High sodium chloride intake is associated with low bone density in calcium stone-forming patients

High sodium chloride intake is associated with low bone density in calcium stone-forming patients

Author Martini, Lígia Araújo Autor UNIFESP Google Scholar
Cuppari, Lilian Autor UNIFESP Google Scholar
Colugnati, Fernando Antonio Basile Autor UNIFESP Google Scholar
Sigulem, Dirce Maria Autor UNIFESP Google Scholar
Szejnfeld, Vera Lucia Autor UNIFESP Google Scholar
Schor, Nestor Autor UNIFESP Google Scholar
Heilberg, Ita Pfeferman Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Although renal stone disease has been associated with reduced bone mass, the impact of nutrient intake on bone loss is unknown. Subjects and methods: The present study was undertaken to investigate the influence of nutrient intake on bone density of 85 calcium stone-forming (CSF) patients (47 male and 38 premenopausal females) aged 41 +/- 11 years (X +/- SD). Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry at the lumbar spine (L-2 - L-4) and femoral neck sites: and low BMD was defined as a T score < -1 (WHO criteria). A 4-day dietary record and a 24-hour urine sample were obtained from each patient for the assessment of nutrient intake and urinary calcium (Uc,), sodium (U-Na), phosphate and creatinine excretion. Results: Forty-eight patients (56%) presented normal BMD and 37 (44%) low BMD. There were no statistical differences regarding age, weight, height, body mass index, protein, calcium and phosphorus intakes between both groups. The mean Uc,, phosphorus and nitrogen appearance also did not differ between groups. However, there was a higher percentage of hypercalciuria among low vs normal BMD patients (62 vs 33%, p < 0.05). Low BMD patients presented a higher mean sodium chloride (NaCl) intake and excretion (UNa) than normal BMD (14 +/- 5 vs 12 +/- 4 g/day and 246 +/- 85 vs 204 +/- 68 mEq/day, respectively p < 0.05). The percentage of patients presenting NaCl intake greater than or equal to 16 g/day was also higher among low vs normal BMD patients (35 vs 12%, p < 0.05). After adjustment for calcium and protein intakes, age, weight, body mass index, urinary calcium, citrate and uric acid excretion, and duration of stone disease, multiple-regression analysis showed that a high NaCl intake (2 16 g/day) was the single variable that was predictive of risk of low bone density in CSF patients (odds ratio = 3.8). Conclusion: These data suggest that reducing salt intake should be recommended for CSF patients presenting hypercalciuria and osteopenia.
Keywords nutrition
bone density
renal stones
Language English
Date 2000-08-01
Published in Clinical Nephrology. Munchen-deisenhofen: Dustri-verlag Dr Karl Feistle, v. 54, n. 2, p. 85-93, 2000.
ISSN 0301-0430 (Sherpa/Romeo, impact factor)
Publisher Dustri-verlag Dr Karl Feistle
Extent 85-93
Access rights Closed access
Type Article
Web of Science ID WOS:000088685500001
URI http://repositorio.unifesp.br/11600/43376

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