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Luo Y, Zheng S, Jiang S, Yang G, Pavel V, Ji H, Zhou S, Bao Y, Xiao W, Li Y. B vitamins and bone health: a meta-analysis with trial sequential analysis of randomized controlled trials. Osteoporos Int 2024:10.1007/s00198-024-07150-0. [PMID: 38953947 DOI: 10.1007/s00198-024-07150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
Our study showed that B vitamins did not have significant effect on fracture incidence, bone mineral density, and bone turnover markers. However, the research data of B vitamins on bone mineral density and bone turnover markers are limited, and more clinical trials are needed to draw sufficient conclusions. PURPOSE The objective of this study was to identify the efficacy of B vitamin (VB) (folate, B6, and B12) supplements on fracture incidence, bone mineral density (BMD), and bone turnover markers (BTMs). METHODS A comprehensive search was performed in PubMed, MEDLINE, EMBASE, Cochrane databases, and ClinicalTrials.gov up to September 4, 2023. The risk of bias was assessed according to Cochrane Handbook and the quality of evidence was assessed according to the GRADE system. We used trial sequential analysis (TSA) to assess risk of random errors and Stata 14 to conduct sensitivity and publication bias analyses. RESULTS Data from 14 RCTs with 34,700 patients were extracted and analyzed. The results showed that VBs did not significantly reduce the fracture incidence (RR, 1.06; 95% CI, 0.95 - 1.18; p = 0.33; I2 = 40%) and did not affect BMD in lumbar spine and femur neck. VBs had no significant effect on bone specific alkaline phase (a biomarker for bone formation), but could increase the serum carboxy-terminal peptide (a biomarker for bone resorption) (p = 0.009; I2 = 0%). The TSA showed the results of VBs on BMD and BTMs may not be enough to draw sufficient conclusions due to the small number of sample data included and needed to be demonstrated in more clinical trials. The inability of VBs to reduce fracture incidence has been verified by TSA as sufficient. Sensitivity analysis and publication bias assessment proved that our meta-analysis results were stable and reliable, with no significant publication bias. CONCLUSIONS Available evidence from RCTs does not support VBs can effectively influence osteoporotic fracture risk, BMD, and BTMs. TRIAL REGISTRATION PROSPERO registration number: CRD42023427508.
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Affiliation(s)
- Yan Luo
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Shengyuan Zheng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Shide Jiang
- The Central Hospital of Yongzhou, Yongzhou, 425000, China
| | - Guang Yang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Volotovski Pavel
- Republican Scientific and Practical Center of Traumatology and Orthopedics, 220024, Minsk, Belarus
| | - Haoran Ji
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shujie Zhou
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunong Bao
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Wenfeng Xiao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yusheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Kositsawat J, Vogrin S, French C, Gebauer M, Candow DG, Duque G, Kirk B. Relationship Between Plasma Homocysteine and Bone Density, Lean Mass, Muscle Strength and Physical Function in 1480 Middle-Aged and Older Adults: Data from NHANES. Calcif Tissue Int 2023; 112:45-54. [PMID: 36344761 PMCID: PMC9813058 DOI: 10.1007/s00223-022-01037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Hyperhomocysteinemia induces oxidative stress and chronic inflammation (both of which are catabolic to bone and muscle); thus, we examined the association between homocysteine and body composition and physical function in middle-aged and older adults. Data from the National Health and Nutrition Examination Survey was used to build regression models. Plasma homocysteine (fluorescence immunoassay) was used as the exposure and bone mineral density (BMD; dual-energy X-ray absorptiometry; DXA), lean mass (DXA), knee extensor strength (isokinetic dynamometer; newtons) and gait speed (m/s) were used as outcomes. Regression models were adjusted for confounders (age, sex, race/Hispanic origin, height, fat mass %, physical activity, smoking status, alcohol intakes, cardiovascular disease, diabetes, cancer and vitamin B12). All models accounted for complex survey design by using sampling weights provided by NHANES. 1480 adults (median age: 64 years [IQR: 56, 73]; 50.3% men) were included. In multivariable models, homocysteine was inversely associated with knee extensor strength (β = 0.98, 95% CI 0.96, 0.99, p = 0.012) and gait speed (β = 0.85, 95% CI 0.78, 0.94, p = 0.003) and borderline inversely associated with femur BMD (β = 0.84, 95% CI 0.69, 1.03, p = 0.086). In the sub-group analysis of older adults (≥ 65 years), homocysteine was inversely associated with gait speed and femur BMD (p < 0.05) and the slope for knee extensor strength and whole-body BMD were in the same direction. No significant associations were observed between homocysteine and total or appendicular lean mass in the full or sub-group analysis. We found inverse associations between plasma homocysteine and muscle strength/physical function, and borderline significant inverse associations for femur BMD.
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Affiliation(s)
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Chloe French
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Maria Gebauer
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- University Hospital of Guadalajara, Guadalajara, Spain
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia.
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia.
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Associations between Plasma Folate and Vitamin B 12, Blood Lead, and Bone Mineral Density among Adults and Elderly Who Received a Health Examination. Nutrients 2022; 14:nu14040911. [PMID: 35215561 PMCID: PMC8878955 DOI: 10.3390/nu14040911] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 02/07/2023] Open
Abstract
This study hypothesized that plasma folate and vitamin B12 levels modified the association between blood lead and cadmium and total urinary arsenic levels and bone loss. A total of 447 study subjects who received a physical examination at the Wanfang Hospital Medical Center were recruited. Bone loss was defined as a calcaneus bone mineral density T-score less than -1. Blood cadmium and lead concentrations were measured by ICP-MS. Urinary arsenic species were determined using HPLC-HG-AAS. A SimulTRAC-SNB radioassay was used to measure plasma folate, vitamin B12, and homocysteine levels. Total urinary arsenic and blood lead concentration were positively correlated with the odds ratio (OR) for bone loss in a dose-response manner. The OR and 95% confidence interval (CI) for bone loss in participants with blood lead concentrations > 56.14 versus ≤33.82 μg/dL were 1.82 and 1.10-3.01. No correlation between plasma folate and vitamin B12 levels alone and bone loss was observed. However, this study is the first observational study to find that blood lead concentrations tend to increase the OR of bone loss in a low plasma folate and plasma vitamin B12 group with multivariate ORs (95% CI) of 2.44 (0.85-6.96).
