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Tomczyk-Warunek A, Winiarska-Mieczan A, Blicharski T, Blicharski R, Kowal F, Pano IT, Tomaszewska E, Muszyński S. Consumption of Phytoestrogens Affects Bone Health by Regulating Estrogen Metabolism. J Nutr 2024; 154:2611-2627. [PMID: 38825042 DOI: 10.1016/j.tjnut.2024.05.026] [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] [Received: 01/11/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024] Open
Abstract
Osteoporosis is a significant concern in bone health, and understanding its pathomechanism is crucial for developing effective prevention and treatment strategies. This article delves into the relationship between estrogen metabolism and bone mineralization, shedding light on how phytoestrogens can influence this intricate process. Estrogen, a hormone primarily associated with reproductive health, plays a pivotal role in maintaining bone density and structure. The article explores the positive effects of estrogen on bone mineralization, highlighting its importance in preventing conditions like osteoporosis. Phytoestrogens, naturally occurring compounds found in certain plant-based foods, are the focal point of the discussion. These compounds have the remarkable ability to mimic estrogen's actions in the body. The article investigates how phytoestrogens can modulate the activity of estrogen, thereby impacting bone health. Furthermore, the article explores the direct effects of phytoestrogens on bone mineralization and structure. By regulating estrogen metabolism, phytoestrogens can contribute to enhanced bone density and reduced risk of osteoporosis. Finally, the article emphasizes the role of plant-based diets as a source of phytoestrogens. By incorporating foods rich in phytoestrogens into one's diet, individuals may potentially bolster their bone health, adding a valuable dimension to the ongoing discourse on osteoporosis prevention. In conclusion, this article offers a comprehensive overview of 137 positions of literature on the intricate interplay between phytoestrogens, estrogen metabolism, and bone health, shedding light on their potential significance in preventing osteoporosis and promoting overall well-being.
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Affiliation(s)
- Agnieszka Tomczyk-Warunek
- Department of Rehabilitation and Physiotherapy, Laboratory of Locomotor Systems Research, Medical University of Lublin, Lublin, Poland
| | - Anna Winiarska-Mieczan
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Lublin, Poland.
| | - Tomasz Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Rudolf Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Filip Kowal
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Inés Torné Pano
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Ewa Tomaszewska
- Department of Animal Physiology, University of Life Sciences in Lublin, Lublin, Poland
| | - Siemowit Muszyński
- Department of Biophysics, University of Life Sciences in Lublin, Lublin, Poland
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Chen X, Shen L, Gao C, Weng R, Fan Y, Xu S, Zhang Z, Hu W. Vitamin D status and its associations with bone mineral density, bone turnover markers, and parathyroid hormone in Chinese postmenopausal women with osteopenia and osteoporosis. Front Nutr 2024; 10:1307896. [PMID: 38268673 PMCID: PMC10806182 DOI: 10.3389/fnut.2023.1307896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
Background Vitamin D is a key factor in bone metabolism, yet vitamin D insufficiency and deficiency are prevalent among postmenopausal women, with potential repercussions on bone mineral density (BMD), bone turnover markers (BTMs), and parathyroid hormone (PTH). Nonetheless, the findings from existing studies exhibit inconsistency, and a notable gap exists in the availability of large-scale investigations. Methods In this real-world study, 8,532 postmenopausal women over 50 years old with a diagnosis of osteopenia (50.9%) and osteoporosis (49.1%) at the first visit were enrolled in this study. Serum 25(OH)D level, PTH, osteocalcin (OC) and Beta-CrossLaps of type 1 collagen containing cross-linked C-telopeptide (β-CTX), were measured. BMD at all sites, including the lumbar spine, femoral neck, and total hip were obtained by dual-energy X-ray absorptiometry (DXA). The associations of serum 25(OH)D level with BMDs and BTMs were investigated using spearman correlation analysis and analysis of general linear model adjusted by age and body mass index. Results The serum 25(OH)D level was 22.17 ± 9.75 ng/mL among all patients included in this study. For the osteopenia group, the serum 25(OH)D level was 22.40 ± 9.41 ng/mL, while for the osteoporosis group, it measured 21.93 ± 10.08 ng/mL. In the osteopenia group, the prevalence of vitamin D deficiency, insufficiency and sufficiency was 45.8, 34.6, and 19.6%, respectively, which was close to that of the osteoporosis group (47.4, 34.3, and 18.3%) (p = 0.202). Spearman correlation analysis unveiled negative associations between serum 25(OH)D concentrations and both BTMs and PTH within both the osteopenia and osteoporosis group. In the osteoporosis group, there were positive correlations between 25(OH)D levels and femoral neck BMD (r = 0.040, p = 0.010) and total hip BMD (r = 0.053, p = 0.001). Furthermore, we found that for the osteopenia group, greater vitamin D levels were associated with greater femoral neck BMD (p = 0.020) and total hip BMD (p = 0.008) and lower β-CTX (p < 0.001), OC (p < 0.001), and PTH (p < 0.001). The same trends were seen in osteoporosis patients (p < 0.05), and with greater lumbar spine BMD with higher levels of 25(OH)D (p = 0.009). Conclusion This study showed high prevalence of vitamin D deficiency and insufficiency in Chinese postmenopausal women with osteopenia and osteoporosis and the relationships between vitamin D and BMD, BTMs and PTH. The results contribute to a more comprehensive understanding of how vitamin D may impact bone health.
