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Wu Q, Burley G, Li L, Lin S, Shi Y. The role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease. Diabetes Obes Metab 2023; 25:1147-1161. [PMID: 36655379 PMCID: PMC10946535 DOI: 10.1111/dom.14980] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
Dietary salt (NaCl) is essential to an organism's survival. However, today's diets are dominated by excessive salt intake, which significantly impacts individual and population health. High salt intake is closely linked to cardiovascular disease (CVD), especially hypertension, through a number of well-studied mechanisms. Emerging evidence indicates that salt overconsumption may also be associated with metabolic disorders. In this review, we first summarize recent updates on the mechanisms of salt-induced CVD, the effects of salt reduction and the use of salt substitution as a therapy. Next, we focus on how high salt intake can impact metabolism and energy balance, describing the mechanisms through which this occurs, including leptin resistance, the overproduction of fructose and ghrelin, insulin resistance and altered hormonal factors. A further influence on metabolism worth noting is the reported role of salt in inducing thermogenesis and increasing body temperature, leading to an increase in energy expenditure. While this result could be viewed as a positive metabolic effect because it promotes a negative energy balance to combat obesity, caution must be taken with this frame of thinking given the deleterious consequences of chronic high salt intake on cardiovascular health. Nevertheless, this review highlights the importance of salt as a noncaloric nutrient in regulating whole-body energy homeostasis. Through this review, we hope to provide a scientific framework for future studies to systematically address the metabolic impacts of dietary salt and salt replacement treatments. In addition, we hope to form a foundation for future clinical trials to explore how these salt-induced metabolic changes impact obesity development and progression, and to elucidate the regulatory mechanisms that drive these changes, with the aim of developing novel therapeutics for obesity and CVD.
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Affiliation(s)
- Qi Wu
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - George Burley
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
| | - Li‐Cheng Li
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Shu Lin
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yan‐Chuan Shi
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
- School of Clinical Medicine, St Vincent's Clinical CampusFaculty of Medicine and HealthSydneyNew South WalesAustralia
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NFAT5 Is Involved in GRP-Enhanced Secretion of GLP-1 by Sodium. Int J Mol Sci 2021; 22:ijms22083951. [PMID: 33921209 PMCID: PMC8069329 DOI: 10.3390/ijms22083951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Gastrin, secreted by G-cells, and glucagon-like peptide-1 (GLP-1), secreted by L-cells, may participate in the regulation of sodium balance. We studied the effect of sodium in mice in vivo and mouse ileum and human L-cells, on GLP-1 secretion, and the role of NFAT5 and gastrin-releasing peptide receptor (GRPR) in this process. A high-sodium diet increases serum GLP-1 levels in mice. Increasing sodium concentration stimulates GLP-1 secretion from mouse ileum and L-cells. GRP enhances the high sodium-induced increase in GLP-1 secretion. High sodium increases cellular GLP-1 expression, while low and high sodium concentrations increase NFAT5 and GRPR expression. Silencing NFAT5 in L-cells abrogates the stimulatory effect of GRP on the high sodium-induced GLP-1 secretion and protein expression, and the sodium-induced increase in GRPR expression. GLP-1 and gastrin decrease the expression of Na+-K+/ATPase and increase the phosphorylation of sodium/hydrogen exchanger type 3 (NHE3) in human renal proximal tubule cells (hRPTCs). This study gives a new perspective on the mechanisms of GLP-1 secretion, especially that engendered by ingested sodium, and the ability of GLP-1, with gastrin, to decrease Na+-K+/ATPase expression and NHE3 function in hRPTCs. These results may contribute to the better utilization of current and future GLP-1-based drugs in the treatment of hypertension.
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Martinelli J, Conde SR, de Araújo AR, Marcadenti A. Association between salt taste sensitivity threshold and blood pressure in healthy individuals: a cross-sectional study. SAO PAULO MED J 2020; 138:4-10. [PMID: 32130310 PMCID: PMC9673843 DOI: 10.1590/1516-3180.2019.0166.r1.02102019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/02/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hypertension is an important public health problem. Overweight and high salt intake are risk factors for its development. OBJECTIVE To evaluate the association between salt taste sensitivity threshold (STST) and blood pressure (BP) in healthy adults. DESIGN AND SETTING Cross-sectional study conducted in a private institution. METHODS 104 healthy adults (aged 18-59 years) were evaluated. Sociodemographic, clinical and dietary data were collected. Nutritional status and BP were assessed using body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). STST was assessed using graded saline solutions with sodium chloride concentrations ranging from 0.228 to 58.44 g/l. Identification of salty taste in solutions ≥ 3.652 g/l was used as the cutoff point for high STST. RESULTS Participants with high STST presented higher daily average intakes for energy (2017.4 ± 641.5 versus 1650.5 ± 357.7 kcal/day; P = 0.01) and sodium (3070.2 ± 1195.1 versus 2435.2 ± 963.6 mg/day; P = 0.01) and higher BMI (P = 0.008) and WC (P = 0.002). After adjustment for age, sex, sodium and potassium intake, WC and family history of hypertension, the averages for SBP and DBP in subjects with high STST were higher than in those with normal STST (SBP: 138.2 ± 1.7 versus 119.7 ± 0.9 mmHg; P < 0.001; DBP: 81.2 ± 1.9 versus 75.1 ± 1.0 mmHg; P = 0.008). CONCLUSION High STST was associated with elevated blood pressure in healthy adults, regardless of other risk factors for hypertension.
