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Kim S, Kim SW, Lee BC, Kim DH, Sung DH. Adult-onset hypophosphatemic osteomalacia as a cause of widespread musculoskeletal pain: A retrospective case series of single center experience. World J Clin Cases 2023; 11:7785-7794. [DOI: 10.12998/wjcc.v11.i32.7785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/14/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Osteomalacia (OM) is frequently confused with various musculoskeletal or other rheumatic diseases, especially in patients with adult-onset widespread musculoskeletal pain because of its low prevalence and non-specific manifestations.
AIM To facilitate the early diagnosis and etiology-specific treatment of adult-onset hypophosphatemic OM.
METHODS A retrospective review of medical records was performed to screen adult patients who visited a physiatry locomotive medicine clinic (spine and musculoskeletal pain clinic) primarily presenting with widespread musculoskeletal pain at a single tertiary hospital between January 2011 and December 2019. We enrolled patients with hypophosphatemia, high serum bone-specific alkaline phosphatase levels, and at least one imaging finding suggestive of OM.
RESULTS Eight patients with adult-onset hypophosphatemic OM were included. The back was the most common site of pain. Proximal dominant symmetric muscle weakness was observed in more than half of the patients. Bone scintigraphy was the most useful imaging modality for diagnosing OM because radiotracer uptake in OM showed characteristic patterns. Six patients were diagnosed with adefovir (ADV)-induced Fanconi syndrome, and the other two patients were diagnosed with tumor-induced OM and light-chain nephropathy, respectively. After phosphorus and vitamin D supplementation and treatment for the underlying etiologies, improvements in pain, muscle strength, and gait were observed in all patients.
CONCLUSION Mechanical pain characteristics, hypophosphatemia, and distinctive bone scintigraphy patterns are the initial diagnostic indicators of adult-onset hypophosphatemic OM. ADV-induced Fanconi syndrome is the most common etiology of hypophosphatemic OM in hepatitis B virus-endemic countries.
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Affiliation(s)
- Sungwon Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Sun Woong Kim
- Department of Physical and Rehabilitation Medicine, Jungdap Hospital, Suwon 16480, South Korea
| | - Byung Chan Lee
- Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul 06973, South Korea
| | - Du Hwan Kim
- Physical Medicine and Rehabilitation, Chung-Ang University, Seoul 06973, South Korea
| | - Duk Hyun Sung
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Seoul 06351, South Korea
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2
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Arcidiacono T, Foligno NE, Brioni E, Bologna A, Weber G, Mora S, Pitea M, Vitale C, Vezzoli G. Different Efficacy of Burosumab on Physical Performance and Serum Phosphate in Adult Patients with X-Linked Hyphophosphatemic Rickets during the First Six-Month of Treatment. J Clin Med 2023; 12:jcm12082906. [PMID: 37109242 PMCID: PMC10143203 DOI: 10.3390/jcm12082906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Burosumab is a monoclonal anti-FGF23 antibody used to treat patients with X-linked hypophosphatemic rickets (XLH). Its effect on serum phosphate and physical performance was compared in patients during a 6-month treatment with burosumab. Eight adult patients with XHL were treated with burosumab (1 mg/kg s.c. every 28 days). In the first 6 months of treatment, calcium-phosphate metabolism variables were measured, and muscle performance (tested with chair and walking test) and quality of life (tested with fatigue, BPI-pain and BPI-life questionnaires) were estimated. A significant increase in serum phosphate was observed during the treatment. From the 16th week, serum phosphate became significantly lower than its value in the 4th week. No patients had serum phosphate below the normal range at the 10th week, but seven patients were hypophosphatemic in the 20th and 24th week. All patients improved the execution time of the chair test and walking test, which reached a plateau after the 12th week. BPI-pain and BPI-life scores significantly decreased from baseline to the 24th week. In conclusion, a six-month burosumab treatment may significantly improve the general condition and physical performance of adult patients with XLH; this improvement was more stable and more indicative of treatment efficacy than that of serum phosphate.
