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Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Kovalskys I, Herrera-Cuenca M, Cortés LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Gómez G. A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition. Food Nutr Bull 2024; 45:S11-S25. [PMID: 38112070 DOI: 10.1177/03795721231215267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
BACKGROUND Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
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Affiliation(s)
- Rafael Monge-Rojas
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Marianella Herrera-Cuenca
- Universidad Central de Venezuela, Caracas, Venezuela
- Framingham State University, Framingham, MA, USA
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Olagunju MT, Abodunrin OR, Omotoso IO, Adewole IE, Ola OM, Abel C, Akinsolu FT. Egg consumption and bone mass density among the elderly: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002519. [PMID: 38696440 PMCID: PMC11065246 DOI: 10.1371/journal.pgph.0002519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/08/2024] [Indexed: 05/04/2024]
Abstract
Eggs offer a range of essential nutrients that could support skeletal health as individuals age. Maintaining bone density is crucial for reducing the risk of fractures and improving overall mobility and quality of life in later years. Understanding the potential benefits of habitual egg consumption on bone mass density among older people is essential, given that the natural decline in bone mass density occurs with age. This area of research has not garnered sufficient attention basically because of the mixed reactions and conflicting reports about the safety of egg consumption especially among the older adults. This scoping review aims to systematically examine the existing literature to map the evidence regarding the association between habitual egg consumption and bone mass density in older adults' individuals. The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to ensure methodological rigor and transparency. Five electronic databases were searched for published pieces of literature. While high egg intake has been linked to increased mortality and dyslipidemia, eggs contain compounds like Ovo transferrin and carotenoids that may benefit bone health. As aging increases vulnerability to bone fragility and fractures, it's crucial to provide comprehensive dietary recommendations. The complex relationship between egg consumption, cholesterol, and health highlights the need for nuanced assessment. Overall, eggs present a potentially valuable dietary component for promoting bone health in aging populations. Limited research on the link between egg consumption and bone mass density in older adults highlights the need for further investigation. Concerns about cholesterol have overshadowed potential benefits. Given aging populations and bone health challenges, exploring eggs' role in preventing falls and fractures is essential for a proactive approach to older adults' well-being.
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Affiliation(s)
| | | | | | | | | | | | - Folahanmi T. Akinsolu
- Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
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Voulgaridou G, Papadopoulou SK, Detopoulou P, Tsoumana D, Giaginis C, Kondyli FS, Lymperaki E, Pritsa A. Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs. Diseases 2023; 11:diseases11010029. [PMID: 36810543 PMCID: PMC9944083 DOI: 10.3390/diseases11010029] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are not suitable for the diagnosis of osteoporosis, the biochemical markers of bone turnover can be measured in serum and/or urine, enabling the assessment of the dynamic bone activity and the short-term effectiveness of the osteoporosis treatment. Calcium and vitamin D are essential for maintaining bone health. The aim of this narrative review is to summarize the effects of vitamin D and calcium supplementation separately and in combination, on bone density and circulating serum and blood plasma vitamin D, calcium, parathyroid hormone levels, markers of bone metabolism concentrations, and clinical outcomes, such as falls and osteoporotic fractures. We searched the PubMed online database to find clinical trials from the last five years (2016-April 2022). A total of 26 randomized clinical trials (RCTs) were included in this review. The present reviewed evidence suggests that vitamin D alone or in combination with calcium increases circulating 25(OH)D. Calcium with concomitant vitamin D supplementation, but not vitamin D alone, leads to an increase in BMD. In addition, most studies did not detect significant changes in circulating levels of plasma bone metabolism markers, nor in the incidence of falls. Instead, there was a decrease in blood serum PTH levels in the groups receiving vitamin D and/or Ca supplementation. The plasma vitamin D levels at the beginning of the intervention, and the dosing regimen followed, may play a role in the observed parameters. However, further study is needed to determine an appropriate dosing regimen for the treatment of osteoporosis and the role of bone metabolism markers.
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Affiliation(s)
- Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece
- Department of Nutritional Science and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Foivi S. Kondyli
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Evgenia Lymperaki
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Agathi Pritsa
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Correspondence:
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Al-Rawaf HA, Alghadir AH, Gabr SA. Circulating MicroRNA Expression, Vitamin D, and Hypercortisolism as Predictors of Osteoporosis in Elderly Postmenopausal Women. DISEASE MARKERS 2021; 2021:3719919. [PMID: 34938374 PMCID: PMC8687791 DOI: 10.1155/2021/3719919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND MicroRNAs (miRNA) identified as critical molecular regulators for bone development, function, and modeling/remodeling process and could be predictable for osteoporotic fractures in postmenopausal elderly women. AIM The potential diagnostic role of circulating miRNAs, miR-148a and miR-122-5p, in the pathogenesis of osteoporosis and its association with bone markers, hypercortisolism, and vitamin D deficiency were explored in postmenopausal elderly women with osteoporosis. METHODS A total of 120 elderly women aged 50-80 years old were recruited in this study, of which only 100 eligible women with amenorrhea of at least 12 consecutive months or surgical menopause participated in this study. Based upon bone mineral density (BMD) measurements, the participants were classified according into two groups: normal (n = 45; T score of ≥-1.0) and osteoporosis (n = 55; T score: ≤-2.5). Circulating miRNAs, miR-148a and miR-122-5p, were estimated by real-time RT-PCR analysis. In addition, bone markers, hypercortisolism, and vitamin D deficiency were colorimetrically and ELISA immune assay estimated. The potential role of miR-148a, miR-122-5p, cortisol, and vitamin D in the diagnosis of osteoporosis was predicted using the analysis of the respective area under the receiver operating characteristic curve (AUC-ROC). RESULTS The expressed level of miR-148a significantly increased and miR-122-5p significantly decreased in the serum of osteoporotic patients compared to healthy controls. In addition, a significant increase in the levels of cortisol, s-BAP, and CTx and significant decrease in the levels of T-BMD, the levels of OC, and s-Ca were also identified. All parameters significantly correlated with fracture risk parameters; BMD, and T score lumbar spine (L2-L4). Thus, the data showed AUC cut off values (miR-148a; 0.876, miR-122-5p; 0.761) were best evaluated for clinical diagnosis of patients with osteoporosis and that AUC cut off values of 0.748 for cortisol and 0.635 for vitamin D were the best cut off values, respectively, reported for the prediction of osteoporosis clinical diagnosis. CONCLUSION In this study, expressed miRNAs miR-148a and miR-122-5p and changes in the levels of both cortisol and vitamin D status are significantly associated with bone loss or osteoporosis. Thus, circulation miRNAs alone or in combination with cortisol and vitamin D status might be considered predictable biomarkers in the diagnosis or the pathogenesis of osteoporosis in elderly postmenopausal women; however, more studies are recommended.
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Affiliation(s)
- Hadeel A. Al-Rawaf
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad H. Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami A. Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Gupta R, Bohat V, Kapoor A, Singhal A, Soni A, Masih GD. High Prevalence of Vitamin D Deficiency among North Indian Athletes. Indian J Community Med 2021; 46:559-561. [PMID: 34759510 PMCID: PMC8575232 DOI: 10.4103/ijcm.ijcm_170_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/18/2021] [Indexed: 11/04/2022] Open
Abstract
Background Vitamin D deficiency is high in athletes and has an impact on athletes' performance. Introduction Assessment of serum Vitamin D levels in healthy North Indian sportspersons and its correlation with serum parathyroid hormone (PTH) levels and bone mineral density (BMD). Materials and Methods Three-hundred and sixty-nine healthy athletes' aged 18-45 years were enrolled. Depending upon Vitamin D levels athletes were categorized into three groups: deficient (<20 ng/ml), insufficient (20-30 ng/ml), and sufficient (>30 ng/ml). BMD and serum PTH levels were assessed in all athletes and correlation was seen with Vitamin D levels. Results Two-hundred and fifty-eight (69.9%) athletes were Vitamin D deficient, 51/369 (13.8%) were Vitamin D insufficient, and 60/369 (16.3%) athletes were Vitamin D sufficient. There was a direct correlation between low serum Vitamin D levels and low BMD (r = 0.473; P < 0.05). Overall, 114/369 (30%) athletes had low BMD and out of these 114 athletes, 108 (95%) were Vitamin D deficient. Serum PTH levels were found to have inverse relations with both Vitamin D (r= -0.629) and BMD (r=-0.267). Conclusions Vitamin D deficiency is highly prevalent among the North Indian athletes and the presence of low Vitamin D (<20 ng/ml) levels is associated with low BMD and high PTH levels.
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Affiliation(s)
- Ravi Gupta
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Vaibhav Bohat
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Anil Kapoor
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Akash Singhal
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Ashwani Soni
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Gladson David Masih
- Department of orthopaedics, Government Medical College Hospital, Chandigarh, India
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Moschonis G, van den Heuvel EGHM, Mavrogianni C, Manios Y. Effect of Vitamin D-Enriched Gouda-Type Cheese Consumption on Biochemical Markers of Bone Metabolism in Postmenopausal Women in Greece. Nutrients 2021; 13:nu13092985. [PMID: 34578863 PMCID: PMC8470132 DOI: 10.3390/nu13092985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 01/22/2023] Open
Abstract
Considering the role of bone metabolism in understanding the pathogenesis of osteoporosis, the aim of the present study was to examine the effects of vitamin D-enriched cheese on the serum concentrations of the parathyroid hormone (PTH) and certain bone remodeling biomarkers in postmenopausal women in Greece. In a randomised, controlled dietary intervention, 79 postmenopausal women (55–75 years old) were randomly allocated either to a control (CG: n = 39) or an intervention group (IG: n = 40), consuming 60 g of either non-enriched or vitamin D3-enriched Gouda-type cheese (5.7 μg of vitamin D3), respectively, daily and for eight weeks during the winter. The serum concentrations of 25-hydroxy vitamin D (25(OH)D), PTH, bone formation (i.e., osteocalcin, P1NP) and bone resorption (i.e., TRAP-5b) biomarkers were measured. Consumption of the vitamin D-enriched cheese led to higher serum 25(OH)D concentrations of 23.4 ± 6.39 (p = 0.022) and 13.4 ± 1.35 (p < 0.001) nmol/L in vitamin D-insufficient women being at menopause for less and more than 5 years, respectively. In vitamin D-insufficient women that were less than 5 years at menopause, consumption of vitamin D-enriched cheese was also associated with lower serum PTH (Beta −0.63 ± 1.11; p < 0.001) and TRAP-5b (Beta −0.65 ± 0.23; p = 0.004) levels at follow-up, compared with the CG. The present study showed that daily intake of 5.7 μg of vitamin D through enriched cheese increased serum 25(OH)D concentrations, prevented PTH increase and reduced bone resorption in vitamin D-insufficient early postmenopausal women, thus reflecting a potential food-based solution for reducing the risk of bone loss occurring after menopause.
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Affiliation(s)
- George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Correspondence: ; Tel.: +61-3-9479-3482
| | | | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (C.M.); (Y.M.)
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (C.M.); (Y.M.)
