Hyponatremia Independent of Osteoporosis is Associated with Fracture Occurrence
Hyponatremia Independent of Osteoporosis is Associated with Fracture Occurrence
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DOI：
10.2215/cjn.06120809
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发表时间：
2010-02-01
影响因子：
9.8
通讯作者：
Eustace, Joseph A.
中科院分区：
文献类型：
--
作者：
Kinsella, Sinead;Moran, Sarah;Eustace, Joseph A.
背景和目标：轻度低钠血症传统上被认为是良性的，但它可能与步态和注意力缺陷以及跌倒风险增加（可能导致骨折）有关。进行了一项回顾性研究，以量化低钠血症与骨折发生的关联，并检查这种关系是否独立于骨质疏松症。 设计、设置、参与者和测量：本研究分析了 1408 名连续女性患者，这些患者在 2006 年 9 月 1 日至 2007 年 4 月 11 日期间接受了骨矿物质密度测量 (Lunar IDXA)，并且拥有可用的实验室数据。自我报告的骨折发生是通过放射学报告或到骨折诊所就诊证实的。使用逻辑回归对低钠血症与骨折相关性的显着性和独立性进行量化。结果：平均（SD）血清钠（[Na+]）为140.6（3.0）mmol/L；平均（SD）血清钠（[Na+]）为140.6（3.0）mmol/L； 59 名 (4.2%) 的 [Na+] < 135 mmol/L。 45% 的受试者患有骨质疏松症，18% 的受试者有过骨折史。确诊骨折的患者中有 8.7% 存在低钠血症，而未确诊骨折的患者则有 3.2% 存在低钠血症（P < 0.001）。在控制年龄、T 分数、慢性肾病分期、骨质疏松危险因素（闭经、家族史、定期使用类固醇、吸烟史、饮酒、肝病史和低钙饮食）和骨质疏松治疗（钙和维生素 D 补充剂、抗吸收剂和激素替代疗法）的多变量逻辑回归分析中，[Na+] < 135 与[Na+] >= 135 mmol/L 相比，与骨折发生显着且独立相关（P < 0.01）。结论：轻度低钠血症可能是易于识别且潜在可改变的骨折危险因素。 Clin J Am Soc Nephrol 5: 275-280, 2010.doi: 10.2215/CJN.06120809
Background and objectives: Mild hyponatremia has traditionally been considered benign, but it may be associated with gait and attention deficits and an increased risk of falls that may result in fracture. A retrospective study was conducted to quantify the association of hyponatremia with fracture occurrence and to examine whether this relationship is independent of osteoporosis.Design, setting, participants, & measurements: This study analyzed 1408 consecutive female patients who underwent bone mineral density measurement (Lunar IDXA) between September 1, 2006 and April 11, 2007 and who had available laboratory data. Self reported fracture occurrence was confirmed by radiology report or attendance at a fracture clinic. The significance and independence of the association of hyponatremia with fracture was quantified using logistic regression.Results: The mean (SD) serum sodium ([Na+]) was 140.6 (3.0) mmol/L; 59 (4.2%) had [Na+] < 135 mmol/L. Forty-five percent of subjects were osteoporotic and 18% had a prior fracture. Hyponatremia was present in 8.7% of those with versus 3.2% of those without a confirmed fracture (P < 0.001). On multivariate logistic regression analysis controlling for age, T-score, chronic kidney disease stage, osteoporotic risk factors (amenorrhea, family history, regular steroid use, smoking history, alcohol use, history of liver disease, and low-calcium diet), and osteoporosis treatments (calcium and vitamin D supplements, antiresorptives, and hormonal replacement therapy), [Na+] < 135 versus [Na+] >= 135 mmol/L remained significantly and independently associated with fracture occurrence (P < 0.01).Conclusions: Mild hyponatremia may be a readily identifiable and potentially modifiable risk factor for fracture. Clin J Am Soc Nephrol 5: 275-280, 2010. doi: 10.2215/CJN.06120809