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Affiliation(s)
- Xi Chen
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Shen
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Gao
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rou Weng
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yier Fan
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuqin Xu
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenlin Zhang
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Hu
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Mobasseri M, Tarverdizadeh N, Mirghafourvand M, Salehi-Pourmehr H, Ostadrahimi A, Farshbaf-Khalili A. The role of bone turnover markers in screening low bone mineral density and their relationship with fracture risk in the postmenopausal period. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:54. [PMID: 37496649 PMCID: PMC10366982 DOI: 10.4103/jrms.jrms_612_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 07/28/2023]
Abstract
Background Using bone turnover marker (BTM) monitoring to identify "quick losers" who may develop osteoporosis in the coming years is one of the main challenges in clinical practice. This study was implemented to examine the association of BTMs with bone mineral density (BMD) as well as to determine their relationship with the fracture risk assessment tool (FRAX) in women in the postmenopausal period. Materials and Methods This study was observational cross-sectional research that was done on women between the ages of 50 and 65 who were in the postmenopausal period. A dual-energy X-ray absorptiometry was applied to select 120 eligible women with normal BMD and 120 women without normal BMD. BTMs were assessed using enzyme-linked immunosorbent assay. Osteoporosis's Odds Ratio (OR) was estimated using a confounder-adjusted logistic regression model. The area under curve was calculated for the differentiation of low BMD in the postmenopausal period through receiver-operator characteristic (ROC) curves. To assess the probability of major osteoporotic fracture and hip fracture for the future 10 years, FRAX was applied. Results Higher serum osteocalcin (OC) (OR: 1.134, 95% confidence interval [CI]: 1.086-1.184), osteopontin (OP) (OR: 1.180; 95%CI: 1.105-1.261), and alkaline phosphatase (ALP) (OR: 1.007; 95%CI: 1.001-1.144) concentrations were potential risk factors for developing low BMD in women after menopause. The area under curve (AUC) (95%CI) for OC, OP, and ALP was 0.75 (0.668-0.8130), 0.75 (0.685-0.812), and 0.602 (0.524-0.670), respectively. ROC analysis indicated that at the cut-off point of 16.28 ng/mL, sensitivity and specificity were 70.3% and 70.9%, respectively, for OC. Furthermore, at the cut-off point of 28.85 ng/mL, the sensitivity of 70.3% and specificity of 66.6% were obtained for OP. The serum OC and OP were significantly related to hip and major osteoporotic fractures (P < 0.05). Conclusion The higher serum concentration of OC, OP, and ALP had significant associations with lower BMD. These BTMs can be complementary tools and helpful in the postmenopausal period as measures for screening of bone loss and possible bone fracture.
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Affiliation(s)
- Majid Mobasseri
- Endocrine Reserach Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Tarverdizadeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Salehi-Pourmehr
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Du Y, Xie B, Wang M, Zhong Y, Lv Z, Luo Y, He Q, Liu Z. Roles of sex hormones in mediating the causal effect of vitamin D on osteoporosis: A two-step Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1159241. [PMID: 37082118 PMCID: PMC10111617 DOI: 10.3389/fendo.2023.1159241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/01/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundAlthough 25-hydroxyvitamin D [25(OH)D] is a risk factor for osteoporosis, it is not clear whether sex hormones mediate this casual association. We aimed to explore how sex hormones affect the association between 25(OH)D and osteoporosis to provide meaningful insights on the underlying mechanisms from a genetic perspective.MethodsGenetic variations in 25(OH)D, total testosterone (TT), androstenedione (A4), estradiol (E2), and testosterone/17β-estradiol (T/E2) were determined through summary statistics. Taking osteoporosis as the outcome (FinnGen biobank, 332,020 samples), we conducted a Mendelian randomization (MR) analysis to establish the association between 25(OH)D and these sex hormones. The two-step MR analysis quantified the mediatory effects of sex hormones on osteoporosis. The results were further verified by pleiotropy and heterogeneity analyses.ResultsMR results showed that 25(OH)D (OR= 1.27, p = 0.04) and TT (OR= 1.25, p = 0.04) had a causal effect on osteoporosis. No significant associations were observed between the other sex hormones (A4, E2, and T/E2) and osteoporosis (p>0.05). Sensitivity analysis (p>0.05) confirmed the robustness of the MR results. The two-step MR analysis provided evidence that the mediatory effect of TT was 0.014 (the percentage of TT mediation was 5.91%). Moreover, the direct effect of 25(OH)D on osteoporosis was 0.221. A4, E2, and T/E2 were not considered as potential mediators of the role of 25(OH)D as a risk factor for OP.ConclusionThis study, through MR analysis, showed that TT mediates the causal effect of 25(OH)D on osteoporosis. Interventions targeting TT, therefore, have the potential to substantially reduce the burden of osteoporosis attributable to high 25(OH)D.
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Affiliation(s)
- Yongwei Du
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Baohui Xie
- Department of Orthopedics, Shangyou Hospital of Traditional Chinese Medicine, Ganzhou, China
| | - Maoyuan Wang
- Department of Rehabilitation, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yanbiao Zhong
- Department of Rehabilitation, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Zhimai Lv
- Department of Internal Medicine-Neurology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yun Luo
- Department of Rehabilitation, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qiwei He
- Ganzhou Polytechnic, Ganzhou, China
| | - Zhen Liu
- Department of Rehabilitation, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- *Correspondence: Zhen Liu,
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Lenz JS, Tintle N, Kerlikowsky F, Badrasawi M, Zahdeh R, Qasrawi R, Hahn A, Schuchardt JP. Assessment of the vitamin D status and its determinants in young healthy students from Palestine. J Nutr Sci 2023; 12:e38. [PMID: 38415242 PMCID: PMC10897509 DOI: 10.1017/jns.2023.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023] Open
Abstract
The global prevalence of vitamin D deficiency is high. Poor vitamin D status, especially in women, has been reported in several countries in the Middle East despite adequate year-round sunlight for vitamin D synthesis. However, data on vitamin D status in Palestine are scarce. The aim of this cross-sectional study was to evaluate vitamin D status based on serum concentrations of 25-hydroxycholecalciferol [25-(OH)D] among young healthy Palestinian students (18-27 years) and to assess associations between 25-(OH)D concentrations and several predictors. The mean 25-(OH)D concentration of women (n 151) was 27⋅2 ± 14⋅5 nmol/l, with the majority having insufficient (31⋅1 %) or deficient (<60 %) 25-(OH)D status. Only 7 % of women achieved sufficient or optimal 25-(OH)D status. In contrast, men (n 52) had a mean 25-(OH)D concentration of 58⋅3 ± 14⋅5 nmol/l, with none classified as deficient, and most obtaining sufficient (55⋅8 %) or even optimal 25-(OH)D status (11⋅5 %). Among women, 98 % wore a hijab and 74 % regularly used sunscreen. Daily dietary vitamin D intake (3-d 24-h recalls) was 45⋅1 ± 36⋅1 IU in the total group (no sex differences). After adjustment, multiple linear regression models showed significant associations between 25-(OH)D concentrations and the use of supplements (B = 0⋅069; P = 0⋅020) and dietary vitamin D (B = 0⋅001; P = 0⋅028). In gender-stratified analysis, the association between supplement use and 25-(OH)D concentrations was significant in women (B = 0⋅076; P = 0⋅040). The vitamin D status of women in the present cohort is critical and appears to be mainly due to wearing a hijab, regular use of sunscreen and low dietary vitamin D intake. The vitamin D status of the women should be improved by taking vitamin D containing supplements or fortified foods.