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Wang P, Liu L, Lei SF. Causal effects of homocysteine levels on the changes of bone mineral density and risk for bone fracture: A two-sample mendelian randomization study. Clin Nutr 2021; 40:1588-1595. [PMID: 33744603 DOI: 10.1016/j.clnu.2021.02.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/30/2021] [Accepted: 02/27/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Observational studies have demonstrated the relations of homocysteine (HCY) with bone mineral density (BMD) and bone fracture risk, but yielding contradictory results. The present study was conducted to evaluate whether the genetically predicted plasma HCY levels were causally associated with the change of BMD and the risk of bone fracture. METHODS Genetic summary statistics were extracted from genome-wide association study (GWAS) meta-analysis of plasma HCY levels (n = 44,147), GWAS meta-analyses of measured forearm (FA), femoral neck (FN) and lumbar spine (LS) BMD (n = up to 32,735), UK Biobank estimated heel BMD (eBMD) (n = 426,824) and fracture (n = 426,795) GWAS data. Two Sample Mendelian Randomization (TSMR) analysis was performed to assess the causal effects of genetically determined plasma HCY on the BMD and bone fractures. RESULTS The MR analysis indicated that, genetically decreased plasma HCY was associated with the increased FA-BMD based on the inverse variance weighting (IVW) method (standard deviation [SD] = 0.348, 95% CI: 0.146 to 0.550, P = 7 × 10-4). However, there were no significant associations of genetically decreased plasma HCY with FN-BMD, LS-BMD, eBMD and the risk for bone fracture (SD = -0.041, 95% CI: -0.189 to 0.106, P = 0.582; SD = -0.053, 95% CI: -0.238 to 0.131, P = 0.572; SD = -0.030, 95% CI: -0.090 to 0.030, P = 0.328, odds ratio [OR]: 1.03, 95% CI: 0.94 to 1.13, P = 0.562, respectively). Moreover, the results also found that genetically determined HCY increase was not correlated with the changes of BMD and the risk for bone fracture. CONCLUSION Our study revealed that genetically decreased plasma HCY was associated with increase of FA-BMD.
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Affiliation(s)
- Peng Wang
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University Medical College, 199 Renai Road, Suzhou, Jiangsu, 215123, China; Jiangsu Key Laboratory of Preventive & Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University Medical College, Suzhou, Jiangsu 215123, China
| | - Lei Liu
- Department of Parasitology, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Shu-Feng Lei
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University Medical College, 199 Renai Road, Suzhou, Jiangsu, 215123, China; Jiangsu Key Laboratory of Preventive & Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University Medical College, Suzhou, Jiangsu 215123, China.
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Berry TM, Moustafa AA. Osteoporosis and the effect of dysregulation of the transsulfuration pathway via taurine on intracellular calcium homeostasis, vitamin D absorption and vitamin K absorption. Clin Nutr ESPEN 2021; 43:191-196. [PMID: 34024513 DOI: 10.1016/j.clnesp.2021.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/21/2021] [Accepted: 02/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS In this article we connect the dysregulation of the transsulfuration pathway to bone dysregulations and propose a novel treatment for osteoporosis. Current treatments for osteoporosis are very frequently inadequate. In osteoporosis, the risk of fractures increases with increased homocysteine (Hcy). METHODS Here, we conduct a review on the relationship between osteoporosis and the dysregulation of the transsulfuration pathway. RESULTS we show that the transsulfuration pathway metabolizes Hcy to L-cysteine. Increased Hcy levels point to the transsulfuration pathway being dysregulated. With the transsulfuration pathway dysregulated, there will be decreased levels of L-cysteine and decreased levels of taurine, which is synthesized from L-cysteine. Taurine levels are decreased in patients with osteoporosis. Taurine regulates intracellular calcium homeostasis. Taurine, also, when conjugated with bile acids assists with absorption of fats and fat-soluble vitamins such as vitamin D and vitamin K. Dysregulated calcium homeostasis, decreased calcium absorption and decreased absorption of vitamin D and vitamin K due to low levels of taurine negatively affect bone mineral density (BMD) leading to osteoporosis and fractures. CONCLUSIONS In this article, we propose that a combination of taurine, calcium, vitamin D and vitamin K, could increase BMD reducing number of years spent in disability and reducing deaths due to fractures in patients with osteoporosis.
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Affiliation(s)
- Thomas M Berry
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Ahmed A Moustafa
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia; Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, Australia; Department of Human Anatomy and Physiology, The Faculty of Health Sciences, University of Johannesburg, South Africa.
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Li X, Liu X. Associations of serum vitamins levels with bone mineral density in the different race-ethnicities US adults. BMC Musculoskelet Disord 2021; 22:137. [PMID: 33541331 PMCID: PMC7860041 DOI: 10.1186/s12891-021-03997-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The conclusions on the associations of specific vitamin levels with bone mineral density (BMD) were controversial. Therefore, the aims of this study were to examine the associations of serum vitamins levels with BMD and the modified effect of race/ ethnicity on these associations in the US adults. METHODS This study was from the third National Health and Nutrition Examination Survey. All participants aged ≥18 years with complete data were eligible. Serum vitamins A, B9, B12, C, and E levels were assayed using the Quantaphase II Radioassay Kit (Bio-Rad). Dual-energy X-ray absorptiometry was employed to measure BMD, including femur neck and the total hip. RESULTS There were 6023 participants included in the final analysis. Serum folate, vitamins A and C levels were positively associated with BMD. No significant associations of serum vitamins B12 and E levels with BMD were observed. There were positive associations of serum folate level (β = 0.00027 and 0.00032; and 95% CI: 0.00002-0.00057 and 0.00002-0.00063, respectively), vitamin A level (β = 0.01132 and 0.01115; and 95% CI: 0.00478-0.01787 and 0.00430-0.01799, respectively), and vitamin C level (β = 0.00027 and 0.00029; and 95% CI: 0.00012-0.00042 and 0.00013-0.00045, respectively) with BMD at femur neck and the total hip only in the Not Hispanic participants. CONCLUSION Elevated serum folate, vitamins A and C levels were associated with a higher BMD. Furthermore, sex and race/ ethnicity modified the associations of serum vitamins levels with BMD.
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Affiliation(s)
- Xiang Li
- Department of Orthopedics, Tianjin Fifth Central Hospital, Tianjin, 300450, China
| | - Xun Liu
- Department of Ultrasonics, Tianjin Fifth Central Hospital, No 41 Zhejiang Road, Tianjin, 300450, China.