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Affiliation(s)
- Teresa Arcidiacono
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Postgraduate School of Nephrology, Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Nadia E Foligno
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Postgraduate School of Nephrology, Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Elena Brioni
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Arianna Bologna
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Postgraduate School of Nephrology, Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Giovanna Weber
- Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Stefano Mora
- Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marco Pitea
- Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Corrado Vitale
- Nephrology and Dialysis Unit, Mauriziano Hospital, 10128 Turin, Italy
| | - Giuseppe Vezzoli
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Postgraduate School of Nephrology, Vita Salute San Raffaele University, 20132 Milan, Italy
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Benito LAO, Kogawa EM, Silva CMDS, Melo FF, Sales-Peres SHDC, da Silva ICR, de Oliveira Karnikowski MG. Bariatric Surgery and Vitamin D: Trends in Older Women and Association with Clinical Features and VDR Gene Polymorphisms. Nutrients 2023; 15:nu15040799. [PMID: 36839157 PMCID: PMC9965411 DOI: 10.3390/nu15040799] [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: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
(1) Background: Obesity and its comorbidities can cause burdens and limitations. Bariatric surgery (BS) is indicated as a safe procedure to reduce body mass and improve present comorbidities. However, several complications were reported, such as vitamin D [25(OH)D] deficiency. We evaluated if 25(OH)D serum levels relate to clinical characteristics, symptoms, or habits in women after their BS, and whether the vitamin D receptor (VDR) gene's TaqI and FokI polymorphisms affected 25(OH)D levels and the total body bone mineral density (TBBMD). (2) Methods: This cohort cross-sectional comparative analytical prospective study consisted of 27 women, 61.6 ± 5.0 years, submitted to BS one year prior at a public reference hospital, DF-Brazil. All participants were asked to follow the physical and dietary activity recommendations and received vitamin D3 supplements. Their anthropometric, biochemical, and immunological measurements and blood samples were obtained. (3) Results: 73.3% of participants had low 25(OH)D levels, and their levels correlated positively with TBBMD and negatively with systolic pressure. VDR TaqI did not affect 25(OH)D levels, whereas VDR FokI's allele f presence correlated to a median rise in 25(OH)D levels. Neither polymorphism correlated to TBBMD. (4) Conclusions: 25(OH)D levels were positively correlated with TBBMD, negatively with systolic blood pressure, and were higher in those with the VDR FokI allele f.
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Affiliation(s)
- Linconl Agudo Oliveira Benito
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, DF, Brazil
| | - Evelyn Mikaela Kogawa
- Bauru School of Dentistry, University of São Paulo (USP), Bauru 7012-901, SP, Brazil
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasília 70.910-900, DF, Brazil
| | - Calliandra Maria de Souza Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, DF, Brazil
| | - Fabíola Ferreira Melo
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasília 70.910-900, DF, Brazil
| | | | - Izabel Cristina Rodrigues da Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, DF, Brazil
- Correspondence:
| | - Margô Gomes de Oliveira Karnikowski
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, DF, Brazil
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Modifying the diets of captive proboscis monkeys in a temperate zoo to reduce weight loss and renal disease. Primates 2023; 64:123-141. [PMID: 36357633 DOI: 10.1007/s10329-022-01031-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
In animal husbandry, diets should help in maintaining a healthy body condition, support reproduction, and promote species-specific longevity. It is recommended to feed folivorous primates kept in zoos a high-fiber diet, i.e., leaves, although satisfying such a requirement is challenging in temperate regions because it is difficult to obtain fresh leaves, especially in autumn and winter. As equally important for their appropriate treatment, it is valuable to provide details of clinical reports of medical problems and pathological findings, although such clinical reports are rather limited. Therefore, in foregut-fermenting proboscis monkeys (Nasalis larvatus), we (1) described the individual clinical reports of renal disease and weight loss at the Yokohama Zoological Gardens in Japan, (2) determined the nutritional profile of the diets supplied to these animals because other potential triggers for their renal disease and weight loss could be excluded, (3) modified the diet regimen to minimize weight loss and the development of hypercalcemia and hypophosphatemia, and (4) assessed the effects of such dietary modification by comparing the body weight and the Ca and P concentrations and the Ca/P ratios in the blood before and after diet modification with a comparison of these measurements between zoo and free-ranging individuals. Based on the nutritional profile of the diets, we concluded that the reported cases of renal failure might be caused by consumption of leaves with a Ca/P ratio far above the appropriate level in autumn and winter. Additionally, the dietary modification of minerals and metabolizable energy achieved certain beneficial effects on zoo-kept proboscis monkeys.
