Sodium and potassium excretion are related to bone mineral density in women with coeliac disease

Abstract

Women with coeliac disease may have a lower bone mineral density due to the malabsorption of calcium before diagnosis. A high sodium excretion is associated with increased calcium and bone loss. Our aim was to describe the bone mineral density (BMD) and sodium excretion in women with coeliac disease. In a cross-sectional study BMD of the lumbar spine and hip was assessed by dual energy X-ray absorptiometry. Sodium, potassium and calcium excretion were measured from a 24 h urine collection. In 33 women (51 ± 16 yr) BMD was 1.14 ± 0.19 g/cm(2) and 0.94 ± 0.14 g/cm(2) at the lumbar spine and hip respectively. Age matched Z-scores were -0.1 ± 1.2 and -0.3 ± 1.1 at lumbar spine and hip respectively. Sodium excretion was 107 ± 51 mmol/d; 14 (42%) had a sodium excretion >100 mmol Na/d (145 ± 45 mmol/d). Potassium and calcium excretion were 87 ± 25 mmol/d and 4.1 ± 2.0 mmol/d respectively. In women with Na excretion >100 mmol Na/d, Ca excretion was significantly greater than those with <100 mmol/d (4.9 ± 2.0 vs 3.4 ± 1.8, p < 0.05). Sodium excretion and BMI were positively correlated (r = 0.61, p < 0.001) as were sodium and calcium excretion (r = 0.43, p < 0.05). Sodium excretion was inversely related to femoral neck BMD (t = -2.4 p = 0.023) after adjustment for weight, age, years since diagnosis and potassium excretion. Weight, but no other variable, was a predictor of BMD at the lumbar spine (t = 2.58 p = 0.018). Sodium excretion was inversely related and potassium excretion positively related to femoral neck density which was similar to age matched women without coeliac disease.