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Zhao F, Guo L, Wang X, Zhang Y. Correlation of oxidative stress-related biomarkers with postmenopausal osteoporosis: a systematic review and meta-analysis. Arch Osteoporos 2021; 16:4. [PMID: 33400044 DOI: 10.1007/s11657-020-00854-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/05/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Oxidative stress (OS) is implicated in postmenopausal osteoporosis (PO). Results show an imbalance between antioxidative and oxidative markers in PO. Thus, monitoring of OS-related biomarkers and keeping balance between reactive oxygen species and antioxidant system are beneficial to the diagnosis and prognosis of PO. PURPOSE Oxidative stress (OS) has been implicated in postmenopausal osteoporosis (PO). However, the relations between OS-related markers and PO are controversial. This study aimed to quantitatively and comprehensively assess the roles of OS-related biomarkers in PO. METHODS Relevant articles were retrieved from electronic databases. All OS-associated biomarkers with at least 2 independent study outcomes were meta-analyzed. The pooled standardized mean differences (SMD) with its 95% confidence intervals (CI) were presented. RESULTS A total of 36 studies involving 16 OS-related biomarkers were investigated. The overall results showed that total oxidant status (TOS), superoxide dismutase (SOD), hydroperoxides (HY), paraoxonase (PON1), nitric oxide (NO), and homocysteine (Hcy) were not statistically different between the PO and control groups, whereas significantly increased levels of oxidative stress index (OSI), malondialdehyde (MDA), advanced oxidation protein products (AOPP), and vitamin B12, along with decreased total antioxidant status (TAS), total antioxidant power (TAP), catalase (CAT), glutathione peroxidase (GPx), uric acid (UA), and folate, were detected in the PO group. Subgroup analysis based on biological samples displayed significantly elevated NO in erythrocyte and Hcy in serum, along with decreased SOD in serum. CONCLUSION Monitoring of certain OS-related biomarkers might be beneficial to the diagnosis and prognosis of PO.
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Affiliation(s)
- Fulong Zhao
- Department of Trauma Orthopedics, Beijing Luhe Hospital affiliated to Capital Medical University, No.82 Xinhua South road, Tongzhou District, Beijing, 101149, China
| | - Lijuan Guo
- Clinical laboratory, Emergency General Hospital, Beijing, 100028, China
| | - Xuefei Wang
- Department of Trauma Orthopedics, Beijing Luhe Hospital affiliated to Capital Medical University, No.82 Xinhua South road, Tongzhou District, Beijing, 101149, China.
| | - Yakui Zhang
- Department of Trauma Orthopedics, Beijing Luhe Hospital affiliated to Capital Medical University, No.82 Xinhua South road, Tongzhou District, Beijing, 101149, China
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Shoffel-Havakuk H, Lava CX, Reuven Y, Moog D, Odell K, Reder LS, Hapner ER, Johns MM. Effect of Vitamin B12 Injection on the Vocal Performance of Professional Singers: A Randomized, Double-blind, Placebo-Controlled, Crossover Trial. JAMA Otolaryngol Head Neck Surg 2021; 147:9-15. [PMID: 33180098 DOI: 10.1001/jamaoto.2020.4026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance One-third of singers and vocal professionals report experiencing a benefit from empirical vitamin B12 injections for improvement of mild singing-related symptoms (eg, reduced stamina, vocal fatigue, and effort). However, there is no objective evidence to support or refute these claims. Objective To assess the presence and magnitude of the effect of empirical vitamin B12 injection on the vocal performance of singers. Design, Setting, and Participants A randomized, double-blind, placebo-controlled, crossover trial was conducted from November 7, 2017, to November 30, 2018, at an academic voice center among 20 active adult singers without dysphonia but with mild vocal symptoms. Individuals with known or suspected vitamin B12 deficiency or active or recent vitamin B12 treatment were excluded. Analysis was on a per-protocol basis. Interventions Participants were randomized to receive an intramuscular (deltoid) injection of either vitamin B12 (1000 μg of cyanocobalmin) or placebo (0.9% sodium chloride). After a washout period of at least 4 weeks, participants were crossed over to receive the opposite injection. Both the investigators and participants were blinded to the order of injections. Main Outcomes and Measures The participants completed the Singing Voice Handicap Index-10 (SVHI-10), the Voice Fatigue Index (VFI), and the Evaluation of the Ability to Sing Easily (EASE) before each injection and at intervals of 1 hour, 3 hours, 24 hours, 72 hours, and 1 week after the injection. The primary time point assessment was 72 hours after injection, and the SVHI-10 score was the primary outcome measure. Results Twenty singers (10 men; median age, 22 years [range, 19-42 years]) were enrolled. The improvements after either placebo or vitamin B12 injections were comparable to each other. At 72 hours after the vitamin B12 injection, the median difference in the SVHI-10 score was 1 (95% CI, -1 to 2) compared with 3 (95% CI, 0-4) after placebo. The median difference between differences at 72 hours between placebo and vitamin B12 injections were 1.5 (95% CI, -2 to 5) for the SVHI-10, 1 (95% CI, -9 to 9) for the VFI, and -1 (95% CI, -3 to 2) for the EASE. The improvements after both injections failed to reach the estimated minimal clinically important difference. Of the 20 participants, 4 (20%) reached the estimated minimal clinically important difference in their SVHI-10 score after 72 hours for both vitamin B12 and placebo injections. Conclusions and Relevance This randomized, double-blind, placebo-controlled, crossover trial found that after empirical vitamin B12 injection to improve mild voice-related symptoms, the improvement in self-reported voice measures in singers shows no meaningful difference compared with placebo. Trial Registration ClinicalTrials.gov Identifier: NCT03437824.
