What Is The Normal Level Of Potassium – Objective: To examine whether serum levels of potassium and sodium are associated with long-term cancer risk in healthy men at baseline.

Patients and methods : A group of 1994 initially healthy men who do not use drugs, aged 40-59 years, followed by cancer during 40 years of follow-up. The association between fasting electrolyte levels and cancer risk was assessed by incidence rates and Cox proportional hazards models.

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Results: Potassium, but not sodium, was directly related to cancer risk. This association remained significant after adjustment for multiple confounding factors, and after excluding the first 10 years of follow-up. The age-adjusted risk for all cancers increased by 16% for each SD increase in potassium level. Men with hyperkalemia showed a 40% higher increase rate than men with normal potassium levels.

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Conclusion: Fasting serum potassium levels in healthy men were positively related to long-term cancer risk. Potassium or potassium ion channels may play a role in cell proliferation or differentiation. These findings may inform future cancer strategies to target individuals with high serum potassium levels.

Electrolyte levels of potassium and sodium have been a topic of interest in the aetiology of cancer for many years. In the 1980s, many observations raised the suspicion that cancer is linked to food or the body’s content of potassium and sodium.

Recently, the structure and function of specific ion channels have been suggested to be involved in tumor development and progression.

Moreover, high levels of potassium and low levels of sodium have been found in patients with various types of cancer,

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Therefore, the extracellular electrolyte concentration may be associated with the diagnosis of cancer, either because the formation of electrolytes can facilitate the development of cancer or because of an undiagnosed cancer. However, the connection between potassium or sodium and the development of cancer has not been studied in healthy people.

In the present study, we aimed to objectively examine the relationship between fasting serum levels of sodium and potassium in early healthy age and the incidence of cancer during a 40-year follow-up.

The Oslo Ischemia Study is a comprehensive health study established in 1972 that aims to examine risk factors for heart disease and other cardiovascular diseases in healthy men. A total of 2341 male employees in five companies in Oslo, Norway, aged 40-59 years, were invited to participate in the period August 1972-March 1975. days. Among those invited, 2014 (86%) agreed to participate and completed the study protocol. At inclusion, all participants were extensively reviewed for medical history, clinical and physical examinations (including measurements of body height and weight), a panel of blood tests, and an advanced cycling endurance test. In addition, information on lifestyle (eg, smoking habits) was collected with a questionnaire. Detailed procedures for selection and implementation have been described previously.

The outcome of the study was the incidence of all site- and site-specific cancers. Information on cancer and vital status was obtained by linking cohort data to the Norwegian Cancer Registry using the 11 personal identification number assigned to all Norwegian citizens after 1960. all negatives from several independent sources confirm the completeness of the data and the high quality of the data, where the percentage of morphologically verified cases was 94%.

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Cancer data obtained include information on cancer location based on the 7th (previous period; 1970-1992) and 10th (latest period; 1993-present) editions of the World Health Organization’s International Classification of Diseases and the date of diagnosis.

At enrollment, all participants provided informed consent according to the Declaration of Helsinki. In the 1990s, after the increase in privacy awareness, the Data Protection Authority re-examined the inclusion process of the Oslo Ischemia Study and judged participation in accordance with provisions in written informed consent. The study was further approved by the Regional Committees for Medical and Health Research, Norway.

Blood samples for the determination of sodium and potassium were made after fasting for 12 h and after 8 h of smoking cessation. Repeated analysis of blood samples showed high accuracy.

Electrolyte was considered as a continuous substance and as a variable substance. Continuous correlations are given in 1 standard deviation (SD) increments. A potassium level below the normal range was classified as hypokalemia (≤3.5 mmol/L), and hyperkalemia if higher (>5.0 mmol/L).

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Normal levels are divided into three equal categories both for potassium (3.6-4.0, 4.1-4.5, and 4.6-5.0 mmol/L) and sodium (136-138, 139-142, and 143-145 mmol/L). L). The ratio of sodium to potassium is calculated as a measure of the electrical potential of the cell.