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Affiliation(s)
- Janina Susann Lenz
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | - Nathan Tintle
- Department of Population Health Nursing Science, College of Nursing, University of Illinois – Chicago, Chicago, IL, USA
| | - Felix Kerlikowsky
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, West Bank, Palestine
| | - Rana Zahdeh
- Department of Chemistry and Applied Sciences, College of Applied Sciences, Palestine Polytechnic University, Hebron, West Bank, Palestine
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine
- Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | - Jan Philipp Schuchardt
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
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Dadda S, El Houate B, El Bouhali B. Multifactorial hypovitaminosis D among women in the South-East Oases of Morocco. Arch Osteoporos 2022; 18:14. [PMID: 36574180 DOI: 10.1007/s11657-022-01204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022]
Abstract
This study assessed the vitamin D status among women in South-East Oases of Morocco. Two hundred thirty-three healthy volunteer women were recruited at five urban and rural health centers. Hypovitaminosis D is very common in this region and correlated to age, monthly income, skin color, daily sun exposure, BMI, and body fat percentage. PURPOSE This study assessed the vitamin D status among women in the Draa-Tafilalet region and its relationship with clinical, anthropometric, and behavioral parameters. METHODS The study was carried out with 233 women in consultation at five urban and rural health centers in the South-East region of Morocco. The data collected relate to age, monthly income, educational level, BMI, body fat percentage, daily sun exposure, physical activity level, veil wear, and skin color. The plasma determination of vitamin D was measured by immunofluorescence. Statistical analyses were performed using Python and Jamovi. RESULTS The median 25(OH)D plasma concentration was 9.95 ng/mL (IQR: 8-13.18). A total of 50.64% of women had 25(OH)D levels below 10 ng/ml and 47.21% had levels between 10 and 30 ng/mL. Statistical tests showed an association between hydroxyvitamin D plasma levels and age (r = - 0.139; p = 0.034), monthly income (p = 0.001), BMI (r = - 0.200; p = 0.002), body fat percentage (r = - 0.131; p = 0.049), daily sun exposure (r = 0.165; p = 0.012), and skin color (p < 0.001). Binomial logistic regression showed that darker skin was associated with vitamin D deficiency (< 10 ng/mL). It also showed that high income and longer sun exposure could be protecting factors against vitamin D deficiency. CONCLUSION The plasma concentrations of vitamin D in women in the Draa-Tafilalet region were low compared to expected results for a high sunshine time area.
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Affiliation(s)
- Sakhr Dadda
- Department of Biology, Faculty of Science and Techniques of Errachidia, Moulay Ismail University of Meknes, Errachidia, Morocco
| | - Brahim El Houate
- Higher Institute of Nursing and Health Professions, Ouarzazate, Morocco
| | - Bachir El Bouhali
- Department of Biology, Faculty of Science and Techniques of Errachidia, Moulay Ismail University of Meknes, Errachidia, Morocco.
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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: 3] [Impact Index Per Article: 1.0] [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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Liu K, Jing P, Liu Z, Wang Y, Han Z, Wang Y, Zheng Z, Wu Y, Wang T, Li Y, Zhang H, Wang L. Serum levels of irisin in postmenopausal women with osteoporotic hip fractures. Cytokine 2021; 148:155708. [PMID: 34560610 DOI: 10.1016/j.cyto.2021.155708] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the role of circulating serum levels of irisin in predicting hip fracture occurrence in a cohort of Chinese postmenopausal women. METHODS This was a cross-section and case-control study. Four hundred and thirty postmenopausal women aged 50-90 years were included (215 with hip fractures and 215 age-matched cases without fracture). Clinical features, bone mineral density (BMD) and serum biomarkers levels including irisin were measured at baseline. Cox proportional hazards regression analysis was used to assess the correlation between irisin and fracture risk. RESULTS The mean age of those participants was 68.7 (S.D. 11.7) and 53.0% were order than 65. The irisin serum levels were positively related to total body BMD and total hip BMD. Women with hip fractures showed lower mean serum levels of irisin compared normal control women (457.6 ± 172.6 ng/ml vs. 602.2 ng/ml; P < 0.001). The irisin levels in third and fourth quartiles were associated with the risk of hip fracture (the lowest quartile of irisin levels as the reference), and risk of fracture reduced by 67% (hazard ratio [HR] = 0.33; 95 %CI: 0.18-0.54; P < 0.001) and 84% (HR = 0.16; 95 %CI: 0.09-0.29; P < 0.001). The irisin levels in third and fourth quartiles were also associated with the risk of osteoporosis, and risk of fracture reduced by 55% (HR = 0.45; 95 %CI: 0.21-0.63; P = 0.003) and 73% (HR = 0.27; 95 %CI: 0.15-0.47; P < 0.001). CONCLUSION Decreased serum levels of circulating irisin are associated with high risk of osteoporosis-related hip fractures and osteoporosis.