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The Relationship of Vitamin D Deficiency with Severity and Outcome of Acute Stroke. ACTA ACUST UNITED AC 2021; 59:351-358. [PMID: 33855844 DOI: 10.2478/rjim-2021-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Indexed: 12/14/2022]
Abstract
Background: There are currently conflicting results regarding the link between vitamin D deficiency and increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke.Methods: This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. The levels of 25-hydroxy vitamin D were evaluated by Electrochemiluminescence (ECL) technique. Clinical severity of stroke on admission as well as on discharge time were evaluated using the National Institutes of Health Stroke Scale (NIHSS) or Modified Rankin (mRS) tools.Results: Mean serum level of vitamin D was 25.51 ± 18.87 ng/mL, ranging from 3.0 to 98.6 ng/ml. There was a significant difference between the two groups (with and without vitamin D deficiency) in terms of stroke severity and disability, as reflected by mRS (P=0.003) and NIHSS evaluation (14.24 ± 9.23 versus 9.73 ± 7.36, P=0.003). Also, regarding patients' clinical condition, the mean NIHSS score in those with deficient and normal levels of vitamin D was 14.24 ± 9.23 and 9.73 ± 7.36, respectively with NIHSS score > 5 in 76.1% and 61.5%, respectively (P = 0.003).Conclusion: According to the results of study, vitamin D status can be related to the severity of stroke. However, considering the cross-sectional design of our study, it could not point out the causality between vitamin D deficiency and acute stroke and further studies are warranted. It is not possible to draw any conclusions in terms of causality. Further studies are required in order to assess the relationship between the serum vitamin D levels and stroke severity.
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Xu HW, Shen B, Hu T, Zhao WD, Wu DS, Wang SJ. Preoperative vitamin D status and its effects on short-term clinical outcomes in lumbar spine surgery. J Orthop Sci 2020; 25:787-792. [PMID: 31759837 DOI: 10.1016/j.jos.2019.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/19/2019] [Accepted: 10/20/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Many studies have found that vitamin D deficiency has a high incidence rate worldwide, but we found few studies on the role of vitamin D in spinal degenerative diseases. We investigated the determinants of preoperative vitamin D deficiency and its effects on postoperative outcomes among patients undergoing elective lumbar spine surgery. METHODS 360 patients treated from July 2017 to July 2018 were retrospectively identified for inclusion. The patients' fasting serum levels of 25(OH)D, N-terminal midfragment of osteocalcin (N-MID), and β typeⅠcollagen carboxyl terminal peptide (β-CTX) were measured by electrochemiluminescence before the operation. The visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) and Oswestry Disability Index scores (ODI) were used to evaluate the clinical outcomes. Standard demographic data and all perioperative complications occurring within 3 months follow-up after operation were recorded. RESULTS The mean serum level of 25(OH)D was 20.81 ± 8.55 ng/mL, the rates of deficiency (<20 ng/ml) was 53.6%. The abnormal proportion of N-MID and β-CTX were 8.61% and 34.44%, bone turnover markers serum level was higher in older age groups (p < 0.05). Female sex (p < 0.001), a high body mass index (BMI) (p = 0.012), lack of vitamin D supplementation (p = 0.018), smoking (p = 0.033), moderate (p < 0.001) to severe pain (p = 0.005) were significant predictors of vitamin D deficiency after the multivariate analysis. The VAS, JOA and ODI scores showed significantly better outcomes compared to deficient group at post-operative and final follow-up (p < 0.05). CONCLUSION Vitamin D deficiency was common in patients undergoing elective lumbar spine surgery. Female sex, high BMI, lack of vitamin D supplementation, smoking and moderate to severe pain were risk factors for vitamin D deficiency. Moreover, preoperative hypovitaminosis D (<20 ng/ml) was correlated with worse surgical outcomes in short-term.
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Affiliation(s)
- Hao-Wei Xu
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bin Shen
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tao Hu
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei-Dong Zhao
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - De-Sheng Wu
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shan-Jin Wang
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
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Hernando VU, Andry MM, María Virginia PF, Valentina A. Vitamin D nutritional status in the adult population in Colombia - An analytical cross-sectional study. Heliyon 2020; 6:e03479. [PMID: 32140595 PMCID: PMC7044797 DOI: 10.1016/j.heliyon.2020.e03479] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/08/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background The key role of Vitamin D is to maintain an adequate calcium and phosphorus metabolism. Vitamin D plays an antagonistic role with the parathyroid hormone. 25 OH Vitamin D is the major circulating form and the best indicator to monitor Vitamin D levels. Methods A cross-sectional study was conducted in 1339 individuals ≥18 years old. The main objective was to establish the nutritional status of Vitamin D and its association with PTH and ionized calcium levels. Other objectives were to compare the levels of 25 OH Vitamin D based on sun exposure habits, and to identify the minimum cut-off point for the levels of 25 OH Vitamin D that could give rise to a concomitant increase in PTH and ionized calcium levels. Results 14.2% of participants presented Vitamin D deficiency, and 28.8% presented insufficiency; ≥89% of the participants with deficiency or insufficiency were exposed to sunlight <30 minutes per week. A value of 25 OH Vitamin D >30 ng/mL was associated with a more stable and "flat" PTH value. The median of 25 OH Vit-D associated with hypercalcemia was <10 ng/mL. Conclusion In Colombia, low 25 OH Vitamin D values are highly prevalent; this may be accounted for by poor sun-exposure habits and frequent use of sunscreen. Just as in other similar trials, the lower the levels of 25 OH Vit-D, the higher the effect on PTH and ionized calcium elevation.
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Affiliation(s)
- Vargas-Uricoechea Hernando
- Metabolic Diseases Study Group, Department of Internal Medicine, Universidad del Cauca, Popayán-Cauca, Colombia
| | - Mera-Mamián Andry
- Epidemiology and Statistics Research Group, Universidad CES, Medellín, Colombia
| | | | - Agredo Valentina
- Metabolic Diseases Study Group, Department of Internal Medicine, Universidad del Cauca, Popayán-Cauca, Colombia
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Trabecular bone score and bone quantitative ultrasound in Spanish postmenopausal women. The Camargo Cohort Study. Maturitas 2020; 132:24-29. [DOI: 10.1016/j.maturitas.2019.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 11/26/2019] [Indexed: 11/18/2022]
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Kopiczko A, Łopuszańska-Dawid M, Gryko K. Bone mineral density in young adults: the influence of vitamin D status, biochemical indicators, physical activity and body composition. Arch Osteoporos 2020; 15:45. [PMID: 32166587 PMCID: PMC7067719 DOI: 10.1007/s11657-020-0684-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/14/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of the study was to assess the associations of bone mineral density and bone mass with physical activity levels, vitamin D, phosphorus, magnesium, total cholesterol and triglyceride concentration and body composition in young women and men. Physical activity has the most significant effect on bone status especially in men. PURPOSE The aim of the study was to assess the associations of bone mineral density and bone mass with physical activity levels, vitamin D, phosphorus, magnesium, total cholesterol and triglyceride concentration and body composition in young women and men. METHODS One hundred subjects aged 19-24 years were included. Bone mineral density (BMD) in distal and proximal parts was evaluated by forearm densitometry. Body composition was analysed with the use of JAWON-Medical-x-scan. The following biochemical indicators were analysed: 25(OH) D and 1,25(OH)2D, magnesium, phosphorus, total cholesterol and triglycerides. Physical activity levels were assessed by interview. RESULTS Significant correlations between BMD and physical activity, skeletal muscle mass and body fat percentage were revealed in men. Among women, considerably weaker correlations of BMD with body composition and physical activity were noted than in men. BMD in the distal part correlated only with lean body mass, soft lean mass and body fat percentage. The strongest relationship between physical activity and bone mineral status parameters was noted for BMD in men. In women, physical activity did not affect BMD. CONCLUSIONS Physical activity has the most significant effect on bone status especially in men.
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Affiliation(s)
- Anna Kopiczko
- Department of Biomedical Sciences, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968, Warsaw, Poland.
| | - Monika Łopuszańska-Dawid
- Department of Biomedical Sciences, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968, Warsaw, Poland
| | - Karol Gryko
- Department of Individual and Team Sports, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968, Warsaw, Poland
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Negative correlation of high-density lipoprotein-cholesterol and bone mineral density in postmenopausal Iranian women with vitamin D deficiency. Menopause 2019; 25:458-464. [PMID: 29557847 DOI: 10.1097/gme.0000000000001082] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the association between high-density lipoprotein (HDL) and bone status taking into account serum vitamin D levels in postmenopausal Iranian women. METHODS During January 2015 and February 2016, a total of 488 postmenopausal Iranian women participated in this cross-sectional study, all of whom were not taking osteoporosis medication and were not suffering from any chronic disorder. Dual X-ray absorptiometry was used to assess bone mineral density (BMD) of the total hip, femoral neck, and lumbar vertebrae (L2-L4). Each person was categorized based on the World Health Organization osteoporosis criteria in at least one skeletal region. At the end of the data collection, lipid profiles and vitamin D levels were measured for all participants. Vitamin D serum levels less than 30 ng/mL were defined as vitamin D deficiency or insufficiency. RESULTS 27.9% of all participants displayed osteoporosis. Osteoporotic participants tended to be older with higher HDL serum levels (P < 0.001). No significant difference was seen in low-density of lipoprotein, total triglyceride, and total cholesterol levels among participants (P > 0.05). In a univariate model, after adjusting for age, menopausal age, obesity, physical activity, and use of antihyperlipidemic drugs (statins), there were significant negative associations among HDL levels and BMD values and T-score in the three regions (P < 0.004). Interestingly, after classification of participants based on vitamin D levels and adjustment for confounding factors, these significant negative associations between HDL levels and BMD values as well as T-score were observed only in participants with vitamin D deficiency or insufficiency, in the three regions (P < 0.008). CONCLUSIONS Our data show that in postmenopausal women with vitamin D deficiency, serum levels of HDL have negative correlation with bone status.
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Gaffney-Stomberg E, Nakayama AT, Guerriere KI, Lutz LJ, Walker LA, Staab JS, Scott JM, Gasier HG, McClung JP. Calcium and vitamin D supplementation and bone health in Marine recruits: Effect of season. Bone 2019; 123:224-233. [PMID: 30902791 DOI: 10.1016/j.bone.2019.03.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/13/2019] [Accepted: 03/17/2019] [Indexed: 12/16/2022]
Abstract
Stress fractures are common overuse injuries caused by repetitive bone loading. These fractures are of particular concern for military recruits and athletes resulting in attrition in up to 60% of recruits that sustain a fracture. Army and Navy recruits supplemented with daily calcium and vitamin D (Ca + D) demonstrated improved bone strength and reduced stress fractures. The aim of the current study was to evaluate whether Ca + D supplementation improves measures of bone health in recruits undergoing United States Marine Corps initial military training (IMT), and whether the effect of supplementation on indices of bone health varied by season. One-hundred ninety-seven Marine recruits (n = 107 males, n = 90 females, mean age = 18.9 ± 1.6 y) were randomized to receive either Ca + D fortified snack bars (2000 mg Ca and 1000 IU vitamin D per day) or placebo divided into twice daily doses during 12 weeks of IMT. Anthropometrics, fasted blood samples, and peripheral quantitative computed tomography (pQCT) scans of the tibial metaphysis and diaphysis were collected upon entrance to- and post-training (12 weeks later). Half of the volunteers entered training in July and the other half started in February. Time-by-group interactions were observed for vitamin D status (25OHD) and the bone turnover markers, BAP, TRAP and OCN. 25OHD increased and BAP, TRAP and OCN all decreased in the Ca + D group (p < .05). Training increased distal tibia volumetric BMD (+1.9 ± 2.8%), BMC (+2.0 ± 3.1%), and bone strength index (BSI; +4.0 ± 4.0%) and diaphyseal BMC (+1.0 ± 2.2%) and polar stress strain index (SSIp; +0.7 ± 2.1%) independent of Ca + D supplementation (p < .05 for all). When analyzed by season, change in BSI was greater in the Ca + D group as compared to placebo in the summer iteration only (T*G; p < .05). No other effects of supplementation on bone tissue were observed. When categorized by tertile of percent change in BSI, recruits demonstrating the greatest changes in BSI and 25OHD entered training with the lowest levels of 25OHD (p < .05). Over all, these results suggest that Ca + D supplementation reduced some markers of bone formation and resorption and the decline in 25OHD over training in volunteers that started training in the summer was prevented by supplementation. Baseline 25OHD and trajectory may impact bone responses to IMT, but little effect of Ca + D supplementation was observed at the investigated doses.
