Hyponatremia and fractures: Findings from the MrOS study

Sophie A. Jamal, Spyridon Arampatzis, Stephanie Litwack Harrison, Roxana C. Bucur, Kristine Ensrud, Eric S. Orwoll, Douglas C. Bauer

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)970-975
Number of pages6
JournalJournal of Bone and Mineral Research
Volume30
Issue number6
DOIs
StatePublished - Jun 1 2015

Keywords

  • DXA
  • FRACTURE RISK ASSESSMENT
  • GENERAL POPULATION STUDIES
  • OSTEOPOROSIS
  • SYSTEMS BIOLOGY - BONE INTERACTIONS

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Hyponatremia and fractures: Findings from the MrOS study'. Together they form a unique fingerprint.

  • Cite this

    Jamal, S. A., Arampatzis, S., Harrison, S. L., Bucur, R. C., Ensrud, K., Orwoll, E. S., & Bauer, D. C. (2015). Hyponatremia and fractures: Findings from the MrOS study. Journal of Bone and Mineral Research, 30(6), 970-975. https://doi.org/10.1002/jbmr.2383