Sodium Intake and Osteoporosis. Findings from the Women's Health Initiative

Laura Carbone¹, Karen Johnson², Ying Huang³, Mary Pettinger⁴, Thomas Fridtjof⁵, Jane A. Cauley⁶, Carolyn Crandall⁷, Lesley Tinker⁸, Meryl LeBoff⁹, Jean Wactawksi-Wende¹⁰, Monique Bethel¹¹, Wenjun Li¹² and Ross Prentice³, ¹Rheumatology, Georgia Regents University, Augusta, GA, ²Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, ³Biostatistics, University of Washington, Seattle, WA, ⁴Fred Hutcinson Cancer Research Center, Seattle, WA, ⁵University of Tennessee Health Science Center, Memphis, TN, ⁶Department of Epidemiology, Univ of Pittsburgh, Pittsburgh, PA, ⁷Medicine, University of California Los Angeles, Los Angeles, CA, ⁸Fred Hutchinson Cancer Research Center, Seattle, WA, ⁹Brigham and Women's Hospital, Boston, MA, ¹⁰University of Buffalo, Buffalo, NY, ¹¹Internal Medicine, Georgia Regents University, Augusta, GA, ¹²Medicine, Division of Preventive Medicine, University of Massachusetts Medical School, Worcester, MA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: menopause, osteoporosis and women's health

Session Information

Date: Sunday, November 8, 2015

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: The relationship of sodium intake to bone mineral density (BMD) in postmenopausal women has not been established, and no study to date has examined its relationship with fracture risk. The purpose of this study was to examine whether sodium intake is associated with changes in BMD at the lumbar spine, total hip, femoral neck and total body and with incident fractures and whether this relationship is modified by potassium and/or calcium intake among women in the Women’s Health Initiative (WHI).

Methods: Data from 69,735 postmenopausal women in the WHI were included in this report. Linear regression models and Cox proportional hazard models were used to estimate the relationships between calibrated sodium intake, changes in BMD, and incident fractures that occurred during WHI follow-up, and to ascertain whether calibrated potassium or calcium intake modified these relationships. Models were adjusted for demographics, clinical factors and medication use.

Results: The median calibrated sodium intake was 2891.6 mg/day (range: 1234.5-7574.9mg/day). There was no association between whether or not sodium intake was above the median and changes in BMD at the total hip, femoral neck or lumbar spine from baseline to three (p>0.24) or six years (p>0.16) or with all fractures, osteoporotic fracture sites other than the spine and hip (other fractures) and spine fractures (p> 0.13). Sodium intakes above the median were associated with significant increases in BMD at the total body from baseline to three years (p=0.02), though changes from baseline to six years were not significant (p=0.36). Sodium intake above the median was also associated with fewer hip fractures (p=0.03). Levels of sodium intake above or below currently recommended guidelines for cardiovascular disease (2300 mg /day) were not associated with changes in BMD at any skeletal site from baseline to three (p> 0.66) or six years (p> 0.74) or with incident fractures (p≥0.70). There was no association of sodium intake with incident fractures after adjusting for potassium intake (p≥0.30). Calcium intake did not modify the association between sodium intake and changes in BMD or risk of incident fracture (p≥0.20).

Conclusion: Adherence to current population-based recommended intakes for sodium intake is unlikely to significantly impact osteoporosis. The surprising association of higher sodium intakes with fewer hip fractures merits further study.

Disclosure: L. Carbone, None; K. Johnson, None; Y. Huang, None; M. Pettinger, None; T. Fridtjof, None; J. A. Cauley, None; C. Crandall, None; L. Tinker, None; M. LeBoff, None; J. Wactawksi-Wende, None; M. Bethel, None; W. Li, None; R. Prentice, None.

To cite this abstract in AMA style:

Carbone L, Johnson K, Huang Y, Pettinger M, Fridtjof T, Cauley JA, Crandall C, Tinker L, LeBoff M, Wactawksi-Wende J, Bethel M, Li W, Prentice R. Sodium Intake and Osteoporosis. Findings from the Women’s Health Initiative [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/sodium-intake-and-osteoporosis-findings-from-the-womens-health-initiative/. Accessed .

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