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Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Christian X Lava
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Yonatan Reuven
- Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominic Moog
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Karla Odell
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Lindsay S Reder
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Edie R Hapner
- UAB Voice Center, Otolaryngology, University of Alabama, Birmingham
| | - Michael M Johns
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
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Álvarez-Cienfuegos A, Cantero-Nieto L, García-Gomez JA, Callejas-Rubio JL, González-Gay MA, Ortego-Centeno N. Association Between Homocysteine Serum Level and Bone Mineral Density in Patients With Rheumatoid Arthritis. J Clin Densitom 2020; 23:561-567. [PMID: 31005409 DOI: 10.1016/j.jocd.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - J A García-Gomez
- Infectious Diseases Unit, Hospital General de Elche, Alicante, Spain
| | - J L Callejas-Rubio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
| | - M A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain; School of Medicine, University of Cantabria, Santander, Spain; Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - N Ortego-Centeno
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
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De Martinis M, Sirufo MM, Nocelli C, Fontanella L, Ginaldi L. Hyperhomocysteinemia is Associated with Inflammation, Bone Resorption, Vitamin B12 and Folate Deficiency and MTHFR C677T Polymorphism in Postmenopausal Women with Decreased Bone Mineral Density. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4260. [PMID: 32549258 PMCID: PMC7345373 DOI: 10.3390/ijerph17124260] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 12/15/2022]
Abstract
Osteoporosis is an age-related bone disease, affecting mainly postmenopausal women, characterized by decreased bone mineral density (BMD) and consequent risk of fractures. Homocysteine (Hcy), a sulfur-aminoacid whose serum level is regulated by methylenetrahydrofolate reductase (MTHFR) activity and vitamin B12 and folate as cofactors, is a risk factor for inflammatory diseases. Literature data concerning the link between Hcy and osteoporosis are still debated. The aim of our study was to assess the relationship among Hcy and BMD, inflammation, vitamin status and bone turnover in postmenopausal osteoporosis. In 252 postmenopausal women, BMD was measured by dual-energy X-ray absorptiometry (DXA). In addition to serum Hcy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and bone turnover markers (bone alkaline phosphatase-BAP, osteocalcin-OC, C-terminal telopeptide of type I collagen (CTX), vitamin deficiencies and MTHFR-C677T polymorphism were evaluated. Hcy, inflammation, bone resorption markers and prevalence of C677T polymorphism were higher, whereas vitamin D, B12, folate, and bone formation markers were lower in women with decreased BMD compared to those with normal BMD. Our results suggest a significant association between Hcy, BMD and inflammation in postmenopausal osteoporosis. The regulation of Hcy overproduction and the modulation of the inflammatory substrate could represent additional therapeutic approaches for osteoporosis prevention.
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Affiliation(s)
- Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04, 64100 Teramo, Italy
| | - Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04, 64100 Teramo, Italy
| | | | - Lara Fontanella
- Department of Legal and Social Sciences, University of Chieti-Pescara, 65127 Pescara, Italy;
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04, 64100 Teramo, Italy
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du Plessis JP, Melse-Boonstra A, Zandberg L, Nienaber-Rousseau C. Gene interactions observed with the HDL-c blood lipid, intakes of protein, sugar and biotin in relation to circulating homocysteine concentrations in a group of black South Africans. Mol Genet Metab Rep 2019; 22:100556. [PMID: 31908954 PMCID: PMC6938949 DOI: 10.1016/j.ymgmr.2019.100556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/05/2019] [Accepted: 12/12/2019] [Indexed: 11/18/2022] Open
Abstract
Background Elevated homocysteine (Hcy) is associated with several pathologies. Gene–diet interactions related to Hcy might be used to customize dietary advice to reduce disease incidence. To explore this possibility, we investigated interactions between anthropometry, biochemical markers and diet and single-nucleotide polymorphisms (SNPs) in relation to Hcy concentrations. Five SNPs of Hcy-metabolizing enzymes were analyzed in 2010 black South Africans. Results Hcy was higher with each additional methylenetetrahydrofolate reductase (MTHFR) C677T minor allele copy, but was lower in methionine synthase (MTR) 2756AA homozygotes than heterozygotes. Individuals harboring cystathionine β synthase (CBS) 833 T/844ins68 had lower Hcy concentrations than others. No interactive effects were observed with any of the anthropometrical markers. MTHFR C677T and CBS T833C/844ins68 homozygote minor allele carriers presented with lower Hcy as high density lipoprotein cholesterol (HDL-c) increased. Hcy concentrations were negatively associated with dietary protein and animal protein intake in the TT and TC genotypes, but positively in the CC genotype of CBS T833C/844ins68. Hcy was markedly higher in TT homozygotes of MTHFR C677T as added sugar intake increased. In CBS T833C/844ins68 major allele carriers, biotin intake was negatively associated with Hcy; but positively in those harboring the homozygous minor allele. Conclusions The Hcy–SNP associations are modulated by diet and open up the possibility of invoking dietary interventions to treat hyperhomocysteinemia. Future intervention trials should further explore the observed gene–diet and gene–blood lipid interactions.
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Key Words
- %TCHO, percentage total carbohydrate intake
- %TE, percentage of total energy
- A, adenine
- Ala, alanine
- Asp, aspartic acid
- Biotin
- Blood lipid–gene interactions
- C, cytosine
- CBS, cystathionine β synthase
- CI, confidence intervals
- CV, coefficient variation
- ES, effect size
- G, guanine
- GGT, gamma glutamyl transferase
- GLM, generalized linear model
- Gene–diet interactions
- Gly, glycine
- HDL-c, high-density lipoprotein cholesterol
- HHcy, hyperhomocysteinemia
- HW, Hardy Weinberg
- HWE, Hardy–Weinberg equilibrium
- HbA1c, glycated hemoglobin
- Hcy, homocysteine
- Hyperhomocysteinemia
- ID, identity
- ISAK, International Society for the Advancement of Kinanthropometry
- Ile, isoleucine
- LD, pairwise linkage-disequilibrium
- LDL-c, low density lipoprotein cholesterol
- MAF, minor allele frequency
- MRC, Medical Research Council
- MT, mutant type
- MTHFR, methylenetetrahydrofolate reductase
- MTR, methionine synthase
- Nutrient–gene interactions
- Nutrigenetics
- PA, physical activity
- PCR, polymerase chain reaction
- PURE, Prospective Urban and Rural Epidemiology
- Precision nutrition
- Protein
- QFFQ, quantitative food frequency questionnaire
- RFLP, restriction fragment length polymorphism
- SD, standard deviations
- SE, standard error
- SFA, saturated fatty acids
- SNP, single-nucleotide polymorphism
- Sugar
- T, thymine
- THUSA, Transition and Health during Urbanization in South Africa
- Thr, threonine
- Total homocysteine
- Val, valine
- WT, wild type.
