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Hyponatremia-Induced Osteoporosis
There is a high prevalence of chronic hyponatremia in the elderly, frequently owing to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Recent reports have shown that even mild hyponatremia is associated with impaired gait stability and increased falls. An increased risk of fall...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Subscription Services, Inc., A Wiley Company
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153395/ https://www.ncbi.nlm.nih.gov/pubmed/19751154 http://dx.doi.org/10.1359/jbmr.090827 |
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author | Verbalis, Joseph G Barsony, Julianna Sugimura, Yoshihisa Tian, Ying Adams, Douglas J Carter, Elizabeth A Resnick, Helaine E |
author_facet | Verbalis, Joseph G Barsony, Julianna Sugimura, Yoshihisa Tian, Ying Adams, Douglas J Carter, Elizabeth A Resnick, Helaine E |
author_sort | Verbalis, Joseph G |
collection | PubMed |
description | There is a high prevalence of chronic hyponatremia in the elderly, frequently owing to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Recent reports have shown that even mild hyponatremia is associated with impaired gait stability and increased falls. An increased risk of falls among elderly hyponatremic patients represents a risk factor for fractures, which would be further amplified if hyponatremia also contributed metabolically to bone loss. To evaluate this possibility, we studied a rat model of SIADH and analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III). In rats, dual-energy X-ray absorptiometry (DXA) analysis of excised femurs established that hyponatremia for 3 months significantly reduced bone mineral density by approximately 30% compared with normonatremic control rats. Moreover, micro-computed tomography (µCT) and histomorphometric analyses indicated that hyponatremia markedly reduced both trabecular and cortical bone via increased bone resorption and decreased bone formation. Analysis of data from adults in NHANES III by linear regression models showed that mild hyponatremia is associated with increased odds of osteoporosis (T-score –2.5 or less) at the hip [odds ratio (OR) = 2.85; 95% confidence interval (CI) 1.03–7.86; p < .01]; all models were adjusted for age, sex, race, body mass index (BMI), physical activity, history of diuretic use, history of smoking, and serum 25-hydroxyvitamin D [25(OH)D] levels. Our results represent the first demonstration that chronic hyponatremia causes a substantial reduction of bone mass. Cross-sectional human data showing that hyponatremia is associated with significantly increased odds of osteoporosis are consistent with the experimental data in rodents. Our combined results suggest that bone quality should be assessed in all patients with chronic hyponatremia. © 2010 American Society for Bone and Mineral Research. |
format | Online Article Text |
id | pubmed-3153395 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Wiley Subscription Services, Inc., A Wiley Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-31533952011-08-19 Hyponatremia-Induced Osteoporosis Verbalis, Joseph G Barsony, Julianna Sugimura, Yoshihisa Tian, Ying Adams, Douglas J Carter, Elizabeth A Resnick, Helaine E J Bone Miner Res Original Article There is a high prevalence of chronic hyponatremia in the elderly, frequently owing to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Recent reports have shown that even mild hyponatremia is associated with impaired gait stability and increased falls. An increased risk of falls among elderly hyponatremic patients represents a risk factor for fractures, which would be further amplified if hyponatremia also contributed metabolically to bone loss. To evaluate this possibility, we studied a rat model of SIADH and analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III). In rats, dual-energy X-ray absorptiometry (DXA) analysis of excised femurs established that hyponatremia for 3 months significantly reduced bone mineral density by approximately 30% compared with normonatremic control rats. Moreover, micro-computed tomography (µCT) and histomorphometric analyses indicated that hyponatremia markedly reduced both trabecular and cortical bone via increased bone resorption and decreased bone formation. Analysis of data from adults in NHANES III by linear regression models showed that mild hyponatremia is associated with increased odds of osteoporosis (T-score –2.5 or less) at the hip [odds ratio (OR) = 2.85; 95% confidence interval (CI) 1.03–7.86; p < .01]; all models were adjusted for age, sex, race, body mass index (BMI), physical activity, history of diuretic use, history of smoking, and serum 25-hydroxyvitamin D [25(OH)D] levels. Our results represent the first demonstration that chronic hyponatremia causes a substantial reduction of bone mass. Cross-sectional human data showing that hyponatremia is associated with significantly increased odds of osteoporosis are consistent with the experimental data in rodents. Our combined results suggest that bone quality should be assessed in all patients with chronic hyponatremia. © 2010 American Society for Bone and Mineral Research. Wiley Subscription Services, Inc., A Wiley Company 2010-03 2009-08-31 /pmc/articles/PMC3153395/ /pubmed/19751154 http://dx.doi.org/10.1359/jbmr.090827 Text en Copyright © 2010 American Society for Bone and Mineral Research http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation. |
spellingShingle | Original Article Verbalis, Joseph G Barsony, Julianna Sugimura, Yoshihisa Tian, Ying Adams, Douglas J Carter, Elizabeth A Resnick, Helaine E Hyponatremia-Induced Osteoporosis |
title | Hyponatremia-Induced Osteoporosis |
title_full | Hyponatremia-Induced Osteoporosis |
title_fullStr | Hyponatremia-Induced Osteoporosis |
title_full_unstemmed | Hyponatremia-Induced Osteoporosis |
title_short | Hyponatremia-Induced Osteoporosis |
title_sort | hyponatremia-induced osteoporosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153395/ https://www.ncbi.nlm.nih.gov/pubmed/19751154 http://dx.doi.org/10.1359/jbmr.090827 |
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