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Affiliation(s)
- Kai Liu
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Pengwei Jing
- Articulation Surgery and Sport Medicine Ward, Yantai Yuhuangding Hospital, Yan Tai, China
| | - Zehan Liu
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Wang
- Department of Otolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yan Tai, China
| | - Zhu Han
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Youqiang Wang
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhirui Zheng
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yue Wu
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tong Wang
- Articulation Surgery and Sport Medicine Ward, Yantai Yuhuangding Hospital, Yan Tai, China
| | - Yuhui Li
- Articulation Surgery and Sport Medicine Ward, Yantai Yuhuangding Hospital, Yan Tai, China
| | - Hongying Zhang
- Department of Cardiology, Heilongjiang Forestry General Hospital, Harbin, China.
| | - Lichun Wang
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Zhao JH, Shi HP, Jiang DJ, Wang LT, Chen SB, Jia WT. Analysis of Combined Indicators for Risk of Osteoporotic Hip Fracture in Elderly Women. Orthop Surg 2021; 13:1205-1212. [PMID: 33942553 PMCID: PMC8274211 DOI: 10.1111/os.12974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022] Open
Abstract
Objective To compare the accuracy of combined independent risk factors in assessing the risk of hip fractures in elderly women. Methods Ninety elderly females who sustained hip fractures (including femoral neck fractures and intertrochanteric fractures) and 110 female outpatients without a hip fracture were included in our cross‐sectional study from 24 November 2017 to 20 May 2019. The age of subjects in the present study was ≥65 years, with the mean age of 78.73 ± 7.77 and 78.09 ± 5.03 years for women with and without elderly hip fractures, respectively. Bone mineral density (BMD), Beta‐carboxy terminal telopeptide (β‐CTX), N‐terminal/mid region (N‐MID), and 25(OH)D levels were analyzed. A novel evaluation model was established to evaluate combined indicators in assessing hip fractures in elderly women. Results Compared with the control group, taller height (155.68 ± 6.40 vs 150.97 ± 6.23, P < 0.01), higher levels of β‐CTX (525.91 ± 307.38 vs 330.94 ± 289.71, P < 0.01), and lower levels of total hip BMD (0.662 ± 0.117 vs 0.699 ± 0.111, P = 0.022), femoral neck BMD (0.598 ± 0.106 vs 0.637 ± 0.100, P = 0.009), and 25(OH)D (15.67 ± 7.23 vs 29.53 ± 10.57, P < 0.01) were found in the facture group. After adjustment for confounding factors, logistic regression analysis revealed that 25(OH)D (adjusted OR 0.837 [95% CI 0.790–0.886]; P < 0.01), femoral neck BMD (adjusted OR 0.009 [95% CI 0.000–0.969]; P = 0.048) and height (adjusted OR 1.207 [95% CI 1.116–1.306]; P < 0.01) remained risk factors for hip fractures in elderly women. Then a model including independent risk factors was established. A DeLong test showed the area under the receiver operator characteristic (ROC) (Area under the curve [AUC]) of 25(OH)D was significantly greater than that for femoral neck BMD (P < 0.01) and height (P < 0.01). The AUC of model including 25(OH)D and height was significantly greater than that of other combinations (P < 0.01). Conclusion 25(OH)D, femoral neck BMD and height were associated with the occurrence of hip fractures in elderly women even after adjustment for confounding factors, and a model including 25(OH)D and height could provide better associated power than other combinations in the assessment of elderly hip fractures.
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Affiliation(s)
- Jin-Hui Zhao
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hui-Peng Shi
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Da-Jun Jiang
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ling-Tian Wang
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Sheng-Bao Chen
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei-Tao Jia
- Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
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Saad MA, Aboelwafa RA, Elsayed EH. Could procollagen type I N-terminal propeptide (PINP) and bone alkaline phosphatase (B-ALP) be valid alternative diagnostic markers to dual X-ray absorptiometry (DEXA) in elderly females with osteoporosis? An Egyptian radiological and laboratory monocentric study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00069-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Osteoporosis is a major health problem of elders. Dual X-ray absorptiometry (DEXA) is the commonly used modality for diagnosis osteoporosis; serum markers have been suggested for predicting osteoporosis and discriminate osteoporotic from healthy subjects. We aimed to analyze the status of some bone turnover biochemical markers namely PINP, B-ALP, estrogen, and progesterone in the elderly osteoporotic and osteopenic women as probable markers for the discrimination between patients and healthy individual in diagnosing osteoporosis, and also, to detect the impact of osteoporosis on quality of life of patients using assessment of the quality of life for osteoporosis (ECOS-16). Post-menopausal 108 females were involved in the current study, divided into two groups (osteoporotic group (60 with BMD˂-2.5), osteopenic group (48 with BMD between − 1 and − 2.5)), and 60 healthy elderly females as control group were involved in the study. Serum levels of procollagen type I N-terminal propeptide (PINP), bone alkaline phosphatase (B-ALP), estrogen, and progesterone were measured by ELISA technique.
Results
PINP and B-ALP significantly differ between studied groups. Also, PINP and B-ALP levels had high sensitivity and specificity to discriminate osteoporotic patients from healthy individuals. PINP and B-ALP significantly correlated with bone mineral density (BMD) and with ECOS-16. Estrogen differs significantly between osteoporotic and osteopenic groups and significantly correlated with bone mineral density of femur (BMD-F) and bone mineral density of spine (BMD-S) in the osteopenic group. Progesterone differed significantly between patients and controls and significantly correlated with BMD-F in the osteoporotic group.
Conclusion
We can consider PINP and B-ALP as biomarkers for early detection then monitoring of osteoporosis. Measuring these serum markers can replace the assessment of BMD if not available. Also, it could replace the gap between BMD subsequently spaced assessment or could be of value in cases with severe spondylosis, DISH syndrome, old spondylarthritis, and/or previous spinal surgery. Sex hormones could not differentiate the normal from the osteoporotic/osteopenic patients, so they cannot be used as diagnostic or prognostic markers. Validation of this assumption needs large and longitudinal studies.
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Nazzal ZA, Hamdan Z, Natour N, Barbar M, Rimawi R, Salaymeh E. Prevalence of Vitamin D Deficiency among Hemodialysis Patients in Palestine: A Cross-Sectional Study. Int J Nephrol 2021; 2021:6684276. [PMID: 33791129 PMCID: PMC7984929 DOI: 10.1155/2021/6684276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The level of vitamin D status and its relationship to kidney function and liver function among patients with and without type 2 diabetes were not studied among Palestinian hemodialysis patients before. The aim of this study was to assess the status of vitamin D in hemodialysis patients with and without type 2 diabetes and its determinants. METHODS Data were collected on 163 patients on hemodialysis therapy in the Nephrology Department at Najah National University Hospital. Information on age, sex, plasma 25 (OH)D, serum calcium, serum phosphate, parathyroid hormone, dialysis period, hypertension, diabetes, ALT, AST, albumin, alkaline phosphates, and BMI was obtained from the medical records. Data were analyzed using SPSS. Findings. The mean level of 25 (OH)D was 17.3 ± 10.5 ng/ml. Only 12.9% of subjects had 25 (OH)D levels >30 ng/ml, whereas 65% had levels between 10 and 30 ng/ml; the remaining 22.1% were severely vitamin D deficient (<10 ng/ml). Vitamin D deficiency was more prevalent among females. It was not related to PTH, calcium, kidney, or liver function tests. CONCLUSION Vitamin D deficiency is highly prevalent among patients on hemodialysis with or without DM2.
