Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy.
Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", "Center for Research, Transfer and High Education on Chronic, Inflammatory, Degenerative and Neoplastic Disorders for the Development of Novel Therapies" (DENOThe), University of Florence, Florence, Italy.
Clin Endocrinol (Oxf). 2018 Oct;89(4):505-513. doi: 10.1111/cen.13790. Epub 2018 Jul 12.
To perform a meta-analysis based on published studies that compared falls and bone fractures between patients with and without hyponatremia.
There is evidence suggesting that hyponatremia is associated with an increased risk of falls and bone fractures.
An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to, 30 April 2017, using the following words: "hyponatremia" or "hyponatraemia" AND "falls" and "bone fractures." A meta-analysis was performed including all studies comparing falls and bone fractures in subjects with or without hyponatremia.
Of 216 retrieved articles, 15 studies satisfied inclusion criteria encompassing a total of 51 879 patients, of whom 2329 were hyponatremic. Across all studies, hyponatremia was associated with a significantly increased risk of falls (MH-OR = 2.14[1.71; 2.67]. This result was confirmed when only hospitalized patients were considered (MH-OR = 2.44 [1.97; 3.02]). A meta-regression analysis showed that the hyponatremia-related risk of falls was higher in those studies considering a lower serum [Na ] cut-off to define hyponatremia. Interestingly, the estimated risk of falls related to hyponatremia was already significantly higher when a serum [Na ] cut-off of 135 mmol/L was considered (MH-OR = 1.26[1.23;1.29]). The presence of hyponatremia was also associated with a higher risk of fractures, particularly hip fractures (MH-OR = 2.00[1.43;2.81]).
This study confirms that hyponatremia is associated with an increased risk of falls and bone fractures. The clinical, social and economic relevance of such association is strengthened by the increased incidence of hyponatremia in older people.
基于已发表的研究进行荟萃分析，比较低钠血症患者与非低钠血症患者的跌倒和骨折情况。
有证据表明，低钠血症与跌倒和骨折风险增加相关。
广泛检索 Medline、Embase 和 Cochrane 数据库，检索截至 2017 年 4 月 30 日的所有研究，使用以下关键词：“低钠血症”或“低钠血症”和“跌倒”和“骨折”。纳入所有比较低钠血症患者和非低钠血症患者跌倒和骨折情况的研究进行荟萃分析。
在检索到的 216 篇文章中，有 15 项研究符合纳入标准，共纳入 51879 例患者，其中 2329 例为低钠血症患者。所有研究均表明，低钠血症与跌倒风险显著增加相关（MH-OR=2.14[1.71;2.67]）。仅考虑住院患者时，该结果得到了证实（MH-OR=2.44 [1.97;3.02]）。Meta 回归分析表明，在考虑较低血清[Na+]截断值来定义低钠血症的研究中，低钠血症相关的跌倒风险更高。有趣的是，当考虑血清[Na+]截断值为 135mmol/L 时，低钠血症相关跌倒风险已显著增加（MH-OR=1.26[1.23;1.29]）。低钠血症的存在也与骨折风险增加相关，尤其是髋部骨折（MH-OR=2.00[1.43;2.81]）。
本研究证实低钠血症与跌倒和骨折风险增加相关。老年人中低钠血症发病率增加，进一步加强了这种关联的临床、社会和经济意义。
