Evidence map›Paper›PMID 40036257›Full record

ArticleThe Journal of clinical endocrinology and metabolism2025

Serum Sodium, Potassium, Magnesium, Calcium, and Phosphorus Levels and Risk of Fracture in the Community.

Atsuko Uehara, Yejin Mok, Kunihiro Matsushita, Pamela L Lutsey, Junichi Ishigami

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Lower calcium/phosphorus ratio is associated with the severity of deformity in patients with scoliosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Atsuko UeharaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.ORCID 0000-0003-3726-8492
Yejin MokDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Kunihiro MatsushitaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.ORCID 0000-0002-7179-718X
Pamela L LutseyDivision of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.ORCID 0000-0002-1572-1340
Junichi IshigamiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.ORCID 0000-0002-6396-3723

Funding

NHLBI NIH HHSNIH HHS HHSN268201700001INIH HHS HHSN268201700002INIH HHS HHSN 268201700003INIH HHS HHSN268201700004INIH HHS HHSN268201700005I
6 · The paper itself

Abstract

contextElectrolytes are essential for mineral and bone metabolism. However, their associations with fracture risk among older adults have not been extensively studied.

objectiveThis work aimed to examine the associations of serum sodium, potassium, magnesium, calcium, and phosphorus levels with the risk of fracture.

methodsA prospective cohort study of a US community comprised 5499 older adults from the Atherosclerosis Risk in Communities Study who completed visit 5 in 2011 to 2013. The analysis was replicated in 11 708 middle-aged adults who completed visit 2 in 1990 to 1992. Exposure included serum levels of sodium, potassium, magnesium, calcium, and phosphorus. The main outcome measure included hospitalization with fracture ascertained through diagnostic codes on hospital discharge records.

resultsIn the visit 5 cohort (mean age, 75.4 years), multivariable Cox models with restricted cubic spline terms showed significant associations of lower sodium, magnesium, and calcium levels, and higher phosphorus levels with an increased risk of fracture. In clinical categories, this association remained significant for hyponatremia (≤135 vs 135-145 mEq/L) but not for hyperphosphatemia (≥4.5 vs 2.5-4.5 mg/dL) (HRs, 1.85 [95% CI, 1.22-2.81] and 2.18 [95% CI, 0.99-4.78], respectively). In the visit 2 cohort (mean age, 56.9 years), a significant association was observed for higher phosphorus levels, but not for other electrolytes, although findings were overall consistent.

conclusionIn this community-based cohort, lower sodium, magnesium, and calcium levels, as well as higher phosphorus levels, were associated with greater fracture risk. These findings support the etiological link of serum electrolyte levels with the risk of fracture.

Indexed as

CalciumFractures, BoneMagnesiumPhosphorusPotassiumSodiumAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsUnited StatesCalciumMagnesiumPhosphorusPotassiumSodiumcalciumfracturemagnesiumphosphoruspotassiumsodium

Identifiers

PMID40036257
PMCPMC12527432

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.