The effects of acute hyponatraemia on bone turnover in patients with subarachnoid haemorrhage: A preliminary report.

Abstract:

CONTEXT:Animal data and cross-sectional human studies have established that chronic hyponatraemia predisposes to osteoporosis; the effects of acute hyponatraemia on bone turnover have not been determined. Our objective was to test the hypothesis that acute hyponatraemia leads to dynamic effects on bone turnover. DESIGN:A prospective observational pilot study. METHODS:Bone turnover markers [C-terminal crosslinking telopeptide of type 1 collagen (CTX-1), N-propeptide of type 1 collagen (P1NP) and osteocalcin] were measured prospectively over one week in 22 eunatraemic patients with subarachnoid haemorrhage. Patients treated with glucocorticoids were excluded. RESULTS:Eight patients developed acute hyponatraemia, median nadir plasma sodium concentration 131 mmol/L (IQR 128-132), and 14 remained eunatraemic, nadir plasma sodium concentration 136 mmol/L (IQR 133-137). Significant main effects of hyponatraemia were found for P1NP (p = .02) and P1NP:CTX-1 ratio (p = .02), both fell in patients with acute hyponatraemia, with significant interaction between hyponatraemia and time from baseline for P1NP (p = .02). Significant main effects of time from baseline (p < .001) but not hyponatraemia (p = .07) were found for osteocalcin. For CTX-1, significant main effects of time from baseline (p = .001) but not hyponatraemia (p = .65) were found. There was a positive correlation between change in P1NP:CTX-1 ratio and nadir plasma sodium concentration, r = +.43, p = .04. Median serum cortisol (measured on days 1, 3 and 7) was higher in the hyponatraemia group than in those who remained eunatraemic, 545 nmol/L (IQR 373-778) versus 444 nmol/L (IQR 379-542) p = .03. CONCLUSION:These data suggest that acute mild hyponatraemia is associated with a reduction in bone formation activity.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Garrahy A,Galloway I,Hannon AM,Dineen R,Javadpour M,Tormey WP,Gan KJ,Twomey PJ,Mc Kenna MJ,Kilbane M,Crowley RK,Sherlock M,Thompson CJ

doi

10.1111/cen.14367

subject

Has Abstract

pub_date

2020-11-11 00:00:00

eissn

0300-0664

issn

1365-2265

pub_type

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