Abstract
Water is the most crucial nutrient that constitutes roughly 20% of the
cortical bone by volume, yet most ignored in health and nutrition areas. Hydration
significantly influences the mechanical properties and tissue quality of bone, whereas
bone dehydration causes an increase in its elastic modulus. Moreover, the low water
content in the trabecular skeleton changes its construction (shrinkage) and leads to a
significant alteration in mechanical properties. Numerous internal (a lack of thirst
sensation) or external (polypharmacy or chronic consumption of certain drugs) factors
cause hypohydration. Unfortunately, frail elderly individuals are more vulnerable to
developing dehydration particularly, due to a decrease in the fat-free mass, which
contains 73% of total body water. Today, technical advancements have led to an
emerging understanding of how bone water changes in various conditions including
aging, diabetes, osteoporosis, and osteogenesis imperfecta. Drugs may also change the
impression of hypohydration through the increase of water elimination causing
diarrhoea, diuresis, or sweat; a decrease in thirst sensation or appetite; or affecting the
central thermoregulation mechanism. However, research on the interaction between
bone hydration status and drugs/excipients has been insufficient. In the present review,
we evaluate studies that focus on the significance of bone hydration and the effects of
drugs/excipients on hydration status.