- bp, base pairs
- d, Cohen's d-value
- ins, insertion
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Affiliation(s)
- Jacomina P du Plessis
- Centre of Excellence for Nutrition, North-West University, Private bag X6001, Nutrition, Box 594, Potchefstroom 2520, South Africa
| | - Alida Melse-Boonstra
- Centre of Excellence for Nutrition, North-West University, Private bag X6001, Nutrition, Box 594, Potchefstroom 2520, South Africa.,Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 9101, 6700 HB Wageningen, The Netherlands
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Private bag X6001, Nutrition, Box 594, Potchefstroom 2520, South Africa
| | - Cornelie Nienaber-Rousseau
- Centre of Excellence for Nutrition, North-West University, Private bag X6001, Nutrition, Box 594, Potchefstroom 2520, South Africa
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The Relationship between Nutrient Patterns and Bone Mineral Density in Postmenopausal Women. Nutrients 2019; 11:nu11061262. [PMID: 31163708 PMCID: PMC6628050 DOI: 10.3390/nu11061262] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 12/20/2022] Open
Abstract
In women, the menopausal transition is characterized by acid-base imbalance, estrogen deficiency and rapid bone loss. Research into nutritional factors that influence bone health is therefore necessary. In this study, the relationship between nutrient patterns and nutrients important for bone health with bone mineral density (BMD) was explored. In this cross-sectional analysis, 101 participants aged between 54 and 81 years were eligible. Body composition and BMD analyses were performed using dual-energy X-ray absorptiometry (DXA). Nutrient data were extracted from a 3-day diet diary (3-DDD) using Foodworks 9 and metabolic equivalent (MET-minutes) was calculated from a self-reported New Zealand physical activity questionnaire (NZPAQ). Significant positive correlations were found between intakes of calcium (p = 0.003, r = 0.294), protein (p = 0.013, r = 0.246), riboflavin (p = 0.020, r = 0.232), niacin equivalent (p = 0.010, r = 0.256) and spine BMD. A nutrient pattern high in riboflavin, phosphorus and calcium was significantly positively correlated with spine (p < 0.05, r = 0.197) and femoral neck BMD (p < 0.05, r = 0.213), while the nutrient pattern high in vitamin E, α-tocopherol, β-carotene and omega 6 fatty acids was negatively correlated with hip (p < 0.05, r = −0.215) and trochanter BMD (p < 0.05, r = −0.251). These findings support the hypothesis that a nutrient pattern high in the intake of vitamin E, α-tocopherol and omega 6 fatty acids appears to be detrimental for bone health in postmenopausal women.
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13
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Oliveira VHF, Rosa FT, Wiechmann S, Narciso AMS, Webel AR, Franzói de Moraes SM, Deminice R. Homocysteine-lowering exercise effect is greater in hyperhomocysteinemic people living with HIV: a randomized clinical trial. Appl Physiol Nutr Metab 2019; 44:1165-1171. [PMID: 30861351 DOI: 10.1139/apnm-2018-0734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Elevated concentration of homocysteine has been identified as an independent risk factor for the development of cardiovascular disease and is frequently associated with oxidative stress. Moreover, studies have shown that people living with human immunodeficiency virus (PLHIV) present elevated concentration of homocysteine and oxidative stress compared with people without HIV. Our purpose was to describe blood homocysteine and oxidative stress markers in PLHIV and those without HIV infection, and to examine the effects of a 16-week combined training exercise program (CTE) on oxidative stress and homocysteine concentrations of PLHIV. We included 49 PLHIV (21 men, 28 women) and 33 people without HIV infection (13 men, 20 women). After baseline evaluations, 30 PLHIV were randomized to either CTE (trained group, n = 18) or the control group (n = 12); CTE consisted of aerobic and strength exercise sessions during 16 weeks, 3 times a week. Plasma homocysteine, oxidative damage markers, folate, and vitamin B12 were assessed pre- and post-training and by hyperhomocysteinemia (homocysteine ≥ 15 μmol/L) status. At baseline, PLHIV had higher levels of homocysteine and malondialdehyde, as well as reduced circulating folate when compared with people without HIV infection. CTE resulted in a 32% reduction (p < 0.05) in homocysteine concentration and a reduction in lipid hydroperoxide in PLHIV with hyperhomocysteinemia, which was not observed in those without hyperhomocysteinemia. Hyperhomocysteinemic participants experienced a 5.6 ± 3.2 μmol/L reduction in homocysteine after CTE. In summary, 16 weeks of CTE was able to decrease elevated homocysteine concentration and enhance redox balance of PLHIV with hyperhomocysteinemia, which could improve their cardiovascular risk.
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Affiliation(s)
- Vitor H F Oliveira
- Department of Physical Education, State University of Londrina, Londrina, PR 86057-900, Brazil
| | - Flávia Troncon Rosa
- Department of Nutrition, Filadélfia University, Londrina, PR 87020-900, Brazil
| | - Susana Wiechmann
- University Hospital, Institute of Health Science, State University of Londrina, Londrina, PR 86057-900, Brazil
| | | | - Allison R Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106-7343, USA
| | | | - Rafael Deminice
- Department of Physical Education, State University of Londrina, Londrina, PR 86057-900, Brazil
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14
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Mittal M, Verma R, Mishra A, Singh A, Kumar V, Sawlani KK, Ahmad MK, Mishra P, Gaur R. Relation of Bone Mineral Density with Homocysteine and Cathepsin K levels in Postmenopausal Women. Indian J Endocrinol Metab 2018; 22:261-266. [PMID: 29911042 PMCID: PMC5972485 DOI: 10.4103/ijem.ijem_575_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Homocysteine (HCY) interferes with collagen cross-linking in bones and stimulates osteoclast activity. The activated osteoclasts secrete cathepsin K (CathK), a cysteine protease, in eminent quantity during bone resorption. Hyperhomocysteinemia may effect bone mineral density (BMD) through CathK. We, therefore, examined the relation between HCY and BMD along with CathK, 25-hydroxyvit-D (25[OH]D), intact parathyroid hormone (iPTH), and Vitamin B12. MATERIALS AND METHODS We recruited a total of 93 postmenopausal women between the age group of 45-60 years, attending the Endocrinology outpatient department at King George's Medical University, Lucknow. BMD was done by DXA scan using Hologic QDR1000 system. Based on the WHO criteria, patients were segregated into three groups as follows; normal bone mass, osteopenia, and osteoporosis. All women underwent routine biochemical laboratory parameters, HCY, Vitamin B12, and CathK levels. RESULTS Among 93 postmenopausal women, 56% (52) had osteoporosis. Nineteen percent (18) had normal BMD (mean age, 53.22 ± 8.5 years) and 23 (25%) had osteopenia (mean age 52.86 ± 6.67 years). The mean age in the osteoporetic group was 56.2 ± 6.9 years. The median (interquartile range) levels of HCY in the three groups were 14.5 μmol/L (12.2-24.7), 15.05 μmol/L (12.1-19.9) and 13.2 μmol/L (10.3-17.0), respectively. CathK levels were similar in three groups 7.6 ng/ml (7.0-80.5), 8.3 ng/ml (7.3-8.5), and 8.6 ng/ml (7.2-8.9). Both HCY and CathK were found positively associated with serum phosphorus (r = 0.584, P < 2.01 and r = 0.249, P < 0.05, respectively). Levels of HCY positively correlate with PTH (r = 0.303, P < 0.01) and inversely with Vitamin B12 (r = -0.248, P < 0.05). No significant association was seen between CathK level and 25(OH) D, iPTH, serum calcium. CONCLUSION Low bone mass by DXA is a significant problem in postmenopausal females. HCY and CathK do not reliably correlate with bone loss in postmenopausal women although phosphorus metabolism may play a role.