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Affiliation(s)
- Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America.
| | - Anna T Nakayama
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America; Oak Ridge Institute for Science and Education, Oakridge, TN 37830, United States of America
| | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Laura J Lutz
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Leila A Walker
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jonathan M Scott
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - Heath G Gasier
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
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14
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Abstract
SUMMARYEvidence from preclinical and clinical studies supports a role for vitamin D deficiency in many mental disorders. In this review, we discuss the role of vitamin D in the aetiology and treatment of schizophrenia and depression and their physical health comorbidities. Although observational studies support a potential association between vitamin D and schizophrenia and depression, sufficient high-quality evidence from clinical trials does not yet exist to establish a place for vitamin D supplementation in optimising clinical response or promoting physical health. Completed randomised controlled trials are needed to provide insights into the efficacy and safety of vitamin D in the management of mental disorders.LEARNING OBJECTIVESAfter reading this article you will be able to:
•outline the epidemiology of vitamin D deficiency in schizophrenia•describe the associations of vitamin D with schizophrenia and depression•know how to assess, and consider treatment for, vitamin D deficiency.DECLARATION OF INTERESTF.G. has received support or honoraria for CME, advisory work and lectures from Bristol-Myers Squibb, Janssen, Lundbeck, Otsuka, Roche and Sunovion, and has a family member with professional links to Lilly and GSK, including shares. She is in part funded by the National Institute for Health Research's (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the South London Collaboration for Leadership in Applied Health Research & Care Funding scheme, and by the Maudsley Charity. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
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15
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Mesinovic J, Mousa A, Wilson K, Scragg R, Plebanski M, de Courten M, Scott D, Naderpoor N, de Courten B. Effect of 16-weeks vitamin D replacement on calcium-phosphate homeostasis in overweight and obese adults. J Steroid Biochem Mol Biol 2019; 186:169-175. [PMID: 30367939 DOI: 10.1016/j.jsbmb.2018.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/03/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022]
Abstract
This randomised placebo-controlled trial aimed to determine the effect of 16-weeks cholecalciferol supplementation on calcium-phosphate homeostasis and bone mineral density (BMD) in overweight and obese adults. Fifty-four vitamin D-deficient (25OHD<50 nmol/L), overweight and obese adults (mean age 32 ± 8.5 years) were included in the trial. Participants were randomly assigned to receive either a bolus oral dose of 100,000 IU cholecalciferol followed by 4000 IU cholecalciferol/d or a matching placebo for 16 weeks. Before and after the intervention, serum calcium, phosphate, 25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH) and C-terminal plasma fibroblast growth factor-23 (cFGF-23) concentrations were measured. Whole-body BMD was assessed using dual-energy X-ray absorptiometry (DXA) and diet and sun exposure were assessed using self-administered questionnaires. There were no significant differences in baseline characteristics between the vitamin D and placebo group. After 16-weeks of vitamin D supplementation, mean changes in 25(OH)D concentration were higher in the vitamin D group (57 nmol/L 95% CI 49, 65) compared with placebo (2 nmol/L 95% CI -4, 8), P < 0.001. Additionally, iPTH concentrations declined in the vitamin D group (-1.19 pmol/L 95% CI -1.9, -0.47) compared with placebo (0.14 pmol/L 95% CI -0.49, 0.77), P = 0.006. There were no significant differences in calcium, phosphate, iPTH and cFGF-23 concentrations and whole-body BMD between vitamin D and placebo at follow-up. Inverse correlations were observed between mean change in serum iPTH and cFGF-23 in the vitamin D group only (r=-0.41, P = 0.029). In individuals with greater vitamin D deficiency at baseline (25(OH)D < 30 nmol/L), there was a significant increase in mean whole-body BMD (0.01 g/cm2, 95% CI 0.001, 0.025) however, the mean change in BMD was not different between vitamin D and placebo groups in this sub-group analysis. We conclude that cholecalciferol supplementation for 16 weeks increases serum 25(OH)D concentrations and reduces iPTH concentrations in overweight and obese, but otherwise healthy adults with vitamin D deficiency, and has no effect on calcium, phosphate and iFGF-23 concentrations and whole-body BMD.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Kirsty Wilson
- Department of Immunology and Pathology, Monash University, Australia
| | | | - Magdalena Plebanski
- Department of Immunology and Pathology, Monash University, Australia; School of Health and Biomedical Sciences, RMIT University, Australia
| | | | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia; Diabetes and Vascular Unit, Monash Health, Australia
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia; Diabetes and Vascular Unit, Monash Health, Australia.
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16
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Suzuki T, Nakamura Y, Kato H. Calcium and vitamin D supplementation with 3-year denosumab treatment is beneficial to enhance bone mineral density in postmenopausal patients with osteoporosis and rheumatoid arthritis. Ther Clin Risk Manag 2018; 15:15-22. [PMID: 30588001 PMCID: PMC6302805 DOI: 10.2147/tcrm.s182858] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background This 3-year retrospective study compared the outcomes of bisphosphonate-pretreated denosumab therapy with or without vitamin D and calcium supplementation in postmenopausal osteoporosis (OP) patients with rheumatoid arthritis (RA). Materials and methods Fifty-eight patients under long-term denosumab treatment were divided into groups without (denosumab group; 31 cases) or with (combination group; 27 cases) vitamin D and calcium supplementation. The bone markers of BAP, TRACP-5b, and urinary NTX were measured at baseline and every year for 3 years. We also evaluated bone mineral density (BMD) of the lumbar 1–4 vertebrae (L-BMD) and bilateral total hips (H-BMD) at the same time points. Results There were no significant differences in the percent changes of serum albumin-corrected calcium between the groups. The percent change in TRACP-5b was significantly higher in the combination group at 2 years. Serum 25-hydroxyvitamin D status was persistently high during therapy in both groups, with significant percent increases over baseline at 2 and 6 months in both groups and at 24 months in the combination group. The percent increase from baseline of serum zinc was significantly higher at 3 years in the combination group over the denosumab group. L-BMD and H-BMD were significantly increased at every time point for 3 years vs pretreatment levels in both groups and were significantly higher in the combination group at all time points. Conclusion Compared with denosumab monotherapy, the combination group displayed significantly increased serum zinc, L-BMD, and H-BMD at 3 years in OP patients with RA. Thus, calcium and vitamin D supplementation may be beneficial to enhance BMD gains, but not necessarily 25-hydroxyvitamin D status, in patients with OP and RA under denosumab.
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Affiliation(s)
- Takako Suzuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan,
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan, .,Department of Orthopaedic Surgery, Showa Inan General Hospital, Komagane, Japan,
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan,
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17
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Abstract
The last decade has seen a dramatic increase in general interest in and research into vitamin D, with many athletes now taking vitamin D supplements as part of their everyday dietary regimen. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship between vitamin D and bone health in non-athletic individuals. In contrast, data have consistently failed to demonstrate any relationship between serum 25[OH]D and bone health, which may in part be due to the osteogenic stimulus of exercise. Vitamin D may interact with extra-skeletal tissues such as muscle and the immune system to modulate recovery from damaging exercise and infection risk. Given that many athletes now engage in supplementation, often consuming extreme doses of vitamin D, it is important to assess whether excessive vitamin D can be detrimental to health. It has been argued that toxic effects only occur when serum 25[OH]D concentrations are greater than 180 nmol·l-1, but data from our laboratory have suggested high-dose supplementation could be problematic. Finally, there is a paradoxical relationship between serum 25[OH]D concentration, ethnicity, and markers of bone health: Black athletes often present with low serum 25[OH]D without physiological consequences. One explanation for this could be genetic differences in vitamin D binding protein due to ethnicity, resulting in greater concentrations of bioavailable (or free) vitamin D in some ethnic groups. In the absence of any pathology, screening may be unnecessary and could result in incorrect supplementation. Data must now be re-examined, taking into consideration bioavailable or "free" vitamin D in ethnically diverse groups to enable new thresholds and target concentrations to be established; perhaps, for now, it is time to "set vitamin D free".
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Affiliation(s)
- Daniel J Owens
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - Richard Allison
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK.,Exercise and Sport Science Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Arsenal Football Club, Bell Lane, London Colney, St Albans, Shenley, AL2 1DR, UK
| | - Graeme L Close
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK.
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18
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Ju SY, Lee JY, Kim DH. Low 25-hydroxyvitamin D levels and the risk of frailty syndrome: a systematic review and dose-response meta-analysis. BMC Geriatr 2018; 18:206. [PMID: 30180822 PMCID: PMC6124011 DOI: 10.1186/s12877-018-0904-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background Vitamin D deficiency and frailty are common with aging. Previous studies examining vitamin D status and frailty have produced mixed results, and in particular, the shape of the association has not been well established. We examined the association between 25-hydroxyvitamin D (25OHD) serum levels and frailty by performing a systematic review and dose-response meta-analysis. Methods We searched the PubMed, EMBASE and Cochrane Library databases of Elsevier through February 2017. Cross-sectional and cohort studies that reported adjusted risk ratios with 95% confidence intervals (CI) for frailty with ≥3 categories of 25OHD serum levels were selected. Data extraction was performed independently by two authors. The reported risk estimates for 25OHD categories were recalculated, employing a comprehensive trend estimation from summarized dose-response data. Results The pooled risk estimate of frailty syndrome per 25 nmol/L increment in serum 25OHD concentration was 0.88 (95% CI = 0.82–0.95, I2 = 86.8%) in the 6 cross-sectional studies and 0.89 (95% CI = 0.85–0.94, I2 = 0.0%) in the 4 prospective cohort studies. Based on the Akaike information criteria (AIC), a linear model was selected (AIC for the nonlinear model: − 5.4, AIC for the linear model: − 6.8 in the prospective cohort studies; AIC for the linear model: − 13.6, AIC for the nonlinear model: − 1.77 in the cross-sectional studies). Conclusions This dose-response meta-analysis indicates that serum 25OHD levels are significantly and directly associated with the risk of frailty. Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome. Electronic supplementary material The online version of this article (10.1186/s12877-018-0904-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sang Yhun Ju
- Department of Family Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea. .,Hospice Palliative Medicine, Division of Spirituality, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea.
| | - June Young Lee
- Department of Biostatistics, Korea University College of Medicine, 145, Anam-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Do Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, 70-9, Darigan 2-gil, Danwon-Gu, Ansan-Si, Gyeonggi-Do, 15459, Republic of Korea
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19
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Williams NC, Killer SC, Svendsen IS, Jones AW. Immune nutrition and exercise: Narrative review and practical recommendations. Eur J Sport Sci 2018; 19:49-61. [PMID: 29975589 DOI: 10.1080/17461391.2018.1490458] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Evidence suggests that periods of heavy intense training can result in impaired immune cell function, and whether this leaves elite athletes at greater risk of infections and upper respiratory symptoms (URS) is still debated. There is some evidence that episodes of URS do cluster around important periods of competition and intense periods of training. Since reducing URS, primarily from an infectious origin, may have implications for performance, a large amount of research has focused on nutritional strategies to improve immune function at rest and in response to exercise. Although there is some convincing evidence that meeting requirements of high intakes in carbohydrate and protein and avoiding deficiencies in nutrients such as vitamin D and antioxidants is integral for optimal immune health, well-powered randomised controlled trials reporting improvements in URS beyond such intakes are lacking. Consequently, there is a need to first understand whether the nutritional practices adopted by elite athletes increases their risk of URS. Second, promising evidence in support of efficacy and mechanisms of immune-enhancing nutritional supplements (probiotics, bovine colostrum) on URS needs to be followed up with more randomised controlled trials in elite athletes with sufficient participant numbers and rigorous procedures with clinically relevant outcome measures of immunity.
