![]() ![]() Sodium is an abundant mineral in the bone, wherein roughly 40% of sodium can be rapidly exchanged with sodium in circulation ( 10). Such hyponatremia is associated with a range of adverse clinical findings and pathophysiological changes in patients with T2D ( 9). Sodium is an essential element for normal physiological processes, and patients with T2D may experience osmotic diuresis as a consequence of disease-related hyperglycemia, contributing to the excess excretion of sodium in the urine and resulting in hyponatremia ( 8). As such, further research clarifying the risk factors associated with low bone turnover in patients with T2D and efforts to facilitate appropriate interventions represent a critical component of T2D management. Several reports have documented significant reductions in these BTMs levels in patients with T2D relative to matched populations unaffected by T2D ( 5– 7). This turnover process can be noninvasively and repeatedly monitored through the assessment of bone biopsy-validated bone turnover markers (BTMs) ( 4). Bone turnover is a continuous process critical for bone health that entails both the resorption and formation of bone such that old, worn bone tissue is replaced with a new calcified matrix ( 3). ![]() Relative to matched populations without T2D, individuals affected by this metabolic disease may exhibit normal or slightly increased bone mineral density (BMD) such that this parameter may not effectively reflect the risk of fragility fractures in this patient cohort ( 2). Linear regression analyses revealed that following adjustment for potential covariates, serum sodium level was and positively significantly associated with lnOC level ( β = 0.134, t = 2.281, p < 0.05) and PINP level ( β = 0.179, t = 3.023, p < 0.01).Ĭonclusion: These results highlight a significant association between low-normal serum sodium levels and low bone turnover.įragility fractures are a common complication in patients with type 2 diabetes (T2D), contributing to high rates of morbidity and mortality together with mounting public health costs ( 1). Only after adjusting for these four factors a positive correlation was detected between serum sodium levels and CTx levels ( r = 0.108, p < 0.05). A positive correlation was detected between serum sodium levels and both lnOC ( r = 0.210, p < 0.001) and lnPINP ( r = 0.196, p < 0.001), with these relationships remaining significant even following adjustment for age, sex, body mass index (BMI), and HbA1c. Serum OC and PINP levels were increased from subgroup with the low sodium tertile to that with the high sodium tertile ( p for trend < 0.05), whereas CTx level was comparable among the subgroups. Results: In total, 372 patients with T2D and sodium levels in the normal range were enrolled in this study. Patients were stratified into three subgroups based on the tertiles of their serum sodium concentrations. BTMs included bone formation markers osteocalcin (OC) and N-terminal propeptide of type-I procollagen (PINP), and bone resorption marker C-terminal telopeptide (CTx). All patients underwent analyses of serum sodium levels, oral glucose tolerance testing (OGTT), bone turnover markers (BTMs), and dual-energy X-ray absorptiometry (DXA) scanning. Methods: Patients with T2D were enrolled in the present study from January 2021 to April 2022. Accordingly, this study was developed to examine the relationships between normal serum sodium concentrations and bone turnover in patients with type 2 diabetes (T2D). However, researches have also revealed that lower serum sodium are linked to reductions in muscle mass and a higher risk of cardiovascular disease even when these levels are within the normal range. 3Department of Ophthalmology, Affiliated Hospital 2 of Nantong University and First People’s Hospital of Nantong City, Nantong, Chinaīackground: Sodium is a critically important component of bones, and hyponatremia has firmly been established as a risk factor associated with the incidence of fragility fractures.2Department of General Surgery, Affiliated Hospital 2 of Nantong University and First People’s Hospital of Nantong City, Nantong, China.1Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People’s Hospital of Nantong City, Nantong, China.Hai-yan Huang 1†, Zhi-qi Huang 2†, Ling-yan Hua 3†, Wang-shu Liu 1, Feng Xu 1, Xiao-qin Ge 1, Chun-feng Lu 1*, Jian-bin Su 1* and Xue-qin Wang 1* ![]()
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