Hyponatremia independent of osteoporosis is associated with fracture occurrence.
Kinsella, Sinead Moran, Sarah Sullivan, Miriam O Molloy, Michael G M Eustace, Joseph A
Kinsella, Sinead
Moran, Sarah
Sullivan, Miriam O
Molloy, Michael G M
Eustace, Joseph A
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Editors
Other Contributors
Date
2010-02
Date Submitted
Keywords
Other Subjects
Subject Mesh
Absorptiometry, Photon
Accidental Falls
Adult
Aged
Aged, 80 and over
Biological Markers
Bone Density
Chi-Square Distribution
Female
Fractures, Bone
Gait Disorders, Neurologic
Humans
Hyponatremia
Logistic Models
Middle Aged
Odds Ratio
Osteoporosis
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Sodium
Young Adult
Accidental Falls
Adult
Aged
Aged, 80 and over
Biological Markers
Bone Density
Chi-Square Distribution
Female
Fractures, Bone
Gait Disorders, Neurologic
Humans
Hyponatremia
Logistic Models
Middle Aged
Odds Ratio
Osteoporosis
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Sodium
Young Adult
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Mild hyponatremia has traditionally been considered benign, but it may be associated with gait and attention deficits and an increased risk of falls that may result in fracture. A retrospective study was conducted to quantify the association of hyponatremia with fracture occurrence and to examine whether this relationship is independent of osteoporosis.
This study analyzed 1408 consecutive female patients who underwent bone mineral density measurement (Lunar IDXA) between September 1, 2006 and April 11, 2007 and who had available laboratory data. Self reported fracture occurrence was confirmed by radiology report or attendance at a fracture clinic. The significance and independence of the association of hyponatremia with fracture was quantified using logistic regression.
The mean (SD) serum sodium ([Na(+)]) was 140.6 (3.0) mmol/L; 59 (4.2%) had [Na(+)] < 135 mmol/L. Forty-five percent of subjects were osteoporotic and 18% had a prior fracture. Hyponatremia was present in 8.7% of those with versus 3.2% of those without a confirmed fracture (P < 0.001). On multivariate logistic regression analysis controlling for age, T-score, chronic kidney disease stage, osteoporotic risk factors (amenorrhea, family history, regular steroid use, smoking history, alcohol use, history of liver disease, and low-calcium diet), and osteoporosis treatments (calcium and vitamin D supplements, antiresorptives, and hormonal replacement therapy), [Na(+)] < 135 versus [Na(+)] >or= 135 mmol/L remained significantly and independently associated with fracture occurrence (P < 0.01).
Mild hyponatremia may be a readily identifiable and potentially modifiable risk factor for fracture.
This study analyzed 1408 consecutive female patients who underwent bone mineral density measurement (Lunar IDXA) between September 1, 2006 and April 11, 2007 and who had available laboratory data. Self reported fracture occurrence was confirmed by radiology report or attendance at a fracture clinic. The significance and independence of the association of hyponatremia with fracture was quantified using logistic regression.
The mean (SD) serum sodium ([Na(+)]) was 140.6 (3.0) mmol/L; 59 (4.2%) had [Na(+)] < 135 mmol/L. Forty-five percent of subjects were osteoporotic and 18% had a prior fracture. Hyponatremia was present in 8.7% of those with versus 3.2% of those without a confirmed fracture (P < 0.001). On multivariate logistic regression analysis controlling for age, T-score, chronic kidney disease stage, osteoporotic risk factors (amenorrhea, family history, regular steroid use, smoking history, alcohol use, history of liver disease, and low-calcium diet), and osteoporosis treatments (calcium and vitamin D supplements, antiresorptives, and hormonal replacement therapy), [Na(+)] < 135 versus [Na(+)] >or= 135 mmol/L remained significantly and independently associated with fracture occurrence (P < 0.01).
Mild hyponatremia may be a readily identifiable and potentially modifiable risk factor for fracture.
Language
en
ISSN
1555-905X
eISSN
ISBN
DOI
10.2215/CJN.06120809
PMID
20056759