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Impact of X-Linked Hypophosphatemia on Muscle Symptoms. Genes (Basel) 2022; 13:genes13122415. [PMID: 36553684 PMCID: PMC9778127 DOI: 10.3390/genes13122415] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
X-linked hypophosphatemia (XLH) is the most common hereditary form of rickets and deficiency of renal tubular phosphate transport in humans. XLH is caused by the inactivation of mutations within the phosphate-regulating endopeptidase homolog X-linked (PHEX) gene and follows an X-dominant transmission. It has an estimated frequency of 1 case per 20,000, and over 300 distinct pathogenic variations have been reported that result in an excess of fibroblast growth factor 23 (FGF23) in the serum. Increased levels of FGF23 lead to renal phosphate loss, decreased serum 1,25-dihydroxyvitamin D, and increased metabolism of 1,25-dihydoxyvitamin D, resulting in hypophosphatemia. Major clinical manifestations include rickets, bone deformities, and growth retardation that develop during childhood, and osteomalacia-related fractures or pseudo-fractures, degenerative osteoarthritis, enthesopathy, dental anomalies, and hearing loss during adulthood, which can affect quality of life. In addition, fatigue is also a common symptom in patients with XLH, who experience decreased motion, muscle weakness, and pain, contributing to altered quality of life. The clinical and biomedical characteristics of XLH are extensively defined in bone tissue since skeletal deformations and mineralization defects are the most evident effects of high FGF23 and low serum phosphate levels. However, despite the muscular symptoms that XLH causes, very few reports are available on the effects of FGF23 and phosphate in muscle tissue. Given the close relationship between bones and skeletal muscles, studying the effects of FGF23 and phosphate on muscle could provide additional opportunities to understand the interactions between these two important compartments of the body. By describing the current literature on XLH and skeletal muscle dysfunctions, the purpose of this review is to highlight future areas of research that could contribute to a better understanding of XLH muscular disability and its management.
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Jang SA, Kwon SJ, Kim CS, Park SW, Kim KM. Association Between Low Serum Phosphate Level and Risk of Falls in Hospitalized Patients Over 50 Years of Age: A Retrospective Observational Cohort Study. Clin Interv Aging 2022; 17:1343-1351. [PMID: 36105916 PMCID: PMC9467292 DOI: 10.2147/cia.s368404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Falls are the leading cause of injury among hospitalized patients, particularly among older patients. We investigated the association between serum phosphate (s-phosphate) levels and the risk of in-hospital falls. Patients and Methods This retrospective observational cohort study included all patients aged over 50 years who were admitted to Yongin Severance Hospital in South Korea between January 2018 and March 2021. Demographic, anthropometric, and biochemical parameters were recorded on admission. S-phosphate levels were classified into three groups: below normal (<2.8 mg/dL), normal (2.8–4.4 mg/dL), and above normal (≥4.5 mg/dL). The normal group was further stratified into tertiles (2.8–3.2, 3.3–3.7, and 3.8–4.4 mg/dL). The incidence of in-hospital falls was compared between the five groups. Logistic regression analyses were performed to assess the association between s-phosphate levels and the incidence of falls during the hospital stay, with clinical factors included as covariates in the multivariable models. Results A total of 15,485 patients (female: 52.1%) with a median age of 70.0 years (interquartile range: 60.0–79.0 years) were included in the analysis, of whom 295 (1.9%) experienced a fall during the hospital stay. The incidence of falls was significantly higher among patients with lower s-phosphate levels, and this relationship also applied among patients with s-phosphate levels within the normal range as well. The association between lower s-phosphate levels and increased risk of falls remained significant in the adjusted analyses. Conclusion A lower s-phosphate level on admission was independently associated with an increased risk of in-hospital falls. Further studies are needed to determine whether the s-phosphate level on admission could improve prediction of the risk of in-hospital falls.
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Affiliation(s)
- Seol A Jang
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Su Jin Kwon
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Chul Sik Kim
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Seok Won Park
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
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Kim I, Son K, Jeong SJ, Lim H. Sex and Diet-Related Disparities in Low Handgrip Strength among Young and Middle-Aged Koreans: Findings Based on the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2017. Nutrients 2022; 14:nu14183816. [PMID: 36145192 PMCID: PMC9504322 DOI: 10.3390/nu14183816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
“Possible sarcopenia” may be defined as a low muscle strength assessed by handgrip strength (HGS) by sex. We examined the sex-specific association between low handgrip strength (LGS) and dietary factors for the prevention of sarcopenia in young and middle-aged Koreans. We used data from the 2014–2017 Korea National Health and Nutrition Examination Survey of 11,635 Korean adults with LGS and normal handgrip strength (NGS). The relationship between dietary factors, e.g., nutrients, foods, and dietary patterns, and HGS was evaluated by multivariate logistic regression analyses. In men, the LGS group had a higher proportion of energy from carbohydrates and a lower proportion of energy from proteins than the NGS group. The LGS group had lower protein, niacin, phosphorus, and iron densities in their diet than the NGS group. The odds of having LGS increased as intake of vitamin B1 (odds ratio (OR) 2.916, 95% confidence interval (CI) 1.265–6.719), niacin (OR 2.286, 95% CI 1.095–4.774), phosphorus (OR 2.731, 95% CI 1.036–7.199), and iron (OR 2.591, 95% CI 1.102–6.088) decreased. In women with LGS, the odds of insufficient protein intake (OR 1.976, 95% CI 1.248–3.127) was significantly higher. This study suggests that adequate intake of protein, vitamin B1, niacin, phosphorus, and iron is beneficial for maintaining HGS.
