3613.3 mg/24 h (IQR 2161.7) for sodium and 1366.0 mg/24 h (IQR 824.9) for potassium, respectively. Potassium excretion exhibited an inverse relationship with blood pressure. Furthermore, a positive correlation was observed between potassium excretion and high-density lipoprotein cholesterol (HDL-C) levels, with an elevation of 0.03 mmol/L (95% confidence interval [CI] 0.00 to 0.05). In binary logistic regression analysis, individuals in the fourth quartile of potassium excretion (Q4) exhibited an odds ratio (OR) of 0.56 (95% CI 0.36-0.87) for hypertension compared to those in the first quartile (Q1). Urinary potassium excretion was inversely associated with low HDL-C levels, with Q4 individuals having 0.62 times the odds of having low HDL-C levels (OR, 0.62; 95% CI 0.39-1.00) compared to Q1.

Conclusions: Potassium excretion demonstrated a direct negative correlation with certain comorbidities. This study underscores the pivotal role of potassium in the management of chronic diseases and associated comorbidities, thereby highlighting the significance of potassium in both public health initiatives and clinical practice.