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Affiliation(s)
- Neil C Williams
- a Exercise and Health Research Group, Department of Sport Science, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Sophie C Killer
- b British Athletics, English Institute of Sport, National Performance Institute, Loughborough University , Loughborough , UK
| | | | - Arwel Wyn Jones
- d Lincoln Institute for Health, University of Lincoln , Lincoln , UK
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20
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Alwan A, Al Rassy N, Berro AJ, Rizkallah M, Matta J, Frenn F, Bachour F, Sebaaly A, Maalouf G, Zouhal H, El Hage R. Vitamin D and Trabecular Bone Score in a Group of Young Lebanese Adults. J Clin Densitom 2018; 21:453-458. [PMID: 29657024 DOI: 10.1016/j.jocd.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/01/2018] [Indexed: 12/29/2022]
Abstract
The relationship between vitamin D and trabecular bone score (TBS) in young adults remains unclear. The aim of this study was to explore the relationship between 25-hydroxyvitamin D [25(OH)D] serum levels and TBS in a healthy adult population. A total of 54 men and 61 women whose ages range from 18 to 35 participated in the present study. Participants with 25(OH)D insufficiency (between 21 and 29 ng/mL) were 55.7%, and those with 25(OH)D deficiency (≤20 ng/mL) were 11.4%. TBS positively correlated with 25(OH)D in men (r = 0.393; p <0.05) and women (r = 0.324; p < 0.05). In both genders, TBS was significantly higher in 25(OH)D-sufficient participants (≥30 ng/mL). The present study provides evidence that vitamin D positively affects bone health and suggests that maintaining adequate vitamin D status may be essential for optimal TBS values.
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Affiliation(s)
- Abir Alwan
- Department of Physical Education, Faculty of Arts and Social Sciences, University of Balamand, El-Koura, Lebanon
| | - Nathalie Al Rassy
- Department of Physical Education, Faculty of Arts and Social Sciences, University of Balamand, El-Koura, Lebanon; Laboratory of Pathophysiology of Inflammatory Bone Diseases PMOIEA4490, University of Littoral Opal Coast ULCO, Boulogne sur Mer and University of Lille, Lille, France
| | - Abdel-Jalil Berro
- Department of Physical Education, Faculty of Arts and Social Sciences, University of Balamand, El-Koura, Lebanon
| | - Maroun Rizkallah
- Bellevue University Medical Center, Faculty of Medicine, Saint Joseph University, Mansourieh, Lebanon
| | - Joseph Matta
- Industrial Research Institute, Baabda, Lebanon; Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Lebanon
| | | | | | | | - Ghassan Maalouf
- Bellevue University Medical Center, Faculty of Medicine, Saint Joseph University, Mansourieh, Lebanon
| | - Hassane Zouhal
- Laboratory of Movement, Sport and Health Sciences (M2S), UFR APS, University of Rennes 2, Rennes, France
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Social Sciences, University of Balamand, El-Koura, Lebanon.
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21
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Matana A, Popović M, Torlak V, Punda A, Barbalić M, Zemunik T. Effects of genetic variants on serum parathyroid hormone in hyperparathyroidism and end-stage renal disease patients: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e10834. [PMID: 29794776 PMCID: PMC6392899 DOI: 10.1097/md.0000000000010834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Parathyroid hormone (PTH) is one of the principal regulators of calcium homeostasis, crucial for normal functioning of the kidneys, bones, heart, and nervous system. Different pathologic conditions can affect serum PTH level resulting in hyperparathyroidism or hypoparathyroidism. Our study assessed the association of previously reported polymorphisms with the level of PTH (expressed in pg/mL) among individuals with different pathologic conditions affecting PTH level. METHODS We searched Web of Science, MEDLINE, and Scopus to identify relevant articles published up to July 2017. The search yielded 6967 publications of which 44 fulfilled the inclusion criteria. We conducted meta-analyses for calcium-sensing receptor gene (CaSR) rs1801725 polymorphism in patients with primary hyperparathyroidism and vitamin D receptor gene (VDR) rs1544410 polymorphism in patients with end-stage renal disease (ESRD). RESULTS None of the polymorphisms were significantly associated with PTH levels in the overall population. In subgroup analysis by ethnicity for VDR rs1544410 gene polymorphism, we found significant differences under dominant model (SMD: -0.18 [-0.32, -0.05], P < .01) and AA versus GG comparison (SMD: -0.29 [-0.52, -0.06], P < .01) in Asian patients with ESRD, while nominally significant results (P < .05) were observed for AG versus GG and AA versus GG comparisons in European individuals with ESRD. CONCLUSION Scientific evidence of genetic association of serum PTH level among individuals with different pathologic conditions remains deficient and published results provide weak evidence. Further well-conducted studies on larger sample sets designed according to evidence-based principles are warranted to assure clinically applicable findings.
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Affiliation(s)
- Antonela Matana
- Department of Medical Biology, University of Split, School of Medicine
| | - Marijana Popović
- Department of Medical Biology, University of Split, School of Medicine
| | - Vesela Torlak
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Maja Barbalić
- Department of Medical Biology, University of Split, School of Medicine
| | - Tatijana Zemunik
- Department of Medical Biology, University of Split, School of Medicine
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22
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Lim WH, Duncan EL. Is there a role or target value for nutritional vitamin D in chronic kidney disease? Nephrology (Carlton) 2018; 22 Suppl 2:57-64. [PMID: 28429558 DOI: 10.1111/nep.13027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Vitamin D is important for bone health in the general population but the value of vitamin D supplementation, and the role of 25-hydroxyvitamin D independently of 1,25-dihydroxyvitmain D, in individuals with chronic kidney disease (CKD), particularly in those who require dialysis, remains uncertain. Supplementation may improve some biochemical parameters, such as reducing PTH levels in patients to CKD-stage 4 who have vitamin D deficiency; but it remains to be established whether the role of nutritional vitamin D in maintaining bone health in the general population can be extrapolated to the CKD population. There is currently insufficient evidence to recommend conclusively that nutritional vitamin D supplementation should be prescribed to individuals with CKD who have 25-hydroxyvitamin D deficiency, either for skeletal or non-skeletal health outcomes.
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Affiliation(s)
- Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Emma L Duncan
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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23
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Osima M, Borgen TT, Lukic M, Grimnes G, Joakimsen RM, Eriksen EF, Bjørnerem Å. Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study. Osteoporos Int 2018; 29:421-431. [PMID: 29134242 DOI: 10.1007/s00198-017-4298-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/01/2017] [Indexed: 01/14/2023]
Abstract
UNLABELLED Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women. INTRODUCTION Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity. METHODS This case-control study included 211 postmenopausal women, 54-94 years old, with prevalent fractures and 232 controls from the Tromsø Study. Serum 25(OH)D, PTH, and bone turnover markers (procollagen type I N-terminal propeptide [PINP] and C-terminal cross-linking telopeptide of type I collagen [CTX]) were measured. Femoral subtrochanteric cortical and trabecular parameters were quantified using computed tomography, and femoral neck areal bone mineral density (FN aBMD) was quantified using dual-energy X-ray absorptiometry. RESULTS Compared with controls, fracture cases exhibited reduced serum 25(OH)D and increased PTH, PINP, and CTX, increased femoral subtrochanteric cortical porosity, and reduced cortical thickness and FN aBMD (all, p < 0.05). Serum 25(OH)D was not associated with cortical parameters (all, p > 0.10). PTH was associated with increased PINP, CTX, and cortical porosity of the inner transitional zone and reduced trabecular bone volume/tissue volume and FN aBMD (p ranging from 0.003 to 0.054). Decreasing 25(OH)D and increasing PTH were associated with increased odds for fractures, independent of age, height, weight, calcium supplementation, serum calcium, cortical porosity, and thickness. CONCLUSIONS These data suggest that serum PTH, not 25(OH)D, is associated with increased intracortical bone turnover resulting in trabecularisation of the inner cortical bone; nevertheless, decreasing 25(OH)D) and increasing PTH are associated with fracture risk, independent of cortical porosity and thickness.
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Affiliation(s)
- M Osima
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, N-9037, Tromsø, Norway.
- Department of Orthopaedic Surgery, University Hospital of North Norway, Tromsø, Norway.
| | - T T Borgen
- Department of Rheumatology, Vestre Viken Hospital Trust, Hospital of Drammen, Drammen, Norway
| | - M Lukic
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, N-9037, Tromsø, Norway
| | - G Grimnes
- Department of Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - R M Joakimsen
- Department of Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - E F Eriksen
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Å Bjørnerem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway
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McKinnon I, Lewis T, Mehta N, Imrit S, Thorp J, Ince C. Vitamin D in patients with intellectual and developmental disability in secure in-patient services in the North of England, UK. BJPsych Bull 2018; 42:24-29. [PMID: 29388522 PMCID: PMC6001870 DOI: 10.1192/bjb.2017.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED Aims and method To assess the benefits of the introduction of routine vitamin D serum sampling for all patients admitted to a secure in-patient hospital in the North of England providing medium security, low security and rehabilitation services for offenders with intellectual and developmental disability. The vitamin D levels of 100 patients were analysed at baseline. Those with insufficient or deficient levels were offered treatment and retested after 1 year. Vitamin D levels were analysed in the context of level of security, seasonality of test and co-prescription of psychotropic medications. RESULTS Eighty-three per cent of patients had suboptimal vitamin D levels at initial test (41% deficient and 42% insufficient). This was seen among established patients and new admissions. Regression analysis of baseline vitamin D levels revealed no differences for levels of security, seasonality, whether patients were taking antipsychotic or anticonvulsant medication, or length of stay. Patients with deficiency or insufficiency were all offered supplementation. Those who opted in had significantly higher vitamin D levels at follow-up, compared with those who declined treatment. Clinical implications Established and newly admitted patients in our secure mental health services had substantial levels of vitamin D insufficiency. In the light of the morbidities that are associated with deficient vitamin D levels, routine screening and the offer of supplementation is advisable. Declaration of interest None.