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Affiliation(s)
- Zaher A. Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
| | - Zakaria Hamdan
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
- Department of Nephrology, An-Najah National University Hospital, Nablus 44839, State of Palestine
| | - Nihal Natour
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
| | - Maram Barbar
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
| | - Rawan Rimawi
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
| | - Eziyeh Salaymeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 44839, State of Palestine
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Pal R, Aggarwal A, Sachdeva N, Ram S, Garg A, Bhansali A, Bhadada SK. Age- and sex-specific concentrations of bone remodeling markers in healthy Indian adults with and without vitamin D deficiency. Arch Osteoporos 2021; 16:10. [PMID: 33415509 DOI: 10.1007/s11657-020-00855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/09/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Bone remodeling markers exhibit marked inter-ethnic variation; hence, population-specific data are required. Herein, we have established age- and sex-specific concentrations of serum PINP and CTX in healthy Indian adults with and without vitamin D deficiency that can be used in clinical practice for monitoring response to anti-osteoporotic therapy. OBJECTIVE The present study was undertaken to generate data on age- and sex-specific concentrations of serum procollagen type I N-propeptide (PINP) and type I collagen C-telopeptide (CTX) in healthy Indian adults with and without vitamin D deficiency. METHODS Apparently, healthy subjects aged ≥ 20 years with no prior co-morbidities were recruited from the community by door-to-door surveys. Provisionally eligible participants underwent blood sampling after overnight fast. Individuals with biochemical abnormalities that could potentially affect bone remodeling were excluded. However, subjects with vitamin D deficiency were not excluded. Serum total PINP and β-CrossLaps (CTX) were measured using electro-chemiluminescence immunoassay. RESULTS After exclusion, 677 subjects were enrolled (M:F = 2.5:4.2, mean age = 45.0 years). Median serum PINP and CTX were 55.78 ng/ml (40.27-71.70) and 0.356 ng/ml (0.238-0.499), respectively. There was no difference in PINP/CTX between men and women or between premenopausal and postmenopausal women. Decade-wise distribution of PINP/CTX showed that maximum values were attained in 3rd decade; subsequently, in men, levels declined with age while in women, there was a peak in the 6th decade coinciding with the early years of menopause. Vitamin D deficiency and severe vitamin D deficiency were seen in 417 (61.5%) and 259 subjects (38.2%), respectively. There was no significant difference in PINP/CTX in subjects with and without vitamin D deficiency. CONCLUSIONS The present study has allowed us to generate data on serum concentrations of PINP/CTX in a diverse group of healthy community-dwelling Indian adults with varying serum vitamin D levels. It might aid in monitoring response to anti-osteoporotic therapy amongst native Indians.
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Affiliation(s)
- Rimesh Pal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anshita Aggarwal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sant Ram
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Abhilasha Garg
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Yuan F, Chen H, Hu P, Su P, Guan X. MiR-26a regulates the expression of serum IGF-1 in patients with osteoporosis and its effect on proliferation and apoptosis of mouse chondrocytes. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:298-307. [PMID: 34059575 PMCID: PMC8185263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To examine the effects of the regulation on IGF-1 by miR-26a on the serum of patients with osteoporosis (OP) and apoptosis and proliferation of chondrocytes of mice with OP. METHODS Totally 47 patients with OP treated in our hospital between July 2018 and November 2019 were selected as the research group, and 42 healthy individuals in physical examination over this period were selected as the control group. Serum was sampled from each participant in both groups, and miR-26a in the sampled serum was quantified and compared. In addition, chondrocytes were sampled from mice with OP. The changes of proliferation and apoptosis of the chondrocytes were analyzed via MTT and flow cytometry, and the levels of Caspase3, Caspase9, Bax, and Bcl-2 were quantified by western blot (WB) assay. RESULTS MiR-26a was expressed highly in the serum of patients with OP and chondrocytes of mice with OP, while IGF-1 was lowly expressed in them. According to the dual-luciferase reporter assay, there was a targeting correlation between miR-26a and IGF-1, and suppressing miR-26a significantly up-regulated the expression and protein level of IGF-1. CONCLUSIONS MiR-26a can serve as a biological marker for the diagnosis of OP, and it can suppress the proliferation of chondrocytes and promote their apoptosis by regulating IGF-1.
