Association Of Hyponatremia And Hypovitaminosis D In Ambulatory Adults

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Summary

Background: Hyponatremia and vitamin D deficiency are frequent disorders, and both have been associated with gait disturbances, falls and fractures. The aim of this study was to evaluate the existence of an association between serum sodium and vitamin D serum levels.

Methods: We performed a retrospective investigation to establish whether hyponatremia and vitamin D deficiency may be associated in a general population of unselected outpatients. An electronic search was performed in the laboratory information systems of the Hospital of Verona and the Hospital of Parma (Italy), to retrieve combined results for total vitamin D and sodium obtained in all outpatients referred for health check-up in the year 2013.

Results: Combined results of vitamin D and sodium could be retrieved for 5097 outpatients (3859 females and 1238 males; mean age 64±17 years). Vitamin D deficient subjects displayed significantly lower levels of serum sodium (140 versus 141 mmol/L; p<0.001), along with a significantly higher rate of hyponatremia (6.3% versus 5.1%; p=0.037). Accordingly, hyponatremic subjects had significantly lower levels of serum vitamin D (55 versus 60 nmol/L; p=0.015), along with a significantly higher rate of vitamin D deficiency (41.8% versus 36.1%; p=0.030). A highly significant correlation was found between sodium and total vitamin D after adjustment for age and gender (p<0.001).

Conclusions: The results of this study demonstrate for the first time the existence of a significant correlation between the serum levels of sodium and total vitamin D in a general population of unselected outpatients.

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  • 1. Miller M. Hyponatremia and arginine vasopressin dysregulation: mechanisms clinical consequences and management. J Am Geriatr Soc 2006; 54: 345–53.

  • 2. Holick MF Siris ES Binkley N et al. Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005; 90: 3215–24.

  • 3. Upadhyay A Jaber BL Madias NE. Incidence and prevalence of hyponatremia. Am J Med 2006; 119: S30–S35.

  • 4. Ellison DH Berl T. The syndrome of inappropriate antidiuresis. N Engl J Med 2007; 356: 2064–72.

  • 5. Adrogué HJ Madias NE. Hyponatremia. N Engl J Med 2000; 342: 1581–9.

  • 6. Hoorn EJ Rivadeneira F van Meurs JBJ et al. Mild Hyponatremia as a Risk Factor for Fractures: The Rotterdam Study. J Bone Mineral Res 2011; 26: 1822–8.

  • 7. Verbalis JG Barsony J Sugimura Y et al. Hyponatremia-induced osteoporosis. J Bone Miner Res 2010; 25: 54–63.

  • 8. Barsony J Manigrasso MB Xu Q et al. Chronic hyponatremia exacerbates multiple manifestations of senescence in male rats. Age 2013; 35: 271–88.

  • 9. Bodyak N Ayus JC Achinger S et al. Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. Proc Natl Acad Sci USA 2007; 104: 16810–5.

  • 10. Dawson-Hughes B Mithal A Bonjour JP et al. IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 2010; 21: 1151–4.

  • 11. van Schoor NM Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 2011; 25: 671–80.

  • 12. Christodoulou S Goula T Ververidis A Drosos G. Vitamin D and bone disease. Biomed Res Int 2013: 396541.

  • 13. Pfeifer M Begerow B Minne HW et al. Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community dwelling older individuals. Osteoporos Int 2008: 16: 16–28.

  • 14. Holick FM. The D-lightful vitamin D for heqalth. J Med Biochem 2013; 32: 1–10.

  • 15. Škodrić-Trifunović V Blanka A Stjepanović MI Ignjatović S Mihailović-Vučinić V Šumarac Z Buha I Ilić K. The Health Benefits of Vitamin D Relevant for Tuberculosis. J Med Biochem 2014; 33: 301–6.

  • 16. Bischoff-Ferrari HA Dawson-Hughes B Staehelin HB et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. BMJ 2009; 339: b3692.

  • 17. Dursun E Gezen-Ak D Yilmazer S. A novel perspective for Alzheimer’s disease: vitamin D receptor suppression by amyloid-beta and preventing the amyloid-beta induced alterations by vitamin D in cortical neurons. J Alzheimer’s Dis 2011; 23: 207–19.

  • 18. Llewellyn DJ Lang IA Langa KM Melzer D. Vitamin D and cognitive impairment in the elderly U.S. population. J Gerontol A Biol Sci Med Sci 2011; 66: 59–65.

  • 19. Copay AG Subach BR Glassman SD Polly DW Jr Schuler TC. Understanding the minimum clinically important difference: a review of concepts and methods. Spine J 2007; 7: 541–6.

  • 20. Vaidya A Forman JP. Vitamin D and Hypertension. Current Evidence and Future Directions. Hypertension 2010; 56: 774–9.

  • 21. Tomaschitz A Pilz S Ritz E et al. Independent association between 125-dihydroxyvitamin D 25-hydroxyvitamin D and the renin-angiotensin system: the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Clin Chim Acta 2010; 411: 1354–60.

  • 22. Cervellin G Bonino P Palummeri E Passeri M. Calcium phosphate and blood pressure: their relationships in a geriatric population. Am J Nephrol 1986; 6 Suppl 1: 16–8.

  • 23. Targher G Pichiri I Lippi G. Vitamin D Thrombosis and Hemostasis: More than Skin Deep. Semin Thromb Hemost 2010; 38: 114–24.

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