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Affiliation(s)
- Iain McKinnon
- Secure Services,Northumberland Tyne and Wear NHS Foundation Trust,UK
| | - Thomas Lewis
- Older People's Community Treatment Team,Northumberland Tyne and Wear NHS Foundation Trust,UK
| | - Naomi Mehta
- Learning Disability (CAMHS),Tees Esk and Wear Valleys NHS Foundation Trust,UK
| | - Shahed Imrit
- Secure Services,Northumberland Tyne and Wear NHS Foundation Trust,UK
| | - Julie Thorp
- Secure Services,Northumberland Tyne and Wear NHS Foundation Trust,UK
| | - Chris Ince
- Autism Services,Northumberland Tyne and Wear NHS Foundation Trust,UK
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Qi L, Ma W, Heianza Y, Zheng Y, Wang T, Sun D, Rimm EB, Hu FB, Giovannucci E, Albert CM, Rexrode KM, Manson JE. Independent and Synergistic Associations of Biomarkers of Vitamin D Status With Risk of Coronary Heart Disease. Arterioscler Thromb Vasc Biol 2017; 37:2204-2212. [PMID: 28882871 PMCID: PMC5658253 DOI: 10.1161/atvbaha.117.309548] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/22/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To comprehensively evaluate the independent associations and potential interactions of vitamin D-related biomarkers including total and bioavailable 25-hydroxyvitamin D (25OHD), VDBP (vitamin D binding protein), and parathyroid hormone (PTH) with risk of coronary heart disease (CHD). APPROACH AND RESULTS We prospectively identified incident cases of nonfatal myocardial infarction and fatal CHD among women in the Nurses' Health Study during 20 years of follow-up (1990-2010). Using risk-set sampling, 1 to 2 matched controls were selected for each case. The analysis of 25OHD and PTH included 382 cases and 575 controls; the analysis of VDBP included 396 cases and 398 controls. After multivariate adjustment, plasma levels of total 25OHD, bioavailable 25OHD, and PTH were not significantly associated with CHD risk. VDBP was associated with a lower CHD risk with an extreme-quartile odds ratio of 0.60 (95% confidence interval, 0.39-0.92; P trend=0.02). When examining the biomarkers jointly, a significant, inverse association between 25OHD and CHD was observed among participants with higher PTH levels (P for interaction=0.02). The odds ratio (95% confidence interval) comparing the highest quartile of 25OHD to lowest was 0.43 (0.23-0.82; P trend=0.003) when PTH levels were above population median (35.3 pg/mL), whereas among the rest of participants the corresponding odds ratio (95% confidence interval) was 1.28 (0.70-2.36; P trend=0.43). CONCLUSIONS Our data suggest that higher 25OHD levels were associated with a lower CHD risk when PTH levels were high, whereas no association was observed for participants with low PTH levels. VDBP but not bioavailable 25OHD was independently associated with lower CHD risk.
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Affiliation(s)
- Lu Qi
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| | - Wenjie Ma
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Yoriko Heianza
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Yan Zheng
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tiange Wang
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Dianjianyi Sun
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Eric B Rimm
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Frank B Hu
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Edward Giovannucci
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Christine M Albert
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kathryn M Rexrode
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - JoAnn E Manson
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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Giollo A, Idolazzi L, Caimmi C, Fassio A, Bertoldo F, Dalle Grave R, El Ghoch M, Calugi S, Bazzani PV, Viapiana O, Rossini M, Gatti D. Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa. Int J Eat Disord 2017; 50:1041-1049. [PMID: 28593655 DOI: 10.1002/eat.22731] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/09/2017] [Accepted: 05/17/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of the study was to investigate a potential role for vitamin D status on bone mineral density (BMD) during weight gain in patients with anorexia nervosa (AN). METHOD Spine and hip BMD assessed by dual-energy X-ray absorptiometry (DXA), serum vitamin D (25-OH-D), N-propeptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), and intact parathyroid hormone (PTH) were measured before and after a 20-week intensive weight-restoration program in ninety-one female patients with AN and secondary amenorrhoea. RESULTS Ninety-one consecutive female patients (age 13-45 years; weight 39.4 ± 5.6 kg, body mass index [BMI] 15.1 ± 1.6 kg m-2 ) were included in the study. Although weight and BMI significantly increased in all patients during treatment, mean BMD only significantly increased at the spine (1.0% ± 3.6%, p = .009). The increase in spine BMD was significantly higher only above post-treatment 25-OH-D levels of 30 ng mL-1 (2.5% vs. 0.5%, respectively, for 25-OH-D ≥ and < 30 ng mL-1 , p = .026). There was a significant decrease in bone resorption (CTX; p = .043) and increased bone formation (P1NP; p < .001) after weight restoration. Nevertheless, a significant increase in PTH was also found, which was inversely correlated with decreased post-treatment 25-OH-D levels (R2 = .153, p < .001). DISCUSSION Hypovitaminosis D may counteract the efficacy of refeeding in AN through increased bone resorption mediated by secondary hyperparathyroidism, which strongly supports the use of vitamin D supplements for bone health in AN.
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Affiliation(s)
- Alessandro Giollo
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Luca Idolazzi
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Cristian Caimmi
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Angelo Fassio
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Francesco Bertoldo
- Department of Medicine, Internal Medicine Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | | | - Ombretta Viapiana
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Maurizio Rossini
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Davide Gatti
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
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Vitamin D deficiency is associated with disability and disease progression in multiple sclerosis patients independently of oxidative and nitrosative stress. J Neurol Sci 2017; 381:213-219. [PMID: 28991684 DOI: 10.1016/j.jns.2017.07.046] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/10/2017] [Accepted: 07/29/2017] [Indexed: 12/31/2022]
Abstract
The aim of this study was to assess vitamin D status in patients with multiple sclerosis (MS) and to evaluate whether it was associated with oxidative and nitrosative stress (O&NS) markers and disability. This study included 137 patients with MS and 218 healthy controls. The markers evaluated were serum levels of 25-hydroxyvitamin D, lipid hydroperoxides, advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), and total radical-trapping antioxidant parameter TRAP/UA. Patients with 25(OH)D<20ng/mL showed higher EDSS (p=0.016), MSSS (p=0.005) and lower AOPP (p=0.046) than those with 25(OH)D≥20ng/mL. After the binary logistic regression analyses, EDSS and MSSS remained significantly associated with vitamin D deficiency. We showed that lower levels of 25(OH)D were associated with higher EDSS and MSSS independently of variables such as O&NS, age, sex, body mass index, ethnicity, MS therapy, use of interferon beta, and clinical forms of MS (odds ratio: 1.380, 95% confidence interval 1.030-1.843, p=0.031). Moreover, the study showed an association between serum levels of 25(OH)D and EDSS (r2=0.115, p=0.002), demonstrating that 25(OH)D may contribute with 11.5% of increase in EDSS. Our results suggest that vitamin D deficiency may be considered one of the predictors of the disability in MS patients, independently of their redox status and influence the progression of disability in MS.
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Stewart NF, Lewis SN. Vitamin D deficiency in adolescents in a tier 4 psychiatric unit. BJPsych Bull 2017; 41:133-136. [PMID: 28584648 PMCID: PMC5451645 DOI: 10.1192/pb.bp.115.053298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 06/28/2016] [Accepted: 07/20/2016] [Indexed: 11/23/2022] Open
Abstract
Aims and method To review the current clinical practice and guidelines for testing and treating vitamin D deficiency in adolescents admitted to a tier 4 adolescent psychiatric unit in north London. The blood test results of 56 patients admitted between 2012 and 2014 were examined to determine whether vitamin D levels had been tested. For those individuals who were tested for vitamin D, results were analysed by gender and ethnicity. Results Of 56 patients admitted, 48% were tested for vitamin D deficiency and in 81.5% of cases we uncovered deficiency or severe deficiency; 18.5% had the minimum levels of vitamin D for bone health as per our trust guidelines. Clinical implications Adolescents within tier 4 adolescent mental health services may be at higher risk of vitamin D deficiency and so assessment of vitamin D levels should be considered as part of a standard physical health review for this group of young people.
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Combination breast cancer chemotherapy with doxorubicin and cyclophosphamide damages bone and bone marrow in a female rat model. Breast Cancer Res Treat 2017; 165:41-51. [DOI: 10.1007/s10549-017-4308-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
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Abdurahman AA, Khorrami-Nezhad L, Mirzaei K. Vitamin D (FokI) Receptor Gene Polymorphism is associated with Vitamin D Deficiency and Chronic Musculoskeletal Pain. A meta-analysis. INT J VITAM NUTR RES 2017; 87:219-232. [PMID: 31084485 DOI: 10.1024/0300-9831/a000569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Musculoskeletal pain is the most common chronic pain experienced by older adults. The aim of this study is to explore the associations between vitamin D (FOKI) receptor gene polymorphism (VDR) and vitamin D deficiency (VDD) and chronic musculoskeletal pain. Methods: Cross-sectional studies published in English from January 2000 to January 2015which reported prevalence of chronic pain (CP) and chronic musculoskeletal pain (CMP) were included in this systematic review and meta-analysis. A heat map was used to visualize and observe the correlation between VDR and CMP, CP and VDD. Results: 20 studies (N = 216,365) were included in the analysis, which showed an overall pooled prevalence estimate of CMP and CP as 30.6 per 100 (95 % CI: 30.59, 30.69) and 27.9 per 100 (95 % CI: 27.68, 28.24) respectively. The heat map clustering analysis visualizes the similarity between CP and CMP. Moreover, a direct correlation was observed between the three disease conditions (namely CMP, CP, and VDD) and FokI VDR polymorphism (FF). Spearman's correlation analyses with adjusted r2 revealed that there is a statistically significant interaction effect of the FF genotype and VDD on CMP (r2 = 0.19, p = 0.03), a marginally significant interaction effect of the ff genotype and VDD on CMP (r2 = 0.11, p = 0.08). VDD was also associated with increased CMP (r2 = 0.19, p = 0.028). The pooled estimates of the prevalence of CMP in this review were found to be high. Conclusion: FokI VDR gene polymorphism (FF) plays an important role in the relationship between VDD and CMP.
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Affiliation(s)
- Ahmed Abdulahi Abdurahman
- 1 Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran, University of Medical Sciences, Tehran, Iran.,2 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences International Campus, Tehran, Iran
| | - Leila Khorrami-Nezhad
- 3 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- 3 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Alfieri DF, Lehmann MF, Oliveira SR, Flauzino T, Delongui F, de Araújo MCM, Dichi I, Delfino VD, Mezzaroba L, Simão ANC, Reiche EMV. Vitamin D deficiency is associated with acute ischemic stroke, C-reactive protein, and short-term outcome. Metab Brain Dis 2017; 32:493-502. [PMID: 27975188 DOI: 10.1007/s11011-016-9939-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 12/07/2016] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate whether vitamin D deficiency (VDD) is associated with acute ischemic stroke, inflammatory markers, and short-term outcome. 168 acute ischemic stroke patients and 118 controls were included. The modified Rankin Scale (mRS) was applied up to 8 h of admission (baseline) and after three-months follow-up, and blood samples were obtained up to 24 h of admission to evaluate serum levels of 25-hydroxivitamin D [25(OH)D] and inflammatory markers. Vitamin D levels classified the individuals in sufficient (VDS ≥ 30.0 ng/mL), insufficient (VDI 20.0-29.9 ng/mL), and deficient (VDD < 20.0 ng/mL) status. Patients had lower levels of 25(OH)D, higher frequency of VDD (43.45% vs. 5.08%, OR: 16.64, 95% CI: 5.66-42.92, p < 0.001), and higher inflammatory markers than controls (p < 0.05). Patients with VDD showed increased high sensitivity C-reactive protein (hsCRP) levels than those with VDS status (p = 0.043); those with poor outcome presented with lower 25(OH)D levels than those with good outcome (p = 0.008); moreover, 25(OH)D levels were negatively correlated with mRS after three-months follow-up (r = -0.239, p = 0.005). The associations between VDD and higher hsCRP levels and between 25(OH)D levels and poor outcome at short-term in acute ischemic stroke patients suggest the important role of vitamin D in the inflammatory response and pathophysiology of this ischemic event.
