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Hyponatremia and osteoporosis: insights from the Danish National Patient Registry

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Abstract

Summary

The association between hyponatremia and osteoporosis was evaluated in humans. A significant association was found between low sodium levels, lower bone mineralization in the hip, and with several common conditions. Hyponatremia could be used as a marker of osteoporosis and systemic disease.

Introduction

The objective of this study was to evaluate the association between hyponatremia and osteoporosis in humans through a cross-sectional study.

Methods

Patient information was gathered from regional and national Danish patient databases, both in- and outpatient settings, from 2004 to 2011. Patients with dual-energy x-ray absorptiometry (DXA) scans performed within this time were included if accompanied [Na+] was measured within 14 days prior or past the scan date. A total of 1575 patients were included.

Results

A total of 104 patients were hyponatremic (6.6 %). Total hip and lumbar spine bone mineral content (BMC) and densities (BMD) and T-scores were all significantly lower with hyponatremia. The odds ratio (OR) of osteoporosis significantly increased among hyponatremic patients at both total hip (unadjusted OR = 2.17, 95 % CI = [1.40–3.34], p < .05) and lumbar spine (unadjusted OR = 1.83, 95 % CI = [1.20–2.80], p < .05) regions. Dose-response found between increasing [Na+] and increasing total hip BMC (slope .174, adjusted p < .05), BMD (slope .004, adjusted p < .05), and T-score (slope .034, adjusted p < .05). Systemic disease was more prevalent in hyponatremia.

Conclusion

The presence of hyponatremia increases the risk of concurrent osteoporosis at both the total hip and lumbar spine in humans. Hyponatremia could be used a screening tool and marker of secondary osteoporosis.

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Conflicts of interest

CK declares no competing interests. PE is an advisory board member with Amgen, MSD and Eli Lilly and at the speakers bureau with Amgen and Eli Lilly. PV has received unrestricted grants from MSD and Servier and travel grants from Amgen, Eli Lilly, Novartis, Sanofi-Aventis, and Servier.

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Authors and Affiliations

  1. Department of Endocrinology, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark

    C. Kruse & P. Vestergaard

  2. Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital Hilleroed, Hilleroed, Denmark

    P. Eiken

  3. Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    P. Eiken

  4. Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark

    P. Vestergaard

  5. Clinical Institute, Aalborg University Hospital, Aalborg, Denmark

    P. Vestergaard

Authors
  1. C. Kruse
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  3. P. Vestergaard
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Corresponding author

Correspondence to C. Kruse.

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Kruse, C., Eiken, P. & Vestergaard, P. Hyponatremia and osteoporosis: insights from the Danish National Patient Registry. Osteoporos Int 26, 1005–1016 (2015). https://doi.org/10.1007/s00198-014-2973-1

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  • DOI: https://doi.org/10.1007/s00198-014-2973-1

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