Background
Dietary Na⁺ or Na⁺/K⁺ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na⁺, K⁺, and Na⁺/K⁺ ratios and BMD in middle-aged Korean women.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na⁺, K⁺, and Na⁺/K⁺ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0.
Results
The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na⁺ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na⁺/K⁺ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD).
Conclusion
A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na⁺/K⁺ ratio. Therefore, based on the results of this study, a higher dietary Na⁺/K⁺ ratio may be associated with a lower BMD.

Citations

• Bioactive Compounds and Health Functions of Plums: Current Status and Future Opportunities
  Ming-Qiang Xu, Samuel Ariyo Okaiyeto, Xiao-Xiao Niu, Qing-Hui Wang, Sriram K. Vidyarthi, Haiou Wang, Li-Zhen Deng, Parag Prakash Sutar, Hong-Wei Xiao
  Food Reviews International.2025; 41(5): 1360.     CrossRef
• Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
  Soo Young Kim
  Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef

Avascular necrosis, or osteonecrosis of the femoral head, is a debilitating condition which leads to the destruction of the hip joint due to an interruption in the blood supply to the bony region and is most commonly due to trauma. The case discussed here has been highlighted as it presented as non-traumatic osteonecrosis of the femoral head with an absence of risk factors in a healthy adult male. A 37-year-old male presented with a 4-month history of recurrent left hip pain, which worsened with initiation of movement and weightbearing on the affected side. The patient was overweight but normotensive with a full range of movement of the hips bilaterally. There were no abnormalities detected on initial X-ray images of the left hip. However, due to the persistent pain and sclerotic changes in a subsequent X-ray, a magnetic resonance image of the bilateral hips was obtained, leading to the diagnosis of osteonecrosis of the bilateral femoral heads. Due to the lack of improvement with physiotherapy and analgesia, the patient was subjected to conservative surgery of the symptomatic left hip with concurring evidence of avascular necrosis based on intraoperative anatomical biopsy. This case emphasizes the importance of identifying underlying issues during history taking and physical examination in adults without risk factors. The early diagnosis of osteonecrosis assists in preventing joint collapse and can delay the requirement of joint replacements. High levels of suspicion are necessary to instigate investigation in persistent cases without the presence of risk factors.