The Effect of Thiazide Diuretics on Urinary Prostaglandin E2 Excretion and Serum Sodium in the General Population
An erratum to this article was published (J Clin Endocrinol Metab, 16 Sep 2024 ↗)
Authors' conclusion
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 specifically.
Study context
- Population
- General population (Rotterdam Study); 65% female, age 64 ± 8 years
- Participants
- 2,178 participants
- Exposure
- Urinary prostaglandin E2 (PGE2)/PGEM excretion, thiazide use and SLCO2A1 rs34550074 single nucleotide polymorphism (SNP) vs serum sodium
- Outcome
- Serum sodium levels
Methodological detailsRotterdam Study
- Rotterdam Study
Main finding
As reported in the abstract
Difference in serum sodium per 2-fold higher PGE2
−0.19 mmol/L
95% CI −0.31 to −0.06
Difference in serum sodium per 2-fold higher PGEM
−0.29 mmol/L
95% CI −0.41 to −0.17
Observational data: associations, not effects.
Further findings
Serum sodium per 2-fold higher excretion, thiazide users vs non-users
- Per 2-fold higher PGE2, thiazide users vs non-users
- −0.73 vs −0.12 mmol/L
- Per 2-fold higher PGEM, thiazide users vs non-users
- −0.6 vs −0.25 mmol/L
- P for interaction (both)
- <.05
- Association stronger in thiazide users
- Propensity score matching analysis of thiazide vs non-thiazide users yielded similar results
SLCO2A1 rs34550074 SNP
- Not associated with lower serum sodium or higher urinary PGE2 or PGEM excretion in thiazide or non-thiazide users
Original publication
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