The association between normal serum sodium levels and bone turnover in patients with type 2 diabetes

Association between serum sodium and sporadic Parkinson's disease

Background

The correlation between serum sodium and sporadic Parkinson's disease remains unclear currently. This study aimed to assess the association between serum sodium and sporadic Parkinson's disease.

Objective

The ultimate goal is to gain a deeper understanding of the implications of this relationship between serum sodium and sporadic Parkinson's disease.

Methods

We conducted a retrospective cross-sectional study involving 1,189 participants in PPMI cohort. Age, sex, education years, race, body mass index, calcium, alanine aminotransferase, aspartate aminotransferase, white blood cell, lymphocytes, neutrophils, monocytes, red blood cell, hemoglobin, platelets, total protein, albumin, serum uric acid, serum sodium, serum potassium, urea nitrogen, creatinine, serum glucose were obtained from all participants. Logistic regression, and smooth curve fitting were utilized to substantiate the research objectives.

Results

The overall sporadic Parkinson's disease was 77.5% (921/1189); it was 71.9% (143/199), 75.4% (295/391), 76.7% (171/223), and 83% (312/376) for serum sodium quantile1 (Q1, 130-138.9 mmol/L), quantile 2 (Q2, 139-140.9 mmol/L), quantile 3 (Q3, 141-141.9 mmol/L), and quantile 4 (Q4, 142-155 mmol/L), respectively (p = 0.011). Multivariate odds ratio regression adjusted for risk factors demonstrates a 1-unit increment in the serum sodium raises the risk of sporadic Parkinson's disease by 1.11 times, respectively. Smooth splines analysis suggested a linear association between levels of serum sodium and risk of sporadic Parkinson's disease (P nonlinearity = 0.5). An interaction was observed between serum sodium and sex in their influence on sporadic Parkinson's disease (p < 0.05). Further exploratory subgroup analysis within the age and BMI groups showed that there were no significant interactions between the subgroups (all p values for interaction were > 0.05). Additional sensitivity analyses supported the primary findings and indicated the conclusions are robust.

Conclusion

This study highlights the influence of inappropriate serum sodium on the risk of incident sporadic Parkinson's disease, independent of confounders. The link between serum sodium and sporadic Parkinson's disease is linear.

Estudio del efecto del tratamiento con fármacos antidiabéticos sobre el metabolismo óseo

Objetivos

La prevalencia de la diabetes mellitus tipo 2 (DMT2) está aumentando de forma exponencial en todo el mundo, habiéndose comprobado que estos pacientes tienen mayor riesgo de presentar fracturas óseas, con respecto a la población sana, por lo que resulta de gran relevancia el conocimiento del efecto de los fármacos antidiabéticos sobre el metabolismo óseo.

Métodos

Estudio estadístico descriptivo, retrospectivo, de 106 pacientes en tratamiento con seis grupos de fármacos antidiabéticos: insulina, inhibidores de dipeptidilpeptidasa 4 (iDPP4), agonistas del receptor del péptido similar al glucagón tipo 1 (arGLP1), sulfonilureas, inhibidores del cotransportador de sodio-glucosa tipo 2 (iSGLT2) y pioglitazona, en los que se determinaron osteocalcina (OC), fosfatasa alcalina ósea (FAO) y telopéptido C-terminal del colágeno tipo 1 o beta-crosslaps (β-CTx).

Resultados

Se encontraron concentraciones más elevadas de β-CTx en los pacientes tratados con pioglitazona que en los tratados con iDPP4 (p=0,035), iSGLT2 (p=0,020) y con arGLP1 (p<0,001), siendo los pacientes tratados con arGLP1 los que presentaron las concentraciones más bajas de β-CTx.

Conclusiones

El tipo de tratamiento antidiabético recibido en pacientes que padecen DMT2 puede afectar el remodelado óseo. En nuestro estudio los pacientes que fueron tratados con pioglitazona mostraron las concentraciones más elevadas de β-CTx con respecto al resto de grupos de fármacos, lo cual parece indicar la conveniencia de evitar estos fármacos, sobre todo en mujeres postmenopáusicas con DMT2. Los fármacos arGLP1 presentaron los valores más bajos de β-CTx, por lo que podrían ejercer un efecto beneficioso sobre el metabolismo óseo.

Effects of antidiabetic drugs on bone metabolism

Objectives

The prevalence of diabetes mellitus type 2 (DMT2) is increasing exponentially worldwide. DMT2 patients have been found to be at a higher risk for bone fractures than the healthy population. Hence, improving our understanding of the impact of antidiabetic drugs on bone metabolism is crucial.

Methods

A descriptive, retrospective study involving 106 patients receiving six groups of antidiabetic drugs: insulin; dipeptidylpeptidase four inhibitors (DPP4i); glucagon-like peptide type 1 receptor agonists (GLP1ra); sulfonylureas; sodium-glucose cotransporter two inhibitors (SGLT2i); and pioglitazone, in which osteocalcin (OC), bone alkaline phosphatase (BAP) and C-terminal telopeptide of collagen type 1 or beta-crosslaps (β-CTx) were determined.

Results

β-CTx concentrations were higher in the patients treated with pioglitazone, as compared to patients treated with DPP4i (p=0.035), SGLT2i (p=0.020) or GLP1ra (p<0.001). The lowest β-CTx concentrations were observed in the patients treated with GLP1ra.

Conclusions

Bone remodeling is influenced by the type of antidiabetic drug administered to DMT2 patients. In our study, the patients who received pioglitazone showed higher β-CTx concentrations, as compared to patients treated with other types of antidiabetic drugs. This finding highlights the convenience of avoiding these drugs, especially in postmenopausal women with DMT2. GLP1ra drugs were associated with the lowest β-CTx concentrations, which suggests that these agents could exert beneficial effects on bone metabolism.