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Affiliation(s)
- Daniela Frizon Alfieri
- Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Márcio Francisco Lehmann
- Department of Clinical Surgery, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Sayonara Rangel Oliveira
- Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Tamires Flauzino
- Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Francieli Delongui
- Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Isaias Dichi
- Departmet of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Vinícius Daher Delfino
- Departmet of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Leda Mezzaroba
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil
| | - Andréa Name Colado Simão
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil.
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Alkhenizan A, Mahmoud A, Hussain A, Gabr A, Alsoghayer S, Eldali A. The Relationship between 25 (OH) D Levels (Vitamin D) and Bone Mineral Density (BMD) in a Saudi Population in a Community-Based Setting. PLoS One 2017; 12:e0169122. [PMID: 28046015 PMCID: PMC5207714 DOI: 10.1371/journal.pone.0169122] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 12/12/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been linked to an increased risk of osteoporosis. Vitamin D deficiency has reached high levels in the Saudi population, but there is conflicting evidence both in the Saudi population, and worldwide, regarding the existence of a correlation between these low vitamin D levels and reduced BMD (bone mineral density), or osteoporosis. OBJECTIVE The objective of this study was primarily to determine whether there was a correlation between vitamin D deficiency and osteoporosis in the Saudi population. We aimed to investigate whether the high levels of vitamin D deficiency and insufficiency would translate to higher prevalence of osteoporosis, and whether there is a correlation between vitamin D levels and bone mineral density. MATERIALS AND METHODS This was a community based cross sectional study conducted in the Family Medicine Clinics at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. Electronic records of 1723 patients were reviewed. Laboratory and radiology results were collected, including vitamin D levels, calcium levels, and bone mineral density scan results. RESULTS Among the whole population, 61.5% had moderate to severe vitamin D deficiency with levels less than 50nmol/L. 9.1% of the population had osteoporosis, and 38.6% had osteopenia. Among the whole population, there was no significant correlation between spine or total femoral BMD and serum 25(OH) D. CONCLUSION Vitamin D deficiency is prevalent in the Saudi population. However, no correlation has been found between vitamin D deficiency and reduced bone mineral density in any age group, in males or females, Saudis or Non-Saudis, in our population in Riyadh, Saudi Arabia.
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Affiliation(s)
- Abdullah Alkhenizan
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Mahmoud
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Aneela Hussain
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Alia Gabr
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Suad Alsoghayer
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Abdelmoneim Eldali
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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Datta P, Philipsen PA, Olsen P, Bogh MK, Johansen P, Schmedes AV, Morling N, Wulf HC. The half-life of 25(OH)D after UVB exposure depends on gender and vitamin D receptor polymorphism but mainly on the start level. Photochem Photobiol Sci 2017; 16:985-995. [DOI: 10.1039/c6pp00258g] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The 25(OH)D decrease over time in a group (N= 22) with high 25(OH)D start levels was exponential. The half-life (T1/2) was 89 days and prolonged in materials with lower 25(OH)D start levels.
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Affiliation(s)
- Pameli Datta
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter A. Philipsen
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter Olsen
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Morten K. Bogh
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter Johansen
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Anne V. Schmedes
- Department of Clinical Immunology and Biochemistry
- Lillebaelt Hospital
- 7100 Vejle
- Denmark
| | - Niels Morling
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Hans C. Wulf
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
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Serdar MA, Batu Can B, Kilercik M, Durer ZA, Aksungar FB, Serteser M, Coskun A, Ozpinar A, Unsal I. Analysis of Changes in Parathyroid Hormone and 25 (OH) Vitamin D Levels with Respect to Age, Gender and Season: A Data Mining Study. J Med Biochem 2017; 36:73-83. [PMID: 28680352 PMCID: PMC5471662 DOI: 10.1515/jomb-2017-0002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/07/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND 25 (OH) vitamin D3 (25(OH)D) and parathyroid hormone (PTH) are important regulators of calcium homeostasis. The aim of this study was to retrospectively determine the cut-off for sufficient 25(OH)D in a four-season region and the influence of age, seasons, and gender on serum 25(OH)D and PTH levels. METHODS Laboratory results of 9890 female and 2723 male individuals aged 38.8±22.1 years who had simultaneous measurements of 25(OH)D and PTH were retrospectively analyzed by statistical softwares. Serum 25(OH)D and PTH levels were measured by a mass spectrometry method and by an electrochemiluminescence immunoassay, respectively. RESULTS Mean serum 25(OH)D levels showed a sinusoidal fluctuation throughout the year and were significantly (p<0.01) higher in summer and autumn. On the other hand, PTH levels were significantly higher (p<0.01) in women and showed an opposite response to seasonal effects relative to 25(OH)D. Lowest levels of 25(OH)D were detected in people aged between 20 and 40 years whereas PTH hormone levels were gradually increasing in response to aging. The significant exponential inverse relationship that was found between PTH and 25(OH)D (PTH=exp(4.12-0.064*sqrt(25(OH)D)) (r=-0.325, R- squared=0.105, p<0.001)) suggested that the cut-off for sufficient 25(OH)D should be 75 nmol/L. CONCLUSIONS Our retrospective study based on large data set supports the suitability of the currently accepted clinical cut-off of 75 nmol/L for sufficient 25(OH)D. However, the issue of assessing Vitamin D deficiency remains difficult due to seasonal variations in serum 25(OH)D. Therefore, PTH measurements should complement 25(OH)D results for diagnosing Vitamin D deficiency. It is imperative that seasonally different criteria should be considered in future.
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Affiliation(s)
- Muhittin A. Serdar
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
- Clinlab Laboratories, Acibadem Healthcare Group, Ankara, Turkey
| | - Başar Batu Can
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Meltem Kilercik
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Zeynep A. Durer
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Fehime Benli Aksungar
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Mustafa Serteser
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Abdurrahman Coskun
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Aysel Ozpinar
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
| | - Ibrahim Unsal
- School of Medicine, Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey
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Kharroubi A, Saba E, Smoom R, Bader K, Darwish H. Serum 25-hydroxyvitamin D and bone turnover markers in Palestinian postmenopausal osteoporosis and normal women. Arch Osteoporos 2017; 12:13. [PMID: 28124221 PMCID: PMC5266783 DOI: 10.1007/s11657-017-0306-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 12/30/2016] [Indexed: 02/06/2023]
Abstract
UNLABELLED This study evaluated the association of vitamin D and bone markers with the development osteoporosis in Palestinian postmenopausal women. Even though vitamin D deficiency was very high for the recruited subjects, it was not associated with osteoporosis except for bones of the hip. Age and obesity were the strongest determining factors of the disease. PURPOSE The purpose of this study was to investigate the association of bone mineral density (BMD) with serum vitamin D levels, parathyroid hormone (PTH), calcium, obesity, and bone turnover markers in Palestinian postmenopausal women. METHODS Three hundred eighty-two postmenopausal women (≥45 years) were recruited from various women clinics for BMD assessment (131 women had osteoporosis and 251 were normal and served as controls). Blood samples were obtained for serum calcium, PTH, 25(OH)D, bone formation (N-terminal propeptide (PINP)), and bone resorption (serum C-terminal telopeptide of type I collagen (CTX1)) markers. RESULTS Women with osteoporosis had statistically significant lower mean weight, height, body mass index (BMI), and serum calcium (p < 0.05) compared to controls. No significant differences were detected between the mean values of bone turnover markers (CTX and PINP), 25(OH)D, and PTH of the two groups. Women with vitamin D deficiency (severe and insufficiency) represented 85.9% of the study subjects. Multiple and logistic regression showed that age and BMI significantly affected BMD and vitamin D had a significant association with BMD only at the lumbar spine. BMI was positively correlated with BMD and PTH but negatively correlated with vitamin D. Logistic regression showed that the odds ratio (OR) for having osteoporosis decreased with increasing BMI (overweight OR = 0.11, p = 0.053; obese OR = 0.05, p = 0.007). CONCLUSIONS There was no direct correlation between BMD and PTH, bone turnover markers, and vitamin D except at the lumbar spine. A negative correlation between BMD and age and a positive correlation with BMI were observed. The protective effect of obesity on osteoporosis was complicated by the effect of obesity on vitamin D and PTH.
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Affiliation(s)
- Akram Kharroubi
- Faculty of Health Professions, Al-Quds University, Jerusalem, Palestine
| | - Elias Saba
- Palestinian Osteoporosis Prevention Society [POPS], Bethlehem, Palestine
| | - Riham Smoom
- Medical Research Center, Al-Quds University, Jerusalem, Palestine
| | - Khaldoun Bader
- Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
| | - Hisham Darwish
- Palestinian Osteoporosis Prevention Society [POPS], Bethlehem, Palestine.
- Medical Research Center, Al-Quds University, Jerusalem, Palestine.
- Faculty of Allied Medical Sciences, Arab American University-Jenin AAUJ, Jenin, Palestine.
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Wierzbicka JM, Żmijewski MA, Piotrowska A, Nedoszytko B, Lange M, Tuckey RC, Slominski AT. Bioactive forms of vitamin D selectively stimulate the skin analog of the hypothalamus-pituitary-adrenal axis in human epidermal keratinocytes. Mol Cell Endocrinol 2016; 437:312-322. [PMID: 27524410 PMCID: PMC5048597 DOI: 10.1016/j.mce.2016.08.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/07/2016] [Accepted: 08/03/2016] [Indexed: 12/22/2022]
Abstract
Ultraviolet radiation B stimulates both the production of vitamin D3 in the skin and the activation of the skin analog of the hypothalamic-pituitary-adrenal axis (HPA) as well as the central HPA. Since the role of vitamin D3 in the regulation of the HPA is largely unknown, we investigated the impact of 1,25(OH)2D3 and its noncalcemic analogs, 20(OH)D3 and 21(OH)pD, on the expression of the local HPA in human epidermal keratinocytes. The noncalcemic analogs showed similar efficacy to 1,25(OH)2D3 in stimulating the expression of neuropeptides, CRF, urocortins and POMC, and their receptors, CRFR1, CRFR2, MC1R, MC2R, MC3R and MC4R. Interestingly, unlike other secosteroids, the activity of 21(OH)pD did not correlate with induction of differentiation, suggesting a separate but overlapping mechanism of action. Thus, biologically active forms of vitamin D can regulate different elements of the local equivalent of the HPA with implications for the systemic HPA.
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Affiliation(s)
| | | | - Anna Piotrowska
- Department of Histology, Medical University of Gdańsk, Poland
| | - Boguslaw Nedoszytko
- Department and Clinic of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland
| | - Magdalena Lange
- Department and Clinic of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland
| | - Robert C Tuckey
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, WA 6009, Australia
| | - Andrzej T Slominski
- Department of Dermatology, University of Alabama Birmingham, Birmingham, AL 35294, USA; Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama Birmingham, Birmingham, AL 35294, USA; VA Medical Center, Birmingham, AL 35294, USA
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Okazaki R, Watanabe R, Inoue D. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease. J Bone Metab 2016; 23:111-20. [PMID: 27622174 PMCID: PMC5018603 DOI: 10.11005/jbm.2016.23.3.111] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 07/02/2016] [Indexed: 12/23/2022] Open
Abstract
Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients.
