The following is a summary of “Association of Urinary Nitrate With Diabetes Complication and Disease-Specific Mortality Among Adults With Hyperglycemia,” published in the June 2023 issue of Endocrinology & Metabolism by Jiang, et al.
Hyperglycemia disrupts the metabolism of nitrate/nitrite and nitric oxide, while dietary nitrate intake can restore nitric oxide balance. For a study, researchers sought to investigate the association between urinary nitrate levels and diabetes complications as well as long-term survival in individuals with hyperglycemia.
A total of 6,208 participants with hyperglycemia from the National Health and Nutrition Examination Survey (2005-2014) were included in the study. Diabetes complications, including congestive heart failure, coronary heart disease, angina, stroke, myocardial infarction, diabetic retinopathy, and nephropathy, were assessed. Mortality data were obtained from the National Death Index until 2015. Urinary nitrate levels were measured using ion chromatography coupled with electrospray tandem mass spectrometry and categorized into tertiles after log transformation. Logistic regression models and Cox proportional hazards models were used to evaluate the association between urinary nitrate levels and the risk of diabetes complications and disease-specific mortality.
After adjusting for potential confounders, including urinary perchlorate and thiocyanate, participants in the highest tertile of urinary nitrate had a lower risk of congestive heart failure (odds ratio [OR] 0.41; 95% CI, 0.27-0.60) and diabetic nephropathy (OR 0.50; 95% CI, 0.41-0.62) compared to those in the lowest tertile. During a total follow-up of 41,463 person-years, participants in the highest tertile had a lower risk of all-cause mortality (hazard ratio [HR] 0.78; 95% CI, 0.62-0.97), cardiovascular disease mortality (HR 0.56; 95% CI, 0.37-0.84), and diabetes-related mortality (HR 0.47; 95% CI, 0.24-0.90). These associations showed a dose-dependent linear relationship (P for nonlinearity > 0.05). There was no significant association between nitrate levels and cancer mortality (HR 1.13; 95% CI, 0.71-1.80).
Higher urinary nitrate levels were associated with a lower risk of congestive heart failure, diabetic nephropathy, and all-cause, cardiovascular disease, and diabetes-related mortality in individuals with hyperglycemia. The findings suggested that inorganic nitrate supplementation could be considered a complementary treatment for individuals with hyperglycemia.
Source: academic.oup.com/jcem/article/108/6/1318/6964614
