ArticleThe Journal of clinical endocrinology and metabolism2022
Low Serum Bicarbonate Levels Increase the Risk of All-Cause, Cardiovascular Disease, and Cancer Mortality in Type 2 Diabetes.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Positive association between LDH to albumin ratio and arthritis: A cross-sectional NHANES study (1999-2010).Medicine · 2026Article
- Article
- Diabetes-Specific Serum Calcium Thresholds for Mortality Risk: A NHANES Nutritional Epidemiology Study.Food science & nutrition · 2025Article
- Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV.Scientific reports · 2025Article
- Post-infectious cough in patients with obesity: an observational study.Frontiers in medicine · 2025Article
- Association of serum bicarbonate with 28-day and 90-day mortality in patients with epilepsy and concurrent sepsis: a retrospective cohort study.Frontiers in neurology · 2025Article
- Article
- Association of cardio-renal biomarkers and mortality in the U.S.: a prospective cohort study.Cardiovascular diabetology · 2023Article
- Relationship between baseline bicarbonate and 30-day mortality in patients with non-traumatic subarachnoid hemorrhage.Frontiers in neurology · 2023Article
- Relationship between serum bicarbonate levels and the risk of death within 30 days in ICU patients with acute ischemic stroke.Frontiers in neurology · 2023Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
contextThe evidence regarding bicarbonate status and mortality among diabetes is scarce.
objectiveThe purpose of this study was to investigate the associations of bicarbonate concentrations with risk of all-cause, cardiovascular disease (CVD), and cancer mortality among patients with type 2 diabetes (T2D).
methodsThis study included 8163 adult diabetic patients from the National Health and Nutrition Examination Survey (NHANES), 1999 to 2018. Death outcomes were ascertained by linkage to National Death Index records through 31 December 2019. The Cox proportional-risk model was used to estimate hazard ratios (HR) and 95% CIs for mortality from all causes, CVD, and cancer. The mediating effects of 11 metabolic, cardiovascular, and renal biomarkers were evaluated using a logistic regression model within a counterfactual framework.
resultsDuring 8163 person-years of follow-up, 2310 deaths were documented, including 659 CVD deaths and 399 cancer deaths. After multivariate adjustment, lower serum bicarbonate levels were significantly linearly correlated with higher all-cause, CVD, and cancer mortality: The risk of all-cause death increased by 40%, the risk of CVD death increased by 48%, and the risk of cancer death increased by 84% compared with the normal group (all P < .05). Altered levels of estimated glomerular filtration rate explained 12.10% and 16.94% of the relation between serum bicarbonate with all-cause and CVD mortality, respectively. Total cholesterol mediated 4.70% and 10.51% of the associations of all-cause and CVD mortality, respectively.
conclusionLower serum bicarbonate concentrations were significantly associated with higher all-cause, CVD, and cancer mortality. These findings suggest that maintaining adequate bicarbonate status may lower mortality risk in individuals with T2D.
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