). Physical fitness was measured as total work (ie, the sum of work done in the cycling test) divided by body weight (kJ/kg). Information on smoking habits was collected from a questionnaire, and individuals were classified as “never”, “former”, or “current” smokers. The erythrocyte sedimentation rate was determined by the Westergren method (mm/hour). In addition, serum creatinine (mg/dL), triglyceride (mmol/L), and total cholesterol (mmol/L) were measured in all subjects.

A group of men were followed by cancer throughout 2012. For the 2014 men included, we excluded two men with missing important data and 15 men due to a cancer diagnosis before the date of the examination. In addition, three men did not receive the value of potassium or sodium. Therefore, 1994 men remained in the cohort for statistical analysis.

Descriptive analysis was performed on the basic characteristics and presented as frequencies, ratio, mean, SD, and range. Tests of significance for all planned variables for potassium and sodium were performed by the Wilcoxon test.

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Men were followed longitudinally from the date of examination (baseline) to the date of cancer diagnosis, death, migration, age 85, or end of follow-up, whichever occurred first.

The overall cancer risk by electrolyte concentration levels was expressed as age-adjusted incidence rates per 1000 person-years. Graphically, the cumulative incidence of overall cancer in the presence of competing risk factors was obtained by Aalen-Johansen estimation.

The relative risk of all site cancer was analyzed with a set of Cox-regression models. To examine the potential bias caused by death as a competing event, the same set of regression models was performed with death without previous cancer as the event of interest.

For each regression model, hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Impure models and age-adjusted models were made, in addition to the following models that could include covariates: body mass index, smoking, physical fitness, triglycerides, cholesterol, creatinine, and sedimentation rate, all measured at baseline. In addition, the level of sodium or potassium is included in the model to investigate the independent effects of electrolytes. The extent of the perceived risks was met by all people who interacted with them, except for smoking. Thus, we performed a stratified Cox model on smoking, where baseline risks were allowed to differ between non-, former, and current smokers. No interaction between the exposure of interest (potassium and sodium) and adjusting covariates was observed.

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To examine the continuous relationship between electrolytes and overall cancer risk we graphically presented the smoothed risk estimates adjusted for Cox-regression analysis. A restricted cubic spline function with four nodes selected according to Harrell’s recommended percentages was used for this purpose.

When studying potassium, a secondary analysis is performed. First, to examine the possibility of reversing the causality (ie, where the high levels of potassium come from the ongoing cancer) we did a limited analysis on men who are already alive and have no cancer 10 years after the baseline, ie, the first 10 years. Observations are excluded and a new zero period is set 10 years after the initial baseline. Second, we calculated the risk of the most common cancers in the study group by potassium levels. An age-adjusted Cox model was used for this purpose due to the small number of events in most cancer sites.

Finally, the association between the sodium-to-potassium ratio and the risk of cancer was examined in a similar manner to the cell’s electrical potential.

The mean age at inclusion in the study was 49.8 years (SD 5.5 years). The values ​​of potassium and sodium were 4.3 mmol/L (SD 0.35, range 1.9-7.0) and 141 mmol/L (SD 3.5, range 107-161), respectively (Table 1). During follow-up (median 26.4 years, range 0.1-40.3 years), 710 men were diagnosed with cancer, and 1248 deaths occurred (739 without previous cancer).

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The potassium level is positively associated with age, sedimentation rate, sodium and the presence of smoking, and is negatively associated with body mass index and fitness while the sodium level is positively associated with creatinine and potassium and is negatively associated with the sedimentation rate (Table 2).

Table 2 Summary of Study Group Characteristics Determined by Fasting Levels of (A) Potassium and (B) Sodium (mmol/L) in Five Groups

An increase in the level of potassium increases the overall risk of cancer everywhere; age-specific incidence rates were 2.1, 12.3, 14.5, 14.9, and 20.3 per 1000 person-years for potassium levels ≤3.5, 3.6-4.0, 4.1-4.5, 4.6-5.0, and >5.0 mmol/T respectively 3). Men with hyperkalemia showed an incidence rate that was 40% higher than

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