Abstract
Low serum sodium levels were associated with increased prevalence of osteoporosis and fractures. The aim of the study was to assess the relationship between serum sodium and bone mineral density and/or osteoporotic fractures� prevalence in elderly people. A total number of 260 patients (23 men / 237 women), aged 66.5 � 12.8 years, were retrospectively assessed. Serum sodium levels were measured in all patients. Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA). Results: serum natremia was 140.3 � 4.4 mmol/L; prevalence of hyponatremia was 7.3%; frailty fractures were present in 117 out of 260 patients (45%). Patients with fractures had lower serum sodium levels as compared to patients without fractures (139 � 3.9 vs. 141.5 � 4.6 mmol/L, p [ 0.001). Patients with osteoporosis (n = 179) also showed lower natremia as compared to patients with normal BMD and osteopenia (n = 81): 139.9 � 4.7 vs. 141.2 � 3.8 mmol/L, p = 0.035. In patients admitted in the hospital for fractures (n = 92), prevalence of hyponatremia was 13.04%. Hyponatremic patients had significantly higher prevalence of fractures (73.7% vs. 42.7%, p = 0.0147) as compared to normonatremic patients. Odds ratio (OR) for fractures in patients with hyponatremia was 3.75 [95% C.I.: 1.3-10.75], p = 0.0138; OR for hip fractures in patients with hyponatremia was 3.65 [95% C.I.: 1.38-9.64], p = 0.0089. Both incidence and prevalence of hyponatremia increase with age, especially in patients treated with diuretics. Several clinical studies found an association between mild chronic hyponatremia in elderly and increased odds ratio of osteoporosis at the total and at femoral neck; the study also showed an increased odds ratio for all fractures and for hip fractures in hyponatremic patients. Elderly people at risk of osteoporotic fractures should have sodium serum measured.
Highlights
Low serum sodium levels were associated with increased prevalence of osteoporosis and fractures
Chronic hyponatremia was associated with cognitive dysfunction, impaired attention, unsteady gait, leading to falls; on the other hand, hyponatremia was recently proved to be directly involved in bone remodelling, by increasing osteoclastic activity and decreasing bone mineralization, decreasing bone mineral mass [12]
Hyponatremia was associated with falls and bone fractures especially in elderly women, users of thiazide diuretics and anti-depressant [1]
Summary
Low serum sodium levels were associated with increased prevalence of osteoporosis and fractures. REV.CHIM.(Bucharest)♦69♦No.12♦2018 patients (23 men / 237 women), aged 66.5 ± 12.8 years (range 30-95 years), hospitalized either in a tertiary endocrine center for bone mineral density (BMD) assessment (group I, n = 168) or in two orthopedics departments of emergency hospitals for hip and distal forearm fractures secondary to falls (group II, n = 92).
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