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Affiliation(s)
- Fangchang Yuan
- Orthopedic Department, Rizhao People’s Hospital, P.R. China
| | - Haixia Chen
- Dermatology Department, Rizhao People’s Hospital, P.R. China
| | - Peng Hu
- Orthopedic Department, Rizhao People’s Hospital, P.R. China
| | - Peng Su
- Orthopedic Department, Lanshan District People’s Hospital, P.R. China
| | - Xiliang Guan
- Orthopedic Department, Rizhao People’s Hospital, P.R. China,Corresponding author: Xiliang Guan, Orthopedic Department, Rizhao People’s Hospital, No. 126 Tai’an Road, Rizhao 276800, Shandong, P.R. China E-mail:
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Kharroubi A, Karmi B, Shamasneh W, Saba E. Bone mineral density among Palestinian patients suffering from hemoglobinopathy disorders. Arch Osteoporos 2020; 15:181. [PMID: 33188480 DOI: 10.1007/s11657-020-00853-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/05/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study aimed to investigate the correlation between bone mineral density (BMD) with hemoglobin and ferritin levels in Palestinian patients suffering from various types of hemoglobinopathies. The study revealed the thresholds of hemoglobin and ferritin to protect against low BMD in these patients. PURPOSE Iron overload is the main cause of low BMD in subjects with hemoglobinopathies. We used iron overload-related parameters like hemoglobin and ferritin to estimate the cutoff values required to maintain bone health and identify subjects with low BMD. METHODS Palestinian patients (135) suffering from various types of hemoglobinopathies were recruited from various medical centers including 87 β thalassemia major (TM), 13 thalassemia intermedia (TI), 16 sickle cell anemia (SCA), 17 sickle cell thalassemia (SCT), and 1 thalassemia trait (TT). Most subjects (84%) were below the age of 30 years. BMD was measured and the z score was used to identify subjects with low BMD (z < - 2.0). Receiver operator characteristic (ROC) curve analysis was used to estimate the thresholds of hemoglobin and ferritin levels needed to protect against low BMD in these patients. RESULTS No difference in means of age, weight, BMI, hemoglobin, and ferritin levels among the recruited male and female subjects were observed. The results showed that 77% of TM subjects had low BMD levels and femoral neck and total hip BMD were significantly lower among female compared to male subjects. Thalassemia patients (TM, TI, and SCT combined) had significantly low BMD and lower hemoglobin mean values compared to normal BMD subjects (8.54 vs. 9.25 g/dL, p = 0.01). Pearson's correlation analysis showed positive correlation between hemoglobin levels and BMD at the three sites, being higher with lumbar spine (r = 0.444) compared to femoral neck (r = 0.291) and total hip (r = 0.224). Ferritin levels in TM patients (4800 ng/ml) and TI subjects (1500 ng/ml) were abnormally high. ROC curve analysis showed that hemoglobin threshold ≤ 9.3 g/dL represents a risk for developing low BMD with an area under the ROC curve (AUC) 0.699 and sensitivity and specificity were 87.9% and 47.7%, respectively. Similar analysis revealed that Ferritin threshold to protect against low BMD should be maintained below 2300 ng/ml with AUC 0.619 and sensitivity and specificity were 55.0% and 71.4%, respectively. CONCLUSIONS The results of this study strongly recommend to maintain hemoglobin levels above 9.3 g/dL and ferritin below 2300 ng/ml to protects against low BMD in TM subjects and patients suffering from the other related hemoglobinopathies.
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Affiliation(s)
- Akram Kharroubi
- Faculty of Health Professions, Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine.
| | - Bashar Karmi
- Thalassemia Patients' Friends Society, Ramallah, Palestine
| | | | - Elias Saba
- Palestinian Osteoporosis Prevention Society [POPS], Bethlehem, Palestine
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15
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Khan AW, Zadran N, Khan A, Ishaq M, Kumar J, Ibrar A, Tahir A. Vitamin D Levels and Bone Mineral Density in Premenopausal Women Compared to Postmenopausal Women: A Multi-Centre Study From Pakistan. Cureus 2020; 12:e11439. [PMID: 33324522 PMCID: PMC7732786 DOI: 10.7759/cureus.11439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction Despite the sunny climate, women in Pakistan are prone to vitamin D deficiency and subsequent low bone mineral density. The current study explores the extent of this deficiency in both pre- and postmenopausal women in our setting. Methodology A cross-sectional study was conducted at the outpatient departments of Lady Reading Hospital and Hayatabad Medical Complex Peshawar, Pakistan during the time period between March 2018 and June 2019. Hundred premenopausal women (control group) and 100 postmenopausal women (study group) were inducted in the study. Serum vitamin D levels were determined in patients with suspected vitamin D deficiency. Bone mineral density (BMD) was determined for each patient and the cost of each scan was afforded by our department. A dual-energy x-ray absorptiometry (DEXA) scan was used to perform the bone mineral density assessment. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 26 (IBM, Chicago, IL). Results Serum 25OHD concentration in postmenopausal women was significantly lower compared to premenopausal women (p<0.001). In the study group, 36.0% of women had a severe deficiency of serum vitamin D levels, whereas, in the control group, only two women suffered from severe deficiency of vitamin D. Similarly, bone mineral density was also significantly correlated with the menopausal status of the women (p<0001). It was found that three-fifths of the postmenopausal women had a low bone density. Twenty-four percent of postmenopausal women had very low BMD. In comparison, only a single premenopausal woman was found to have a Z-score of below -2.0. Conclusion The current study highlights the impact of menopause on vitamin D levels and BMD. In our study, we found a significant difference between vitamin D levels and BMD in women of reproductive age compared to postmenopausal women.
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Affiliation(s)
- Abdul Wali Khan
- Internal Medicine, College of Physicians and Surgeons Pakistan, Peshawar, PAK
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | - Abat Khan
- Cardiology, Khyber Teaching Hospital, Peshawar, PAK
| | - Muhammad Ishaq
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | | | - Amber Tahir
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Tehrani SS, Moallem M, Ebrahimi R, Hosseini SR, Nooreddini H, Parsian H. Status of circulating bone turnover markers in elderly osteoporosis/osteopenia patients in comparison with healthy subjects. ASIAN BIOMED 2020. [DOI: 10.1515/abm-2020-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
In the aging individuals, osteoporosis is a major health problem. Due to the various limitations of dual X-ray absorptiometry (DEXA) for diagnosis osteoporosis, serum-based biochemical markers have been suggested for the discrimination between the patients and healthy subjects.
Objective
To investigate the serum levels of bone turnover markers in elderly osteoporosis patients.
Methods
The serum samples from elderly subjects (osteoporosis (n = 28), osteopenia (n = 28), and healthy ones (n = 28) were collected from Amirkola Health and Ageing Project study. Furthermore, serum levels of bone formation and bone resorption markers as well as estrogen and progesterone were measured by enzyme-linked immunosorbent assay. Kruskal–Wallis test and receiver operating characteristic curve analysis were used for statistical analysis using SPSS.
Results
Levels of bone alkaline phosphatase (B-ALP) and procollagen type I N-terminal propeptide (PINP) differed between groups (P = 0.003 and 0.009, respectively). Furthermore, PINP and B-ALP levels had the best area under the curve, sensitivity, and specificity for the discrimination between patients with osteoporosis and healthy individuals.
Conclusion
In conditions in which we are not able to assess the bone mineral density by DEXA, analysis of the B-ALP and PINP levels may be a helpful tool.
