Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in Patients With Type 2 Diabetes: A Cross-Section Study

Abstract Background: It has been well documented that left ventricular hypertrophy (LVH) is highly associated with incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake has been observed related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.Methods: A total of 1356 patients with T2DM were recruited. Urinary sodium was measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. LVH was assessed by echocardiography. The associations between urinary sodium excretion and the risk factors for cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines.Results: Urinary sodium excretion levels was positively associated with cardiometabolic risk factors, including systolic blood pressure (P<0.001), body mass index (P<0.001), waist circumference (P<0.001) and LVMI (P<0.001). In multivariable logistic regression analyses, increased urinary sodium excretion were significantly associated with increased risks of LVH [OR (95% CI), 1.47 (1.02-2.10); P=0.037] and CVD [OR (95% CI), 2.08 (1.20-3.61); P=0.009], after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted restricted cubic spline analyses of the association between urinary sodium excretion and LVMI showed a significant association (P=0.002) and provided no evidence of a nonlinear association (P=0.135).Conclusions: This study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake is valuable in the prevention of diabetic cardiovascular complications.