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Affiliation(s)
- Madhukar Mittal
- Department of Endocrinology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajeev Verma
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Arvind Mishra
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ajay Singh
- Department of Orthopedics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - K. K. Sawlani
- Department of Endocrinology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - M. Kaleem Ahmad
- Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pratishtha Mishra
- Department of Endocrinology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rishika Gaur
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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15
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Lee HO, Wang L, Kuo YM, Andrews AJ, Gupta S, Kruger WD. S-adenosylhomocysteine hydrolase over-expression does not alter S-adenosylmethionine or S-adenosylhomocysteine levels in CBS deficient mice. Mol Genet Metab Rep 2018; 15:15-21. [PMID: 30023284 PMCID: PMC6047060 DOI: 10.1016/j.ymgmr.2018.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/08/2018] [Accepted: 01/08/2018] [Indexed: 11/29/2022] Open
Abstract
Elevated plasma total homocysteine (tHcy) is associated with a number of human diseases including coronary artery disease, stroke, osteoporosis and dementia. It is highly correlated with intracellular S-adenosylhomocysteine (SAH). Since SAH is a strong inhibitor of methyl-transfer reactions involving the methyl-donor S-adenosylmethionine (SAM), elevation in SAH could be an explanation for the wide association of tHcy and human disease. Here, we have created a transgenic mouse (Tg-hAHCY) that expresses human S-adenosylhomocysteine hydrolase (AHCY) from a zinc-inducible promoter in the liver and kidney. Protein analysis shows that human AHCY is expressed well in both liver and kidney, but elevated AHCY enzyme activity (131% increase) is only detected in the kidney due to the high levels of endogenous mouse AHCY expression in liver. Tg-hAHCY mice were crossed with mice lacking cystathionine β-synthase activity (Tg-I278T Cbs−/−) to explore the effect to AHCY overexpression in the context of elevated serum tHcy and elevated tissue SAM and SAH. Overexpression of AHCY had no significant effect on the phenotypes of Tg-I278T Cbs−/− mice or any effect on the steady state concentrations of methionine, total homocysteine, SAM, SAH, and SAM/SAH ratio in the liver and kidney. Furthermore, enhanced AHCY activity did not lower serum and tissue tHcy or methionine levels. Our data suggests that enhancing AHCY activity does not alter the distribution of methionine recycling metabolites, even when they are greatly elevated by Cbs mutations.
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Key Words
- AHCY, S-adenosylhomocysteine hydrolase
- CBS, cystathionine beta synthase
- CMC, carboxymethylcellulose
- Cbs−, CBS knockout allele
- HA, hemagglutinin
- HHcy, hyperhomocysteinemia
- Hcy, homocysteine
- Met, methionine
- Metabolism
- Methionine
- SAH, S-adenosyl homocysteine
- SAM, S-adenosyl methionine
- Tg-I278T, transgene human CBS containing the I278T mutation
- Transgenic
- Zn, zinc water
- tHcy, total homocysteine
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Affiliation(s)
- Hyung-Ok Lee
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Liqun Wang
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Yin-Ming Kuo
- Cancer Epigenetics Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Andrew J Andrews
- Cancer Epigenetics Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Sapna Gupta
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Warren D Kruger
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
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16
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Shoffel-Havakuk H, Lava CX, Hapner ER, O'Dell K, Reder L, Johns MM. The Singer's and the Clinician's Perspective on Vitamin B 12 Treatment for Vocal Benefits. J Voice 2018; 33:352-356. [PMID: 29306524 DOI: 10.1016/j.jvoice.2017.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is a belief among vocalists that there are voice benefits from vitamin B12 treatment. Yet there are no previous reports regarding vitamin B12 effects on voice. OBJECTIVES To assess the prevalence of vitamin B12 use among singers and their beliefs regarding vitamin B12 therapy. METHODS Anonymous online survey administered to singers, singing-teachers, speech-language pathologists, and laryngologists. RESULTS A total of 192 participants completed the surveys; 128 singers (68 singing-teachers, 30 speech-language pathologists) and 64 laryngologists. Among singers, 12% have perceived voice benefits from vitamin B12 treatment taken for any reason. Four percent used vitamin B12 for voice benefits; all perceived voice benefits as a result. The leading voice benefits were improved stamina, reduced effort, confidence, and control. Nineteen percent of the singers would recommend vitamin B12 treatment to a friend; 15% of the singing-teachers would recommend it to a student. Among laryngologists, 33% been asked by a singer to prescribe vitamin B12 for voice benefits; 9% have prescribed it in the past. Yet only 3% would you recommend it to a patient. When asked "Do you believe vitamin B12 therapy improves vocal performance?" 31% of the singers responded "Yes," compared with none in the laryngologists. When asked "Do you think the singing community believes vitamin B12 therapy improves vocal performance?" 26% of the singers responded "Yes," compared with 53% of the laryngologists (P = 0.0002). CONCLUSIONS There is a discrepancy between the singers' and the laryngologists' beliefs regarding vocal benefits perceived by vitamin B12. Blinded randomized trials are required to verify or refute this belief.
