000			03213nam a22004337a 4500
008			190314s20192019 xxu||||| |||| 00| 0 eng d
022			_a2472-1972
024			_a10.1210/js.2018-00320 [doi]
024			_ajs_201800320 [pii]
024			_aPMC6364625 [pmc]
040			_aOvid MEDLINE(R)
099			_a30746503
245			_aHyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in Patients With Diabetes With Matched Glycemic Control.
251			_aJournal of the Endocrine Society. 3(2):411-426, 2019 Feb 01.
252			_aJ. endocr. soc.. 3(2):411-426, 2019 Feb 01.
253			_aJournal of the Endocrine Society
260			_c2019
260			_fFY2019
265			_sepublish
266			_d2019-03-14
520			_aConclusions: Our analyses support the hypothesis that hyponatremia is an additional risk factor for osteoporosis and fragility fracture among patients with diabetes mellitus.
520			_aContext: Patients with diabetes mellitus are at increased risk for bone fragility fracture secondary to multiple mechanisms. Hyperglycemia can induce true dilutional hyponatremia. Hyponatremia is associated with gait instability, osteoporosis, and increased falls and bone fractures, and studies suggest that compromised bone quality with hyponatremia may be independent of plasma osmolality. We performed a case-control study of patients with diabetes mellitus matched by median glycated hemoglobin (HbA1c) to assess whether hyponatremia was associated with increased risk of osteoporosis and/or fragility fracture.
520			_aDesign: Osteoporosis (n = 823) and fragility fracture (n = 840) cases from the MedStar Health database were matched on age of first HbA1c >=6.5%, sex, race, median HbA1c over an interval from first HbA1c >=6.5% to the end of the encounter window, diabetic encounter window length, and type 1 vs type 2 diabetes mellitus with controls without osteoporosis (n = 823) and without fragility fractures (n = 840), respectively. Clinical variables, including coefficient of glucose variation and hyponatremia (defined as serum [Na<sup>+</sup>] <135 mmol/dL within 30 days of the end of the diabetic window), were included in a multivariate analysis.
520			_aResults: Multivariate conditional logistic regression models demonstrated that hyponatremia within 30 days of the outcome measure was independently associated with osteoporosis and fragility fractures (osteoporosis OR 3.09; 95% CI, 1.37 to 6.98; fracture OR, 6.41; 95% CI, 2.44 to 16.82).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aMedicine/General Internal Medicine
657			_aJournal Article
700			_aFernandez, Stephen J
700			_aMete, Mihriye
700			_aShara, Nawar M
700			_aUsala, Rachel L
790			_aFernandez SJ, Mete M, Shara NM, Usala RL, Verbalis JG
856			_uhttps://dx.doi.org/10.1210/js.2018-00320 _zhttps://dx.doi.org/10.1210/js.2018-00320
858			_yUsala, Rachel L _uhttps://orcid.org/0000-0002-3480-5996 _zhttps://orcid.org/0000-0002-3480-5996
942			_cART _dArticle
999			_c10965 _d10965