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Affiliation(s)
- Inhye Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Kumhee Son
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Su Jin Jeong
- Statistics Support Part, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul 02447, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-969-7717
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Molecular Mechanisms of Inflammation in Sarcopenia: Diagnosis and Therapeutic Update. Cells 2022; 11:cells11152359. [PMID: 35954203 PMCID: PMC9367570 DOI: 10.3390/cells11152359] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 01/10/2023] Open
Abstract
Sarcopenia is generally an age-related condition that directly impacts the quality of life. It is also related to chronic diseases such as metabolic dysfunction associated with diabetes and obesity. This means that everyone will be vulnerable to sarcopenia at some point in their life. Research to find the precise molecular mechanisms implicated in this condition can increase knowledge for the better prevention, diagnosis, and treatment of sarcopenia. Our work gathered the most recent research regarding inflammation in sarcopenia and new therapeutic agents proposed to target its consequences in pyroptosis and cellular senescence. Finally, we compared dual X-ray absorptiometry (DXA), magnetic resonance imaging (MRI), and ultrasound (US) as imaging techniques to diagnose and follow up on sarcopenia, indicating their respective advantages and disadvantages. Our goal is for the scientific evidence presented here to help guide future research to understand the molecular mechanisms involved in sarcopenia, new treatment strategies, and their translation into clinical practice.
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Handgrip Strength and Anthropometry in Parkinson’s Disease at Diagnosis. PARKINSON'S DISEASE 2022; 2022:1516807. [PMID: 35818405 PMCID: PMC9271002 DOI: 10.1155/2022/1516807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/15/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022]
Abstract
Objectives To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to controls. Materials & Methods. This cross-sectional study includes baseline data from a cohort of newly diagnosed patients with Parkinson's disease (N = 75; M/F = 41/34) in the New Parkinsonism in Umeå study (NYPUM). Body Impedance (BIS), handgrip strength (HGS) assessments, and evaluation of risk for malnutrition (Mini Nutritional Assessment (MNA) score) and cognitive performance (Mini-Mental State Examination (MMSE)) were performed at time of PD diagnosis. Results Low fat-free mass index (FFMI), MNA score, and a high Unified Parkinson's Disease Rating Scale (UPDRS-total and UPDRS-III) were associated with high daytime levels of P-cortisol in total PD population but not in controls. Partial correlations reveal that high fat mass percent (FM (%)) and low FFMI were associated with older age in males with PD but not females with PD. Risk of malnutrition was associated with P-cortisol in males but not in females with PD (r = −0.511, P=0.001, and n = 41 and r = −0.055, P=0.759, and n = 34, respectively). Multiple linear regressions show that an interaction between P-cortisol and P-phosphate, older age, and high UPDRS-III score were associated with HGS in total patient population and males but not females. Conclusions Age- and disease-associated risk factors that decrease muscle mass and HGS and increase FM (%) in patients with PD differ between males and females by an association with levels of cortisol and phosphate.
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Trombetti A, Al-Daghri N, Brandi ML, Cannata-Andía JB, Cavalier E, Chandran M, Chaussain C, Cipullo L, Cooper C, Haffner D, Harvengt P, Harvey NC, Javaid MK, Jiwa F, Kanis JA, Laslop A, Laurent MR, Linglart A, Marques A, Mindler GT, Minisola S, Yerro MCP, Rosa MM, Seefried L, Vlaskovska M, Zanchetta MB, Rizzoli R. Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia. Nat Rev Endocrinol 2022; 18:366-384. [PMID: 35484227 DOI: 10.1038/s41574-022-00662-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/17/2022]
Abstract
X-linked hypophosphataemia (XLH) is the most frequent cause of hypophosphataemia-associated rickets of genetic origin and is associated with high levels of the phosphaturic hormone fibroblast growth factor 23 (FGF23). In addition to rickets and osteomalacia, patients with XLH have a heavy disease burden with enthesopathies, osteoarthritis, pseudofractures and dental complications, all of which contribute to reduced quality of life. This Consensus Statement presents the outcomes of a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, and provides robust clinical evidence on management in XLH, with an emphasis on patients' experiences and needs. During growth, conventional treatment with phosphate supplements and active vitamin D metabolites (such as calcitriol) improves growth, ameliorates leg deformities and dental manifestations, and reduces pain. The continuation of conventional treatment in symptom-free adults is still debated. A novel therapeutic approach is the monoclonal anti-FGF23 antibody burosumab. Although promising, further studies are required to clarify its long-term efficacy, particularly in adults. Given the diversity of symptoms and complications, an interdisciplinary approach to management is of paramount importance. The focus of treatment should be not only on the physical manifestations and challenges associated with XLH and other FGF23-mediated hypophosphataemia syndromes, but also on the major psychological and social impact of the disease.
