Trial reportThe Journal of clinical endocrinology and metabolism2023
An Increase in Plasma Sodium Levels Is Associated With an Increase in Osteoblast Function in Chronic SIAD.
Trial report in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03202667 (Effects of the SGLT2-inhibitor Empagliflozin on Patients With Chronic SIADH - the SANDx Study), which is not on this map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of the SGLT2-inhibitor Empagliflozin on Patients With Chronic SIADH - the SANDx Study
Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Bone turnover in arginine vasopressin deficiency: a comparative study with primary polydipsia and healthy controls.The Journal of clinical endocrinology and metabolism · 2026Trial
- An Increase in Plasma Sodium Levels Is Associated With an Increase in Osteoblast Function in Chronic SIAD.The Journal of clinical endocrinology and metabolism · 2023Trial
- Chronic hyponatremia and skeletal vulnerability: bone loss, fragility fracture risk, and therapeutic uncertainties.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Hyponatraemia in ageing.Nature reviews. Endocrinology · 2025Review
- Mild Hyponatremia Is Not Associated With Degradation of Trabecular Bone Microarchitecture Despite Bone Mass Loss.The Journal of clinical endocrinology and metabolism · 2025Article
- Halofuginone Inhibits Osteoclastogenesis and Enhances Osteoblastogenesis by Regulating Th17/Treg Cell Balance in Multiple Myeloma Mice with Bone Lesions.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2024Article
- Empagliflozin: a wonder drug for the treatment of SIAD?Frontiers in endocrinology · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
contextHyponatremia is associated with increased risk for osteoporosis. Preclinical studies in untreated hyponatremia suggest osteoclast upregulation, whereas a clinical study showed improved osteoblast function after hyponatremia normalization in hospitalized patients with syndrome of inappropriate antidiuresis (SIAD).
objectiveThis work aimed to investigate the effect of an increase in sodium on bone turnover, that is, the ratio of the osteoblast marker procollagen type 1 N-terminal propeptide (P1NP) to the osteoclast marker cross-linked C-terminal telopeptide of type 1 collagen (CTX), in outpatients with chronic SIAD.
methodsA predefined secondary analysis was conducted of the 2-month double-blind, crossover, placebo-controlled SANDx Trial (NCT03202667) performed from December 2017 to August 2021. Participants included 11 outpatients with chronic SIAD: 6 women, median age 73 years, who received a 4-week treatment with 25-mg empagliflozin or placebo. Main outcome measures included the relationship between the change in bone formation index (BFI), defined as P1NP/CTX, and the change in plasma sodium levels.
resultsChanges in sodium were positively correlated with changes in BFI and P1NP (BFI: ρ=.55; P < .001; P1NP: ρ=.45; P = .004) but not with CTX (P = .184) and osteocalcin (P = .149). A sodium increase of 1 mmol/l was associated with an increase of 5.21 in BFI (95% CI, 1.41-9.00; P = .013) and with an increase of 1.48 µg/l in P1NP (95% CI, .26-2.62; P = .03). The effect of sodium change on bone markers was independent of the study medication empagliflozin.
conclusionAn increase in plasma sodium levels in outpatients with chronic hyponatremia due to SIAD, even when mild, was associated with an increase in bone formation index (P1NP/CTX) triggered by an increase in P1NP, a surrogate marker of osteoblast function.
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Registered trials
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