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Affiliation(s)
- Ryo Okazaki
- Third Department of Medicine, Teikyo University Chiba Medical Center, Japan
| | - Reiko Watanabe
- Third Department of Medicine, Teikyo University Chiba Medical Center, Japan
| | - Daisuke Inoue
- Third Department of Medicine, Teikyo University Chiba Medical Center, Japan
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Schray D, Neuerburg C, Stein J, Gosch M, Schieker M, Böcker W, Kammerlander C. Value of a coordinated management of osteoporosis via Fracture Liaison Service for the treatment of orthogeriatric patients. Eur J Trauma Emerg Surg 2016; 42:559-564. [PMID: 27458065 DOI: 10.1007/s00068-016-0710-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/11/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The prevalence of osteoporosis in female patients over 75 years of age is 59.2 %. In Germany ~6.3-7.8 million patients are affected by osteoporosis. In 77 % of german patients osteoporosis is not treated adequately. Even after fragility fractures only 16-21 % of female patients and 3 % of male patients are supplied with a specific osteoporosis therapy. Establishing a Fracture Liaison Services (FLS) is a possible addition to co-management for an efficient treatment of osteoporosis in orthogeriatric patients. MATERIALS AND METHODS According to a treatment algorithm adapted to the DVO guideline 2014, data of 251 (77 male, 173 female) patients were collected over 3 months. For the assessment specific and standardized questionnaires were used. There was also a basic laboratory testing for osteoporosis done. RESULTS The average age of female patients was 76.1 years, in male patients 76.6 years. Thirty-seven patients had vertebral fractures, 25 patients proximal humerus fractures, 18 distal radius fractures and a total of 78 proximal femur fractures were recorded. Eighteen percent of the 251 patients have already been treated with a basic and 11 % with a specific osteoporosis medication. Approximately 40 % of the orthogeriatric patients were diagnosed with osteoporosis for the first time in our clinic. Less than 1 % of the patients had a vitamin D level over 40 ng/ml and 32 % had a vitamin D level under 10 ng/ml. Sixty-five percent of the discharged patients received a basic osteoporosis therapy and 25 % an additional specific therapy. DISCUSSION Due to the demographic development osteoporosis-associated fractures steadily increase. In addition to the surgical treatment of fractures, osteological diagnosis and treatment are essential components of successful treatment and critical to the prevention of further fractures. A combination of orthogeriatric center and fracture liaison service allows a more efficient treatment of osteoporosis by close supervision of orthogeriatric patients by the physicians involved.
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Affiliation(s)
- D Schray
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
| | - C Neuerburg
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany
| | - J Stein
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany
| | - M Gosch
- Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private Medical University, Nuremberg, Germany
| | - M Schieker
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany
| | - W Böcker
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany
| | - C Kammerlander
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany
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Tønnesen R, Hovind PH, Jensen LT, Schwarz P. Determinants of vitamin D status in young adults: influence of lifestyle, sociodemographic and anthropometric factors. BMC Public Health 2016; 16:385. [PMID: 27170258 PMCID: PMC4863340 DOI: 10.1186/s12889-016-3042-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 04/22/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Very few studies have investigated the determinants of circulating 25-hydroxyvitamin D (25[OH]D) in young adults (18-25 years old) using a set of variables that include lifestyle, sociodemographic, and anthropometric data. Our aim was to investigate the association between these variables and vitamin D status in a sample of untreated young adults. METHODS A total of 738 young adults were enrolled in a (June cross-sectional study 2012 to May 2014) and were recruited from educational institutions in the Copenhagen area. For multivariate logistic regression subjects was categorized based on 25[OH]D in serum into; vitamin D sufficiency (S-25[OH]D > 50 nmol/L), vitamin D insufficiency (25 nmol/L ≤ S-25[OH]D ≤ 50 nmol/L), vitamin D deficiency (S-25[OH]D < 25 nmol/L). Information on lifestyle factors and education was obtained by self-reported questionnaires. RESULTS 700 subjects with a valid measurement of S-25[OH]D and a completed questionnaire was analysed. 238 had vitamin D insufficiency, 135 had vitamin D deficiency of which 13 had severe vitamin D deficiency (S-25[OH]D < 12.5 nmol/L). The relative risk (RR) for vitamin D deficiency was highest for men 2.09 (1.52, 2.87); obese subjects 2.00 (1.27, 3.15); smokers 1.33 (1.02, 1.73); subjects who exercised 0-½ hours a week 1.88 (1.21, 2.94); and subjects who consumed fast food once a week 1.59 (1.05, 2.43). The relative risk was significantly lower for subjects who were studying for a Bachelor's degree (0.40 (0.23, 0.68). For vitamin D insufficiency, the highest RR was again for men 1.31 (1.06, 1.61); obese subjects 1.57 (1.17, 2.11); and subjects who exercised 0-½ hours a week 1.51 (1.11, 2.06). CONCLUSION In this study of young adults, vitamin D deficiency was highly prevalent. Modifiable factors such as smoking, maintenance of normal BMI, and physical activity are all potential targets for interventional trials to determine the causal order; such knowledge would be useful in improving S-25[OH]D in young adults. The small group with severe vitamin D deficiency warrants increased attention.
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Affiliation(s)
- Rune Tønnesen
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Nordre Ringvej 57, 2600, Copenhagen, Glostrup, Denmark.
| | - Peter Hambak Hovind
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Nordre Ringvej 57, 2600, Copenhagen, Glostrup, Denmark
| | - Lars Thorbjørn Jensen
- Department of Clinical Physiology and Nuclear Medicine, University Hospital of Herlev, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Schwarz
- Department of Endocrinology PE and Research Centre of Ageing and Osteoporosis, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Li M, Lv F, Zhang Z, Deng W, Li Y, Deng Z, Jiang Y, Wang O, Xing X, Xu L, Xia W. Establishment of a normal reference value of parathyroid hormone in a large healthy Chinese population and evaluation of its relation to bone turnover and bone mineral density. Osteoporos Int 2016; 27:1907-16. [PMID: 26733373 DOI: 10.1007/s00198-015-3475-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 12/21/2015] [Indexed: 01/06/2023]
Abstract
UNLABELLED A normal reference value of parathyroid hormone (PTH) was established for the first time in a large sample of healthy Chinese subjects by completely excluding interference of vitamin D deficiency. A high PTH level correlated significantly with an elevated bone turnover and a reduced bone mineral density (BMD). INTRODUCTION The aims of this study are to establish a normal reference value for serum PTH and to evaluate the effect of parathyroid gland status on bone turnover and BMD. METHODS Our cross-sectional study included 1436 healthy individuals from 5 different Chinese cities. Concentrations of serum PTH, 25-hydroxyvitamin D (25OHD), procollagen I N-terminal peptide (P1NP, a bone formation marker), and carboxyl-terminal telopeptide of type I collagen (β-CTX, a bone resorption marker) were measured by electrochemiluminescence immunoassay. BMD was measured by dual-energy X-ray absorptiometry. The relation of PTH concentration to age, gender, height, and weight was examined. Reference values of PTH were established for all subjects and for subjects categorized by serum 25OHD concentrations. Correlations of PTH levels with bone turnover biomarkers and BMD were statistically analyzed. RESULTS Reference values of PTH were 8.84-69.95 pg/mL in all the subjects and 7.48-60.73 and 5.83-56.78 pg/mL in the subjects with serum 25OHD concentrations of ≥20 and ≥30 ng/mL, respectively. Serum PTH showed a negative linear correlation with 25OHD, and the breakpoint was 18.21 ng/mL, below which the PTH level rapidly increased. The increase in PTH levels with age showed a positive linear correlation with P1NP and β-CTX concentrations and a negative linear correlation with BMD at the lumbar spines and the femoral neck. CONCLUSIONS A reference value of PTH was established in a large sample of healthy Chinese subjects according to 25OHD status, gender, and age. A high PTH level correlated significantly with an elevated bone turnover and a reduced BMD.
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Affiliation(s)
- M Li
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - F Lv
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Z Zhang
- Department of Osteoporosis, Sixth People's Hospital, Shanghai Jiaotong University, No. 600 Yishan Road, Shanghai, 200233, China
| | - W Deng
- Department of Geriatrics, General Hospital of Guangzhou Military Command, No. 111 Liuhua Road, Guangzhou, 510010, China
| | - Y Li
- Department of Laboratory, Hubei General Hospital, No. 238 Jiefang Road, Wuhan, 430060, China
| | - Z Deng
- Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang road, Chongqing, 400010, China
| | - Y Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - O Wang
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - X Xing
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - L Xu
- Department of Obstetrics and Gynecology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - W Xia
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China.
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Inoue D, Watanabe R, Okazaki R. COPD and osteoporosis: links, risks, and treatment challenges. Int J Chron Obstruct Pulmon Dis 2016; 11:637-48. [PMID: 27099481 PMCID: PMC4820217 DOI: 10.2147/copd.s79638] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis and its related fractures are common and have significant impacts on quality of life and even respiratory function in patients with COPD. COPD-associated osteoporosis is however extremely undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Various clinical risk factors of osteoporosis in COPD patients, including older age, emaciation, physical inactivity, and vitamin D deficiency, have also been described. It is critically important for pulmonologists to be aware of the high prevalence of osteoporosis in COPD patients and evaluate them for such fracture risks. Routine screening for osteoporosis will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage and give them appropriate treatment to prevent fracture, which may lead to improved quality of life as well as better long-term prognosis.
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Affiliation(s)
- Daisuke Inoue
- Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Reiko Watanabe
- Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Ryo Okazaki
- Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
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Vitamin D Deficiency with High Intact PTH Levels is More Common in Younger than in Older Women: A Study of Women Aged 39-64 Years. Keio J Med 2016; 65:33-8. [PMID: 26853879 DOI: 10.2302/kjm.2015-0010-oa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Low serum 25-hydroxyvitamin D (25(OH)D) levels are implicated as a risk factor for hip and spine fractures. Studies of the relation between 25(OH)D levels and fractures have primarily involved elderly osteoporosis patients or patients with fractures; however, the serum 25(OH)D and parathyroid hormone (PTH) status in younger adult populations remains largely unknown. We evaluated serum 25(OH)D and intact PTH levels in 411 women aged 39-64 years who were not receiving medication for osteoporosis or other bone diseases. Serum 25(OH)D levels were positively correlated with age (P = 0.019), whereas intact PTH levels were inversely correlated with 25(OH)D levels (P < 0.001). Thus, low vitamin D levels with high intact PTH levels were more common in younger than in older women. Our data show that serum 25(OH)D insufficiency could be a more serious concern in the younger population than had been previously anticipated. Because serum 25(OH)D insufficiency is reportedly a risk factor for hip and spine fracture, the number of fracture patients could increase in the future, suggesting that we may need to correct the serum vitamin D/intact PTH status to prevent future osteoporosis.
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Datta P, Philipsen PA, Olsen P, Petersen B, Johansen P, Morling N, Wulf HC. Major inter-personal variation in the increase and maximal level of 25-hydroxy vitamin D induced by UVB. Photochem Photobiol Sci 2016; 15:536-45. [DOI: 10.1039/c5pp00462d] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Individual differences in vitamin D formation and metabolism after long-term UVB exposure were at least 131 nmol l−1, even after eliminating most of the known external and behavioural sources of variation.
