The Effect of Thiazide Diuretics on Urinary Prostaglandin E2 Excretion and Serum Sodium in the General Population.
J Clin Endocrinol Metab
; 2024 May 22.
Article
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| MEDLINE
| ID: mdl-38776231
ABSTRACT
CONTEXT Thiazide-induced hyponatremia is one of the most common forms of hyponatremia, but its pathogenesis is incompletely understood. Recent clinical data suggest links with prostaglandin E2 (PGE2) and a single nucleotide polymorphism (SNP) in the prostaglandin transporter gene (SLCO2A1), but it is unknown if these findings also apply to the general population. OBJECTIVE:
To study the associations between serum sodium, thiazide diuretics, urinary excretions of PGE2 and its metabolite (PGEM), and the rs34550074 SNP in SLCO2A1 in the general population.DESIGN:
Prospective population-based cohort study (Rotterdam Study).SETTING:
General population.PARTICIPANTS:
2,178 participants (65% female, age 64 ± 8 years). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Serum sodium levels.RESULTS:
Higher urinary PGE2 excretion was associated with lower serum sodium difference in serum sodium for each two-fold higher PGE2 -0.19â mmol/l (95%CI -0.31 to -0.06), PGEM -0.29â mmol/l (95%CI -0.41 to -0.17). This association was stronger in thiazide users (per two-fold higher PGE2 -0.73 vs. -0.12â mmol/l and PGEM -0.6 vs. -0.25â mmol/l, p for interaction < 0.05 for both). A propensity score matching analysis of thiazide vs. non-thiazide users yielded similar results. The SNP rs34550074 was not associated with lower serum sodium or higher urinary PGE2 or PGEM excretion in thiazide or non-thiazide users.CONCLUSIONS:
Serum sodium is lower in people with higher urinary PGE2 and PGEM excretion and this association is stronger in thiazide users. This suggests that PGE2-mediated water reabsorption regulates serum sodium, which is relevant for the pathogenesis of hyponatremia in general and thiazide-induced hyponatremia in specific.
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01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2024
Tipo del documento:
Article
País de afiliación:
Países Bajos