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Affiliation(s)
- Jéssica Martinelli
- Registered Nutritionist, School of Nutrition, Biological and Health Sciences Center, Universidade do Vale do Taquari (UNIVATES), Lajeado (RS) Brazil.
| | - Simara Rufatto Conde
- MSc. Registered Nutritionist, School of Nutrition, Biological and Health Sciences Center, Universidade do Vale do Taquari (UNIVATES), Lajeado (RS) Brazil.
| | - Aline Ramos de Araújo
- MSc. Registered Nutritionist, Postgraduate Program on Nutrition Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil.
| | - Aline Marcadenti
- PhD. Professor, Postgraduate Program on Health Sciences (Cardiology), Instituto de Cardiologia, Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre (RS); Professor, Postgraduate Program on Nutrition Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS); and Researcher, HCor Research Institute, Hospital do Coração (IP-HCor), São Paulo (SP), Brazil.
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Tan M, He FJ, Wang C, MacGregor GA. Twenty-Four-Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2019; 8:e012923. [PMID: 31295409 PMCID: PMC6662145 DOI: 10.1161/jaha.119.012923] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background In China, high sodium and low potassium intakes result in elevated blood pressure, a major cause of cardiovascular disease, yet the intake estimates lack accuracy and nutritional strategies remain limited. Methods and Results We aimed to determine sodium and potassium intake by systematically searching for and quantitatively summarizing all published 24‐hour urinary sodium and potassium data (ie, the most accurate method). MEDLINE, EMBASE, Scopus, China National Knowledge Infrastructure, and Wanfang were searched up to February 2019. All studies reporting 24‐hour urinary sodium or potassium in China were included; hospitalized patients were excluded. Data were pooled using random‐effects meta‐analysis and heterogeneity was explored with meta‐regression. Sodium data were reported in 70 studies (n=26 767), 59 of which also reported potassium (n=24 738). Mean sodium and potassium excretions were 86.99 mmol/24 h (95% CI, 69.88–104.10) and 14.65 mmol/24 h (95% CI, 11.10–18.20) in children aged 3 to 6 years, 151.09 mmol/24 h (95% CI, 131.55–170.63) and 25.23 mmol/24 h (95% CI, 22.37–28.10) in children aged 6 to 16 years, and 189.07 mmol/24 h (95% CI, 182.14–195.99) and 36.35 mmol/24 h (95% CI, 35.11–37.59) in adults aged >16 years. Compared with southern China, sodium intake was higher in northern China (P<0.0001) but is declining (P=0.0066). Conclusions Average sodium intake in all age groups across China is approximately double the recommended maximum limits, and potassium intake is less than half that recommended. Despite a decline, sodium intake in northern China is still among the highest in the world, and the North–South divide persists. Urgent action is needed to simultaneously reduce sodium and increase potassium intake across China.
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Affiliation(s)
- Monique Tan
- 1 Wolfson Institute of Preventive Medicine Barts and The London School of Medicine & Dentistry Queen Mary University of London London United Kingdom
| | - Feng J He
- 1 Wolfson Institute of Preventive Medicine Barts and The London School of Medicine & Dentistry Queen Mary University of London London United Kingdom
| | - Changqiong Wang
- 1 Wolfson Institute of Preventive Medicine Barts and The London School of Medicine & Dentistry Queen Mary University of London London United Kingdom
| | - Graham A MacGregor
- 1 Wolfson Institute of Preventive Medicine Barts and The London School of Medicine & Dentistry Queen Mary University of London London United Kingdom
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Goto R, Kondo T, Ono K, Kitano S, Miyakawa N, Watanabe T, Sakaguchi M, Sato M, Igata M, Kawashima J, Motoshima H, Matsumura T, Shimoda S, Araki E. Mineralocorticoid Receptor May Regulate Glucose Homeostasis through the Induction of Interleukin-6 and Glucagon-Like peptide-1 in Pancreatic Islets. J Clin Med 2019; 8:jcm8050674. [PMID: 31091693 PMCID: PMC6571682 DOI: 10.3390/jcm8050674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
Because the renin-angiotensin-aldosterone system influences glucose homeostasis, the mineralocorticoid receptor (MR) signal in pancreatic islets may regulate insulin response upon glucose load. Glucagon-like peptide-1 (GLP-1) production is stimulated by interleukin-6 (IL-6) in pancreatic α-cells. To determine how glucose homeostasis is regulated by interactions of MR, IL-6 and GLP-1 in islets, we performed glucose tolerance and histological analysis of islets in primary aldosteronism (PA) model rodents and conducted in vitro experiments using α-cell lines. We measured active GLP-1 concentration in primary aldosteronism (PA) patients before and after the administration of MR antagonist eplerenone. In PA model rodents, aldosterone decreased insulin-secretion and the islet/pancreas area ratio and eplerenone added on aldosterone (E+A) restored those with induction of IL-6 in α-cells. In α-cells treated with E+A, IL-6 and GLP-1 concentrations were increased, and anti-apoptotic signals were enhanced. The E+A-treatment also significantly increased MR and IL-6 mRNA and these upregulations were blunted by MR silencing using small interfering RNA (siRNA). Transcriptional activation of the IL-6 gene promoter by E+A-treatment required an intact MR binding element in the promoter. Active GLP-1 concentration was significantly increased in PA patients after eplerenone treatment. MR signal in α-cells may stimulate IL-6 production and increase GLP-1 secretion, thus protecting pancreatic β-cells and improving glucose homeostasis.
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Affiliation(s)
- Rieko Goto
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Tatsuya Kondo
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Kaoru Ono
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Sayaka Kitano
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Nobukazu Miyakawa
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Takuro Watanabe
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Masaji Sakaguchi
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Miki Sato
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Motoyuki Igata
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Junji Kawashima
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Hiroyuki Motoshima
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Takeshi Matsumura
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Seiya Shimoda
- Food and Health Sciences, Prefectural University of Kumamoto, Kumamoto, 862-8502, Japan.
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
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