Salt Consumption Tied to Heart Risk in T2D

Salt Consumption Tied to Heart Risk in T2D

Posted on August 18, 2014 by ECR Louisville in Blog, Education

Higher salt intake was associated with a greater risk of cardiovascular disease in patients with type 2 diabetes, researchers in Japan found.

In an analysis of data from a Japanese cohort, diabetic patients (HbA1c ≥6.5%.) in the highest quartile of salt intake had a significantly greater risk of cardiovascular disease than those in the lowest quartile (HR 2.07, 95% CI 1.16 to 3.71), Hirohito Sone, MD, PhD, of Niigata University in Japan, and colleagues reported in the Journal of Clinical Endocrinology & Metabolism.

Although guidelines for diabetes care recommend reducing salt intake, the evidence has been based on studies of people without diabetes. Some work has suggested that reducing salt intake holds benefits for patients with type 2 diabetes, but the relationship between sodium intake and diabetes complications isn’t clear, the researchers said.

Sone and colleagues looked at data from 1,588 patients in the Japan Diabetes Complication Study, which involved 59 university and general hospitals in Japan. The prospective study set out to investigate the incidence of, and risk factors for, macrovascular and microvascular complications of diabetes.

The mean dietary salt intake ranged from 2.8 g in the lowest quartile to 5.9 g in the highest quartile (current daily goals for sodium intake are 1.5 g/day in the U.S., 2.36 g/day in Europe, and 3.9 g/day in Japan).

The researchers found in controlled analyses that during 8 years of follow-up, patients in the highest quartile of sodium intake had a twofold increased risk of cardiovascular disease than those in the lowest quartile (P=0.01).

They also reported that each 1-g/day increase in sodium intake was associated with an increased risk of heart and vascular disease (HR 1.20, 95% CI 1.03-1.41, P=0.02).

When broken down by blood sugar control, risk was dramatically elevated for patients in the top quartile of salt consumption compared with the bottom quartile if they had an HbA1c greater than 9% (HR 16.14 versus a nonsignificant HR 1.58), they found.

Risks of nephropathy, diabetic retinopathy, and all-cause mortality, however, weren’t associated with sodium intake.

The study had some limitations, including its observational nature which could not show “cause-effect relationships as to whether medical nutritional treatment encouraging sodium reduction would reduce incident [cardiovascular disease] in clinical practice,” the authors stated.

They concluded that the results “show that high dietary sodium intake is associated with an elevated incidence of cardiovascular disease in patients with type 2 diabetes, which supports current guidelines for patients with diabetes.”

The study was supported by the Ministry of Health, Labor and Welfare, Japan.

Sone disclosed receiving a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science. A co-author disclosed receiving a Grant-in-Aid from the Honjo International Scholarship Foundation and a grant from the University of Tsukuba Research Infrastructure Support Program.

The authors disclosed no relevant relationships with industry.

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