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Affiliation(s)
- Sadra Samavarchi Tehrani
- Department of Clinical Biochemistry, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
- Student Scientific Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Maryam Moallem
- Social Determinants of Health Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , Iran
| | - Reyhane Ebrahimi
- Department of Clinical Biochemistry, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
- Student Scientific Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , Iran
| | - Hajighorban Nooreddini
- Department of Internal Medicine , Ayatollah Rouhani Hospital , Babol University of Medical Sciences , Babol , Iran
| | - Hadi Parsian
- Social Determinants of Health Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , Iran
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Tariq S, Tariq S, Khaliq S, Baig M, Murad MA, Lone KP. Association Between Vitamin D and Resistin in Postmenopausal Females With Altered Bone Health. Front Endocrinol (Lausanne) 2020; 11:615440. [PMID: 33519717 PMCID: PMC7844394 DOI: 10.3389/fendo.2020.615440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/30/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Resistin is a relatively novel adipokine that has a role in bone remodeling and may regulate bone mineral density (BMD). Vitamin D and adipokines have a dynamic role in the body's various metabolic processes, including bone metabolism, and may alter bone metabolism in relation to each other. This study aimed to investigate the association between vitamin D and serum resistin levels in postmenopausal non-osteoporotic and osteoporotic females. METHODS This correlational analytical study was conducted on 161 postmenopausal females, divided into two groups, non-osteoporotic and osteoporotic, between 50-70 years. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA) scan. Serum resistin and vitamin D levels were analyzed by enzyme-linked immunosorbent assay (ELISA) method. Serum calcium, phosphate, and alkaline phosphatase with spectrophotometry. A correlation was checked using spearman's rho correlation coefficient, and multivariate stepwise regression analysis was used to predict serum resistin levels. RESULTS Postmenopausal females (n=161) having sufficient, insufficient and deficient levels of vitamin D were 87 (54.0%), 64 (39.8%), and 10 (6.2%), respectively. Lumbar spine BMD (p < 0.001), total hip BMD (p < 0.001), and serum resistin levels (p < 0.001) were significantly different between the two groups. There was a significant negative correlation between serum resistin and vitamin D in postmenopausal females (rho = -0.182, p = 0.021) and osteoporotic group (rho = -0.253, p = 0.019) but non-significant in non-osteoporotic group (rho = -0.077, p = 0.509). Serum vitamin D was found to be independent predictor of serum resistin levels, accounting for only 3% variance. CONCLUSION Serum vitamin D levels were low while serum resistin levels were high in postmenopausal osteoporotic females and vitamin D is a negative predictor of serum resistin levels.
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Affiliation(s)
- Sundus Tariq
- Department of Physiology, University Medical & Dental College, The University of Faisalabad, Faisalabad, Pakistan
- Department of Physiology and Cell Biology, University of Health Sciences, Lahore, Pakistan
- *Correspondence: Sundus Tariq,
| | - Saba Tariq
- Department of Pharmacology and Therapeutics, University of Health Sciences, Lahore, Pakistan
- Pharmacology and Therapeutics, University Medical & Dental College, The University of Faisalabad, Faisalabad, Pakistan
| | - Saba Khaliq
- Department of Physiology and Cell Biology, University of Health Sciences, Lahore, Pakistan
| | - Mukhtiar Baig
- Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manal Abdulaziz Murad
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid Parvez Lone
- Department Physiology and Cell Biology/Metabolic Disorders, University of Health Sciences, Lahore, Pakistan
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Zhang Y, Wang Y. Clinical Research of the Application of Bone Turnover Markers in Monitoring the Short-Term Therapeutic Efficacy of Vitamin D in Postmenopausal Osteoporotic women in Harbin, China. J Nutr Health Aging 2020; 24:485-493. [PMID: 32346686 DOI: 10.1007/s12603-020-1362-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence of osteoporosis (OP) is increasing year by year. researches have shown that there was an intense link between the vitamin D (VitD) status and the efficacy of zoledronate (ZOL) in patients with osteoporosis. Since VitD is related to the geogen, its promotion effect on zoledronate has regional specificity. AIM Combining dual-energy X-ray and bone turnover markers (BTM) to explore the VitD level in postmenopausal osteoporosis patients in Harbin and monitor its effect on the anti-osteoporosis effect of ZOL. METHODS A total of 120 patients with postmenopausal osteoporosis (PMO) were enrolled .These patients were divided into two groups with 25(OH)D levels = 10ng/ml as a critical point, and each group was randomly divided into experimental groups and control groups). All of the patients were conducted 5 mg ZOL. Then the experimental group was given calcitriol and calcium carbonate, and the control group was only given calcium carbonate. BTM were measured at baseline, 24h, 3 months and 6 months. We also measured bone mineral density (BMD) of bilateral hips (TH BMD) and lumbar spine (LS BMD) at baseline and 6 months. RESULTS The VitD deficiency rates of the patients enrolled were 84.1%. There was an inverse relationship between the baseline level of VitD and the serum levels of P1NP / β-CTX, (r=-0.452,p=0.00; r=-0.225, p=0.01). Comparing with baseline, the level of serum P1NP,β-CTX in each group declined significantly after the treatment (P<0.05). The mean decreasing rates of P1NP and β-CTX in the both experimental groups were significantly higher than that of the corresponding control groups at the same time point (P<0.05), after 6 months of medication. Both TH BMD and LS BMD at 6 months increased significantly. The increase rate of LS BMD in the high VitD experimental group was significantly higher than the other three groups (P<0.05), the increase rates of TH BMD in the low VitD control group were significantly lower than the other three groups (P<0.05). CONCLUSIONS The levels of serum VitD in the patients enrolled in this study were generally low. VitD could increase the therapeutic effect of ZOL on osteoporosis.