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Affiliation(s)
- Hagit Shoffel-Havakuk
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | | | - Edie R Hapner
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Karla O'Dell
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Lindsay Reder
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Michael M Johns
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California.
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Oxidative Stress-Related Biomarkers in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analyses. DISEASE MARKERS 2016; 2016:7067984. [PMID: 27594735 PMCID: PMC4995322 DOI: 10.1155/2016/7067984] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/03/2016] [Indexed: 01/02/2023]
Abstract
Numerous studies suggested that oxidative stress (OS) played a central role in the onset and development of postmenopausal osteoporosis (PO); however, conflicting results were obtained as to the association of OS-related biomarkers and PO. This meta-analysis aimed to identify the association between these markers and PO, and explore factors that may explain the inconsistencies in these results. A systematic literature search was conducted in relevant database. Search terms and selection criteria were priorly determined to identify and include all studies that detected markers of OS in PO patients. We pooled data with a random effects meta-analysis with standardized mean differences and 95% confidence interval. Total 17 studies including 12 OS markers were adopted. The results showed that superoxide dismutase (SOD) in erythrocytes, catalase (CAT), total antioxidant status (TAS), hydroperoxides (HY), advanced oxidation protein products (AOPP), malondialdehyde (MDA), and vitamin B12 (VB12) in plasma/serum were not statistically different between the PO and control group, whereas significantly increased level of homocysteine (Hcy) and nitric oxide (NO), along with decreased SOD, glutathione peroxidase (GPx), folate, and total antioxidant power (TAP) in plasma/serum were obtained in the PO group. In summary, OS might serve as potential biomarkers in the etiopathophysiology and clinical course of PO.
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18
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Yang Y, Luo Y, Yuan J, Tang Y, Xiong L, Xu M, Rao X, Liu H. Association between maternal, fetal and paternal MTHFR gene C677T and A1298C polymorphisms and risk of recurrent pregnancy loss: a comprehensive evaluation. Arch Gynecol Obstet 2015; 293:1197-211. [DOI: 10.1007/s00404-015-3944-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 10/23/2015] [Indexed: 11/24/2022]
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19
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Chen H, Yang X, Lu M. Methylenetetrahydrofolate reductase gene polymorphisms and recurrent pregnancy loss in China: a systematic review and meta-analysis. Arch Gynecol Obstet 2015; 293:283-90. [DOI: 10.1007/s00404-015-3894-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
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20
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Bailey RL, Looker AC, Lu Z, Fan R, Eicher-Miller HA, Fakhouri TH, Gahche JJ, Weaver CM, Mills JL. B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States. Am J Clin Nutr 2015; 102:687-94. [PMID: 26224297 PMCID: PMC4548174 DOI: 10.3945/ajcn.115.108787] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 07/02/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous data suggest that elevated serum total homocysteine (tHcy) may be a risk factor for bone fracture and osteoporosis. Nutritional causes of elevated tHcy are suboptimal B-vitamin status. To our knowledge, this is the first nationally representative report on the relation of B vitamins and bone health from a population with folic acid fortification. OBJECTIVE The purpose of this analysis was to examine the relation between B-vitamin status biomarkers and bone mineral density (BMD), risk of osteoporosis, and biomarkers of bone turnover. DESIGN We examined the relation of tHcy, methylmalonic acid (MMA), and serum/red blood cell folate and total-body and lumbar spine BMD in women aged ≥50 y participating in the NHANES 1999-2004 (n = 2806), a nationally representative cross-sectional survey. These are the only years with concurrent measurement of tHcy and whole-body dual-energy X-ray absorptiometry. We also examined B-vitamin biomarkers relative to bone turnover markers, bone alkaline phosphatase, and urinary N-terminal cross-linked telopeptide of type I collagen in a 1999-2002 subset with available data (n = 1813). RESULTS In comparison with optimal concentrations, women with elevated tHcy were older with lower serum vitamin B-12, red blood cell folate, and dietary micronutrient intakes and had significantly higher mean ± SE markers of bone turnover (bone alkaline phosphatase: 15.8 ± 0.59 compared with 14.0 ± 0.25 μg/L; urinary N-terminal cross-linked telopeptide of type I collagen: 48.2 ± 2.9 compared with 38.9 ± 0.90 nmol bone collagen equivalents per mmol creatinine/L). Elevated MMA (OR: 1.88; 95% CI: 1.10, 3.18) and tHcy (OR: 2.17; 95% CI: 1.14, 4.15) were related to increased risk of lumbar osteoporosis. When examined as a continuous variable, tHcy was negatively associated, serum folates were positively associated, and MMA and vitamin B-12 were not significantly associated with lumbar and total-body BMD. CONCLUSION In this nationally representative population of older US women with high exposure to B vitamins through food fortification and dietary supplements, only elevated tHcy and MMA were independently associated with risk of lumbar spine osteoporosis.
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Affiliation(s)
- Regan L Bailey
- Office of Dietary Supplements and Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Anne C Looker
- National Center for Health Statistics, CDC, Hyattsville, MD
| | - Zhaohui Lu
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
| | - Ruzong Fan
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
| | | | | | - Jaime J Gahche
- National Center for Health Statistics, CDC, Hyattsville, MD
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - James L Mills
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
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21
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Deminice R, Silva TCV, Oliveira VHFD. Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis. World J Virol 2015; 4:147-155. [PMID: 25964880 PMCID: PMC4419119 DOI: 10.5501/wjv.v4.i2.147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/28/2014] [Accepted: 03/05/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the association between the levels of homocysteine (Hcy), folate, vitamin B12 in human immunodeficiency virus (HIV)-infected patients who were treated with antiretroviral therapy (ART) or not treated with ART.
METHODS: The PubMed and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes (1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and; (2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevMan (version 5.2) was employed for data synthesis.
RESULTS: A total of 12 studies were included in outcome 1 (1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy (2.05 µmol/L; 95%CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations (-2.74 ng/mL; 95%CI: -5.18 to -0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis (1167 participants; 404 HIV-infected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to non-ART HIV subjects (4.13 µmol/L; 95%CI: 1.34 to 6.92, P < 0.01).
CONCLUSION: This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection.
