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2015 ; 30
(6
): 970-5
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Hyponatremia and Fractures: Findings From the MrOS Study
#MMPMID25294595
Jamal SA
; Arampatzis S
; Harrison SL
; Bucur RC
; Ensrud K
; Orwoll ES
; Bauer DC
J Bone Miner Res
2015[Jun]; 30
(6
): 970-5
PMID25294595
show ga
Hyponatremia may be a risk factor for fracture. To determine the relationship
between hyponatremia and fracture we conducted cross-sectional and longitudinal
analyses using data from the Osteoporotic Fractures in Men (MrOS) study. The MrOS
study enrolled 5122 community dwelling men aged ?65 years from six centers across
the United States. We excluded men taking bisphosphonates, those with unknown
medication history, those without serum sodium measures, or those with out of
range assays for serum sodium. Serum sodium was measured at study entry. Subjects
were followed for fractures (nonspine [including hip], hip, incident
morphometric, and prevalent morphometric) for up to 9 years. We used Cox
proportional hazards models to analyze the association between serum sodium
levels (<135?mmol/L versus ?135?mmol/L) and risk of nonspine and hip fractures,
with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs).
We examined the association between morphometric vertebral fractures and serum
sodium using logistic regression models, presented as odds ratios (ORs) and 95%
CI. Hyponatremia was observed in 64 men (1.2% of the cohort). After adjusting for
age, BMI, study center, and other covariates, we found that, compared to men with
serum sodium ?135?mmol/L, those with serum sodium <135?mmol/L, had an increased
risk of hip fracture (HR?=?3.04; 95% CI, 1.37 to 6.75), prevalent morphometric
spine fracture (OR?=?2.46; 95% CI, 1.22 to 4.95), and incident morphometric spine
fracture (OR?=?3.53; 95% CI, 1.35 to 9.19), but not nonspine fracture (OR?=?1.44;
95% CI, 0.85 to 2.44). Adjusting for bone mineral density (BMD) did not change
our findings. Our data show that hyponatremia is associated with up to a doubling
in the risk of hip and morphometric spine fractures, independent of BMD. Further
studies, to determine how hyponatremia causes fractures and if correction of
hyponatremia decreases fractures, are needed.
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