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Affiliation(s)
- Y Zhang
- Yansong Wang, Department of Spine Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China,
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Gu H, Wu L, Chen H, Huang Z, Xu J, Zhou K, Zhang Y, Chen J, Xia J, Yin X. Identification of differentially expressed microRNAs in the bone marrow of osteoporosis patients. Am J Transl Res 2019; 11:2940-2954. [PMID: 31217865 PMCID: PMC6556634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
This study aimed to identify specific microRNAs (miRNAs) related to postmenopausal osteoporosis (OP) in human. A total of 67 conserved miRNAs, including 50 miRNAs significantly up-regulated and 17 miRNAs significantly downregulated, showed differential expression between OP group and control group. 180 hairpin structures were predicted and 199 potential novel miRNA candidates with 18 to 25 nt in length, which will greatly enrich the human miRBase. 4 miRNAs (miR-518b, miR-582-3p, miR-148a-3p and miRNA-223-3p) had upregulated expression and 4 (miR-7d-5p, miR-210-3p, miR-324-5p and miR-654-3p) showed down-regulated expression. Target genes of these miRNAs were involved in bone development, cell proliferation in bone marrow, osteoblast development, negative regulation of osteoblast differentiation, and negative regulation of osteoclast development, as well as several osteogenesis related pathways. Canonical Wnt signaling pathway was selected for verification and function analysis. The expression of Wnt1, FZD10, LRP5, DVL2 and LEF1 was down-regulated significantly, while that of SFRP1, DKK1, and CHD8 was up-regulated markedly. In conclusion, these genes play important roles in OP, which improves our understanding of pathogenesis of OP.
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Affiliation(s)
- Huijie Gu
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Liang Wu
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Haihong Chen
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Zhongyue Huang
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Jun Xu
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Kaifeng Zhou
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Yiming Zhang
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Jiong Chen
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Jiangni Xia
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
| | - Xiaofan Yin
- Department of Orthopedics, Minhang Hospital, Fudan University Shanghai 201199, China
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Komar C, Ahmed M, Chen A, Richwine H, Zia N, Nazar A, Bauer L. Advancing Methods of Assessing Bone Quality to Expand Screening for Osteoporosis. ACTA ACUST UNITED AC 2019; 119:147-154. [DOI: 10.7556/jaoa.2019.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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21
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Al-Yatama FI, AlOtaibi F, Al-Bader MD, Al-Shoumer KA. The Effect of Clothing on Vitamin D Status, Bone Turnover Markers, and Bone Mineral Density in Young Kuwaiti Females. Int J Endocrinol 2019; 2019:6794837. [PMID: 31341474 PMCID: PMC6612396 DOI: 10.1155/2019/6794837] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/25/2019] [Accepted: 05/23/2019] [Indexed: 12/13/2022] Open
Abstract
Many Arab women in the Gulf region cover their bodies for cultural and religious reasons, limiting the skin's exposure to sunlight and therefore its ability to synthesize vitamin D. The aim of this study is to determine whether the clothing style of Kuwaiti premenopausal women affects their vitamin D status, bone marker expression, and bone density. Three groups of healthy unmarried single Kuwaiti females (20-35 years old; n=30 per group) were recruited randomly from the general community: a control group who wear Western-style clothing (unveiled group), a group who wear a hejab that covers the whole body except for the face and hands (hejab group), and a group who wear a black veil with the entire body covered (veiled group). Bone mineral density (BMD), bone markers (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin, and β-CrossLaps), 25-hydroxy vitamin D, intact parathyroid hormone [iPTH], and calcitonin were measured. The bone marker osteocalcin was significantly higher in the hejab group compared to the control group, whereas P1NP and β-CrossLaps were significantly higher in the veiled group compared to the control group. 25-hydroxy vitamin D, iPTH, calcitonin, and BMD were not significantly different across the three groups despite the observed elevation in bone turnover markers. The majority of participants in all three groups exhibited vitamin D deficiency; however, the lowest vitamin D levels were observed among the hejab and veiled participants. These findings suggest that clothing style may contribute to vitamin D deficiency in young Kuwaiti women.
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Affiliation(s)
| | - Fatemah AlOtaibi
- Department of Physiology, Faculty of Medicine, Kuwait University, Kuwait
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22
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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: 1.3] [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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Smilic TN, Novakovic TR, Markovic-Jovanovic SR, Smilic LLJ, Mitic JS, Radunovic ML. The Relevance of Osteoclastic and Osteoblastic Activity Markers Follow-Up in Patients on Antiresorptive Osteoporosis Treatment. J Clin Densitom 2018; 21:322-328. [PMID: 29103946 DOI: 10.1016/j.jocd.2017.06.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/23/2017] [Accepted: 06/05/2017] [Indexed: 12/22/2022]
Abstract
In general, markers of bone formation and markers of bone resorption are changing synergistically, so the monitoring of any osteoclastic and any osteoblastic marker should reflect the rate of bone transformation. The aim of the study is to monitor the bone metabolism markers in postmenopausal women with osteoporosis and osteopenia along with the variations caused by the effects of bisphosphonate therapy. The study involved 55 women of average age of 57.95 years, with osteopenia or osteoporosis. The patients with osteoporosis were treated with bisphosphonates (75 mg once a week); the laboratory tests were performed before the treatment and 6 months later. Patients with osteopenia were evaluated at the first assessment and 6 months later. The tests included bone densitometry, dual-energy X-ray absorptiometry, osteocalcin, alkaline phosphatase, collagen 1 N-terminal pro-peptide (P1NP), and beta C telopeptide of type I collagen (CTX). The mean T-score was -2.80 ± 0.63 before therapy and -2.64 ± 0.45 6 months later (p < 0.001). Women with osteoporosis had elevated levels of osteocalcin and P1NP at the first assessment, whereas the alkaline phosphatase level did not change with the treatment. After the introduction of antiresorptive therapy, the levels of osteocalcin and P1NP significantly decreased (p < 0.001). In the group with osteopenia, the biochemical markers activity were increased in both assessments. In patients with osteoporosis, Beta-CTX was increased in the first evaluation, and decreased after treatment (p = 0.001). The results indicate that the assessment of biochemical markers of bone metabolism show excellent results in the assessment of prognosis, monitoring the course and the response to various treatment regimens of osteoporosis and evince strong correlation with standard densitometry and dual-energy X-ray absorptiometry procedures. P1NP and CTX show better diagnostic applicability compared with osteocalcin and alkaline phosphatase. The analysis of the activity of biochemical markers may obtain early information on the therapeutic response, before definitive assessment by bone density measurements.
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Affiliation(s)
- Tanja N Smilic
- Medical Faculty, University of Pristina/K.Mitrovica, Kosovo, Serbia
| | | | | | | | - Javorka S Mitic
- Medical Faculty, University of Pristina/K.Mitrovica, Kosovo, Serbia
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