THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Area of Science:

• Endocrinology and Bone Metabolism
• Geriatric Medicine
• Epidemiology

Background:

• Hyponatremia is linked to reduced bone mineral density.
• It is a significant risk factor for fragility fractures.
• The impact of hyponatremia on bone health and mortality requires comprehensive analysis.

Purpose of the Study:

• To systematically review and meta-analyze the effects of hyponatremia on bone fractures.
• To assess the association between hyponatremia and osteoporosis.
• To evaluate the impact of hyponatremia on mortality risk.

Main Methods:

• Systematic review and meta-analysis of studies from Medline, Cochrane Central, and EMBASE (1960-2017) and conference abstracts (2007-2017).
• Inclusion criteria: studies reporting serum sodium, fractures, bone density, or osteoporosis diagnoses.
• Random effects models meta-analysis used for outcomes with at least three studies; bias assessed using Newcastle-Ottawa scale.

Main Results:

• Hyponatremia significantly increased the odds of fractures (OR, 2.34; 95% CI, 1.86-2.96).
• Increased odds of osteoporosis were observed (OR, 2.67; 95% CI, 2.07-3.43).
• Mortality risk was elevated in patients with hyponatremia (OR, 1.31; 95% CI, 1.16-1.47).

Conclusions:

• This meta-analysis confirms a significant association between hyponatremia, bone fractures, and osteoporosis.
• Hyponatremia is linked to increased mortality.
• Further long-term prospective studies are needed to evaluate the impact of correcting hyponatremia on bone health and mortality.