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Abstract
Osteoporosis (OP) and cardiovascular diseases (CVD) are the most important causes of mortality and morbility in the elderly. Lots of studies showed a correlation between bone loss and cardiovascular risk mediated by the vascular calcification. The relationship between OP and CVD could be firstly explained by their common risk factors such as age, smoking, alcohol consumption, physical activity and menopause. However, other different hypotheses were proposed to clarify this link. Multiple factors, for example bone morphogenetic proteins, osteoprotegerin, receptor activator of nuclear factor κB ligand, parathyroid hormone, phosphate, oxidized lipids and vitamins D and K seemed to be involved in both conditions, indicating a possible common pathophysiologic mechanism. We review and discuss the available data describing this association. Further studies are necessary to better investigate similarities between OP and CVD.
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Affiliation(s)
- S Lello
- a Department of Woman and Child Health , Catholic University , Rome , Italy
| | - A Capozzi
- a Department of Woman and Child Health , Catholic University , Rome , Italy
| | - G Scambia
- a Department of Woman and Child Health , Catholic University , Rome , Italy
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Buckens CF, de Jong PA, Verkooijen HM, Verhaar HJ, Mali WP, van der Graaf Y. Vertebral fractures on routine chest computed tomography: relation with arterial calcifications and future cardiovascular events. Int J Cardiovasc Imaging 2014; 31:437-45. [PMID: 25451815 DOI: 10.1007/s10554-014-0567-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 11/05/2014] [Indexed: 11/25/2022]
Abstract
Osteoporosis and cardiovascular disease often coexist. Vertebral fractures incidentally imaged in the course of routine care might be able to contribute to the prediction of cardiovascular events. Following a case-cohort design, 5,679 patients undergoing chest CT were followed for a median duration of 4.4 years. Cases were defined as patients who subsequently developed a cardiovascular event (n = 493). The presence and severity of vertebral fractures, as well as aortic, coronary and valvular calcifications on CT were investigated. Cases were more likely to be male (69 vs 60 %) and older (66 vs 61 years old). Prevalent vertebral fractures conferred an elevated risk of cardiovascular events after adjustment for age and gender [hazard ratio (HR) of 1.28, 95 % confidence interval (CI) 1.07 to 1.54]. This effect remained moderate after correction for cardiovascular calcifications (HR 1.20, CI 0.99-1.44). However, in terms of discrimination, vertebral fractures did not have substantial incremental prognostic value after correction (C-index was 0.683 vs 0.682 for models with and without vertebral fractures respectively). Prevalent vertebral fractures on routine clinical chest CT are related to future cardiovascular events but do not have additional prognostic value to models that already include age, gender and cardiovascular calcifications.
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Affiliation(s)
- Constantinus F Buckens
- Radiology Department, University Medical Center Utrecht, Heidelberglaan 100, E01.132, 3508 GA, Utrecht, The Netherlands,
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Eren E, Ellidag HY, Aydin O, Yılmaz N. HDL-Associated Paraoxonase 1 as a Bridge between Postmenopausal Osteoporosis and Cardiovascular Disease. Chonnam Med J 2014; 50:75-81. [PMID: 25568841 PMCID: PMC4276794 DOI: 10.4068/cmj.2014.50.3.75] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 06/11/2014] [Accepted: 06/12/2014] [Indexed: 12/17/2022] Open
Abstract
The association of postmenopausal osteoporosis (PMOP) with both atherosclerosis and vascular/valvular calcification is well known. Recently, ample evidence has suggested a common etiologic factor, namely, reduced HDL-associated paraoxonase 1 (PON1) activity, as a causative factor in the development of PMOP and cardiovascular disease (CVD). This common etiologic factor not only contributes to atherosclerotic diseases but also to PMOP following an almost identical mechanism including dysfunctional HDL and lipid oxidation. According to recent studies, lipid oxidation might improve osteoblastic transformation of vascular cells and obstruct such transformation in bone cells. The primary objective of this current review was to summarize the evidence revealing the role of HDL-associated PON1 enzyme in PMOP. Additionally, the review aimed to address some of the subjects that need further investigation in order to define whether hyperhomocysteinemia and sensitivity to lipid oxidation may be risk factors for PMOP.
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Affiliation(s)
- Esin Eren
- Biochemistry Laboratory, Antalya Public Health Center of Ministry of Health, Antalya, Turkey
| | - Hamit Yasar Ellidag
- Central Laboratories of Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Ozgur Aydin
- Biochemistry Laboratory, Maternity and Children's Hospital, Batman, Turkey
| | - Necat Yılmaz
- Central Laboratories of Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
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Dovjak P, Föger-Samwald U, Konrad M, Bichler B, Pietschmann P. Secondary confounders of osteoporotic hip fractures in patients admitted to a geriatric acute care department. Z Gerontol Geriatr 2014; 48:633-40. [PMID: 25421255 DOI: 10.1007/s00391-014-0821-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 08/27/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND With respect to the pathogenesis of osteoporosis, primary and secondary forms of the disease can be distinguished. It has been recognized that the incidence of primary and secondary osteoporosis differs in women and men. OBJECTIVE The aim of the present study was to assess the incidence and gender distribution of factors contributing to osteoporosis in older hip fracture patients. METHODS In this cross-sectional study 404 patients with hip fractures and controls referred to an acute geriatric care department over a period of 15 months were included. The medical history was recorded and blood samples were analyzed for routine laboratory parameters. RESULTS A total of 249 patients with hip fractures and 155 matched controls were studied. The Tinetti test and the Barthel index were found to show highly significant differences in both groups mainly because of the postoperative state of patients with fractures. Vitamin D deficiency was found in 94.1% of male fracture patients and 94.6% of female fracture patients. On average 2.4 secondary contributors of osteoporosis were present in male fracture patients versus 2.9 in male controls and 2.3 in female fracture patients versus 2.3 in female controls. For most parameters no significant gender differences of possible secondary contributors to osteoporosis were found. Secondary osteoporosis was diagnosed in all male fracture patients and in 56.2% of all female fracture patients. CONCLUSION Based on the findings of this study it is recommended that hip fracture patients should be assessed for secondary contributors of osteoporosis. Although the overall distribution of secondary contributors was similar in women and men, the prevalence of secondary osteoporosis was higher in men.
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Affiliation(s)
- Peter Dovjak
- Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria.
| | - Ursula Föger-Samwald
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Spitalsgasse 23, 1090, Vienna, Austria
| | - Maarit Konrad
- Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria
| | - Bernhard Bichler
- Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria
| | - Peter Pietschmann
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Spitalsgasse 23, 1090, Vienna, Austria
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