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Affiliation(s)
- Pameli Datta
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter A. Philipsen
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter Olsen
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Bibi Petersen
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
| | - Peter Johansen
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Niels Morling
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Hans C. Wulf
- Department of Dermatology
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen NV
- Denmark
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Jacob EA, Blum L, Bedair HS, Freiberg AA, Quraishi SA. The Association of Vitamin D Status and Pre-operative Physical Activity in Patients with Hip or Knee Osteoarthritis. JOURNAL OF RESTORATIVE MEDICINE 2015; 4:3-10. [PMID: 30505632 PMCID: PMC6261296 DOI: 10.14200/jrm.2015.4.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Vitamin D is important for musculoskeletal health and may have significant implications for maintaining physical activity in elderly patients. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are associated with pre-operative physical activity in patients who are offered elective knee or hip joint replacement surgery. METHODS We performed a single-center, retrospective analysis of patients who had elective knee or hip replacement surgery from 2002 to 2012. To investigate the association of serum 25OHD levels with pre-operative physical activity, as assessed by the University of California, Los Angeles (UCLA) activity scale, we performed a multivariable logistic regression analysis while controlling for age, sex, race, body mass index, American Society of Anesthesiologists physical status score, and season. RESULTS We identified 182 patients who met inclusion criteria. Mean (± standard deviation) 25OHD level and UCLA activity scale score were 29±13 ng/mL and 4±2, respectively. Patients with 25OHD levels <20 ng/mL were almost three times more likely to have UCLA activity scale scores ≤3 [adjusted odds ratio 2.78; 95% confidence interval 1.72-9.17]. Further adjusting for "type of 25OHD assay" or "type of joint surgery" did not materially change this result. CONCLUSION In our cohort of knee or hip joint replacement surgery patients, 25OHD levels were associated with pre-operative physical activity scores. Prospective, randomized, clinical trials are needed to verify whether optimizing pre-operative vitamin D status may improve physical activity and influence clinical decision-making in knee or hip joint replacement surgery candidates.
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Affiliation(s)
| | - Livnat Blum
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hany S. Bedair
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrew A. Freiberg
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sadeq A. Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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45
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Lin G, Ning L, Gu D, Li S, Yu Z, Long Q, Hou LN, Tan WL. Examining the association of circulating 25-hydroxyvitamin D with kidney cancer risk: a meta-analysis. Int J Clin Exp Med 2015; 8:20499-20507. [PMID: 26884966 PMCID: PMC4723811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the relationship between circulating 25-hydroxy-vitamin D (25 (OH) D) and risk of kidney cancer. METHODS We searched PubMed, EMBASE, and Web of Science databases through August 31, 2015 for eligible studies. Pooled ORs with 95% confidence interval were calculated using fixed effect models. All data analyses were performed with STATA version 12.0. RESULTS The final analysis included 2 prospective cohort studies and 7 nested case-control studies, with a total of 130, 609 participants and 1, 815 cases of kidney cancer. No obvious heterogeneity was observed between individual studies. The results of this study revealed that higher circulating 25-hydroxyvitamin D levels were associated with lower risk of kidney cancer (OR=0.79, 95% CI 0.69-0.91; P value for heterogeneity: 0.61, I(2)=0%). After stratified by geographical region, the similar association was detected in European studies (OR=0.81, 95% CI 0.69-0.94; P value for heterogeneity: 0.38, I(2)=0%), though no significant association was observed in the USA studies (OR=0.73, 95% CI 0.51-1.04; P value for heterogeneity: 0.44, I(2)=0%). CONCLUSION Our present findings suggest that higher levels of circulating 25-hydroxyvitamin D could reduce the risk of kidney cancer by 21%. Further well-designed large-scaled prospective studies and randomized controlled trials are warranted to provide more conclusive evidence.
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Affiliation(s)
- Guangzheng Lin
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Ling Ning
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Di Gu
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Shi Li
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Zhe Yu
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Qicheng Long
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Li-Na Hou
- Department of Health Management, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Wan-Long Tan
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
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Al-Sharafi BA, Al-Imad SA, Shamshair AM, Al-Faqeeh DH. Brown tumours of the tibia and second metacarpal bone in a woman with severe vitamin D deficiency. BMJ Case Rep 2015; 2015:bcr-2014-207722. [PMID: 26240093 DOI: 10.1136/bcr-2014-207722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Brown tumours caused by vitamin D deficiency are rare. Most cases are caused by primary hyperparathyroidism, and are rarely caused by secondary hyperparathyroidism in cases of renal failure. We present a case of Brown tumours of the tibia and second metacarpal bone in a 50-year-old woman who had a low dietary intake of vitamin D and had worn a veil for most of her adult life. The Brown tumours were caused by vitamin D deficiency and secondary hyperparathyroidism. The patient improved on treatment with vitamin D3 and calcium supplements. This is a rare case and the first, to our knowledge, with a Brown tumour of the tibia caused by vitamin D deficiency due to decreased dietary intake and decreased exposure to sunlight. The course of treatment and investigations of the patient are described.
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Affiliation(s)
| | - Shafiq A Al-Imad
- Department of Medicine, University of Science and Technology Hospital, Sana'a, Yemen
| | - Amani M Shamshair
- Department of Pathology, University of Science and Technology Hospital, Sana'a, Yemen
| | - Derhim H Al-Faqeeh
- Department of Radiology, University of Science and Technology Hospital, Sana'a, Yemen
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Carmeliet G, Dermauw V, Bouillon R. Vitamin D signaling in calcium and bone homeostasis: a delicate balance. Best Pract Res Clin Endocrinol Metab 2015; 29:621-31. [PMID: 26303088 DOI: 10.1016/j.beem.2015.06.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Loss-of-function mutations in genes involved in the vitamin D/vitamin D receptor system have clearly evidenced its critical role for mineral and skeletal homeostasis. Adequate levels of 1,25-dihydroxyvitamin D [1,25(OH)2D], the active form of vitamin D are therefore required and depend on sufficient sunlight exposure or dietary intake. Intestinal calcium absorption is a primary target of 1,25(OH)2D action and this pathway indirectly promotes calcium incorporation in bone. Severe vitamin D deficiency may thus decrease bone quality and leads to osteomalacia, whereas less severe deficiency increases the risk of osteoporosis and bone fractures. On the other hand, high vitamin D levels together with low dietary calcium intake will increase bone resorption and decrease bone mineralization in order to maintain normal serum calcium levels. Appropriate dietary calcium intake and sufficient serum vitamin D levels are thus important for skeletal health. Dosing of calcium and vitamin D supplements is still debated and requires further investigation.
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Affiliation(s)
- Geert Carmeliet
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Veronique Dermauw
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium.
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Associations between frailty and serum N-terminal propeptide of type I procollagen and 25-hydroxyvitamin D in older Spanish women: The Toledo Study for Healthy Aging. Exp Gerontol 2015; 69:79-84. [PMID: 26031553 DOI: 10.1016/j.exger.2015.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 11/21/2022]
Abstract
Frail older people are at high risk for fractures and falls increasing the rates of institutionalization and mortality. Bone markers have been related to both aging and fractures. However, no previous reports have shown a potential relationship between serum bone markers such as N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (β-CTX) and parathyroid hormone (PTH) with frailty in elderly female populations. This study is aimed at examining the associations of bone metabolism markers and frailty in older Spanish women through a descriptive cross-sectional analysis based on a cohort of the Toledo Study for Healthy Aging (TSHA). The levels of serum PINP, β-CTX, PTH and 25-hydroxyvitamin D (25(OH)D) were assessed in 592 participants (median age 74years) who were defined as robust, prefrail and frail according to Fried's approach. Frail subjects had significantly high levels of PINP, β-CTX and PTH and low production of 25(OH)D. After adjustment for confounders, high PINP levels (defined by the upper quartile) and low levels of 25(OH)D (lower quartile) remained significantly associated to frailty [OR for PINP: 2.19 (95% CI, 1.15-4.18; P=0.017); OR for 25(OH)D: 1.65 (95% CI, 1.02-2.67; P=0.042)]. Women with both high PINP levels and low 25(OH)D levels presented a 5.85-fold increased frailty risk (95% CI, 1.64-20.93; P=0.007). The main contribution of this paper is the novel definition of PINP and 25(OH)D markers as potential biomarkers of frailty and targets for intervention.
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Zhang Y, Su J, Wu S, Teng Y, Yin Z, Guo Y, Li J, Li K, Yao L, Li X. DDR2 (discoidin domain receptor 2) suppresses osteoclastogenesis and is a potential therapeutic target in osteoporosis. Sci Signal 2015; 8:ra31. [PMID: 25805889 DOI: 10.1126/scisignal.2005835] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Osteoporosis is a disease characterized by abnormal skeletal fragility due to an imbalance in bone homeostasis. Finding therapeutic targets that promote bone formation is valuable for treating osteoporosis. Discoidin domain receptor 2 (DDR2) is a receptor tyrosine kinase that promotes the differentiation of bone-depositing cells, osteoblasts, and bone formation. We investigated the role of DDR2 in osteoclastogenesis, the formation of cells responsible for bone resorption. We found that, although differentiated osteoclasts had catalytically active DDR2, its abundance was decreased. Overexpression of DDR2 inhibited the expression of osteoclastic markers, osteoclast maturation, and osteoclast-mediated bone resorption in a culture model of bone matrix. Conversely, knocking down Ddr2 through RNA interference accelerated osteoclast differentiation and bone resorption in mice. Further, we identified the co-receptor Neuropilin-1 (Nrp1) as a DDR2-interacting protein. DDR2 facilitated the binding of Nrp1 and the co-receptor PlexinA1 by forming a DDR2-Nrp1-PlexinA1 complex, which blocked PlexinA1-mediated stimulation of osteoclastogenesis. DDR2 prevented PlexinA1 from interacting with the receptor TREM2 and the adaptor DAP12. Moreover, knocking down Nrp1 rescued the expression of osteoclastic markers observed in DDR2-overexpressing cells, whereas ectopic expression of Nrp1 in DDR2-silenced cells inhibited the induction of osteoclastogenesis. Nrp1 enhanced the function of DDR2 in promoting osteoblast differentiation and bone formation in mice. In an ovariectomized mouse model of osteoporosis, adenovirus-mediated delivery of DDR2 to the femur bone alleviated osteopenic phenotypes. Our results revealed that DDR2 functions as an inhibitor of osteoclastogenesis, as well as a promoter of osteoblastogenesis, suggesting that enhancing DDR2 may be therapeutic for patients with osteoporosis.
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Affiliation(s)
- Yan Zhang
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China
| | - Jin Su
- Department of Biochemistry and Molecular Biology, the Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Shufang Wu
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China
| | - Yue Teng
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China
| | - Zhanhai Yin
- Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China
| | - Yan Guo
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Institute of Molecular Genetics, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, People's Republic of China
| | - Jing Li
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China
| | - Kun Li
- Clinical laboratory, ShanXi Mineral Hospital, Xi'an, Shaanxi 710014, People's Republic of China
| | - Libo Yao
- Department of Biochemistry and Molecular Biology, the Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Xu Li
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, People's Republic of China.
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Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury 2015; 46:445-52. [PMID: 25597514 DOI: 10.1016/j.injury.2014.12.031] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/01/2014] [Accepted: 12/13/2014] [Indexed: 02/02/2023]
Abstract
Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. The cornerstone of their management is anatomic reduction and stable internal fixation of the femoral neck in an attempt to salvage the femoral head. Complications including avascular necrosis of the femoral head, non-union and post-traumatic osteoarthritis are not uncommon. The clinical outcomes of these patients can be improved with good pre-operative planning, optimization of surgical procedures and introduction of new improved implants and techniques. In the herein study, we attempt to describe the biomechanical properties of the hip and compare the performance of the most commonly used devices. Experimental evidence suggests that in Pauwels type III fracture patterns a cephalomedullary nail was significantly stronger in axial loading. Moreover, in unstable basicervical patterns cannulated screws (triangular configuration) demonstrated a lower ultimate load to failure, whereas in subcapital or transervical patterns both the cannulated screws (triangular configuration) and the sliding hip screw demonstrated no compromise in fixation strength. The fracture pattern appears to be the major determinant of the ideal type of implant to be selected. For a successful outcome each patient needs to be considered on an individual basis taking into account all patient and implant related factors.
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