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Affiliation(s)
- Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Jorge B Cannata-Andía
- Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Retic REDinREN-RICORS, 2040-ISCIII, Madrid, Spain
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liège, Liège, Belgium
| | - Manju Chandran
- Complicated Metabolic Bone Disorders Clinic, Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Catherine Chaussain
- Université de Paris, Institut des maladies musculo-squelettiques, URP2496, UFR Odontologie, Montrouge, France
- AP-HP, FHU DDS-Net, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Service médecine bucco-dentaire, Hôpital Bretonneau, GH Paris Nord Université de Paris, Paris, France
| | - Lucia Cipullo
- Patient representative with XLH, Geneva, Switzerland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Dieter Haffner
- Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Pol Harvengt
- XLH Belgium, Belgian association of patients with XLH (a member of the International XLH Alliance), Waterloo, Belgium
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Famida Jiwa
- Chair of the Committee of Patients Societies at the International Osteoporosis Foundation, Osteoporosis Canada, Toronto, Canada
| | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Vienna, Austria
| | - Michaël R Laurent
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Agnès Linglart
- Paris-Saclay University, INSERM U1185, Le Kremlin-Bicêtre, France
- AP-HP, endocrinology and diabetes for children, Reference centre for rare diseases of calcium and phosphate metabolism, OSCAR network, Platform of expertise for rare diseases of Paris Saclay Hospital, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Andréa Marques
- Rheumatology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICiSA:E), Nursing School of Coimbra, Coimbra, Portugal
| | - Gabriel T Mindler
- Department of Paediatric Orthopaedics, Orthopaedic Hospital Speising, Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria
| | - Salvatore Minisola
- Department of Clinical, Internal, Anaesthesiologic and Cardiovascular Sciences, 'Sapienza', Rome University, Rome, Italy
| | | | - Mario Miguel Rosa
- Departamento de Neurociências, Laboratório de Farmacologia Clínica E Terapêutica Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Lothar Seefried
- Orthopedic Department, University of Würzburg, Würzburg, Germany
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology, Medical University Sofia, Sofia, Bulgaria
| | - María Belén Zanchetta
- Instituto de Investigaciones Metabólicas (IDIM), Universidad del Salvador, Buenos Aires, Argentina
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Thompson Bastin ML, Stromberg AJ, Nerusu SN, Liu LJ, Mayer KP, Liu KD, Bagshaw SM, Wald R, Morris PE, Neyra JA. Association of Phosphate-Containing versus Phosphate-Free Solutions on Ventilator Days in Patients Requiring Continuous Kidney Replacement Therapy. Clin J Am Soc Nephrol 2022; 17:634-642. [PMID: 35477673 PMCID: PMC9269583 DOI: 10.2215/cjn.12410921] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/22/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Hypophosphatemia is commonly observed in patients receiving continuous KRT. Patients who develop hypophosphatemia may be at risk of respiratory and neuromuscular dysfunction and therefore subject to prolongation of ventilator support. We evaluated the association of phosphate-containing versus phosphate-free continuous KRT solutions with ventilator dependence in critically ill patients receiving continuous KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our study was a single-center, retrospective, pre-post cohort study of adult patients receiving continuous KRT and mechanical ventilation during their intensive care unit stay. Zero-inflated negative binomial regression with and without propensity score matching was used to model our primary outcome: ventilator-free days at 28 days. Intensive care unit and hospital lengths of stay as well as hospital mortality were analyzed with a t test or a chi-squared test, as appropriate. RESULTS We identified 992 eligible patients, of whom 649 (65%) received phosphate-containing solutions and 343 (35%) received phosphate-free solutions. In multivariable models, patients receiving phosphate-containing continuous KRT solutions had 12% (95% confidence interval, 0.17 to 0.47) more ventilator-free days at 28 days. Patients exposed to phosphate-containing versus phosphate-free solutions had 17% (95% confidence interval, -0.08 to -0.30) fewer days in the intensive care unit and 20% (95% confidence interval, - 0.12 to -0.32) fewer days in the hospital. Concordant results were observed for ventilator-free days at 28 days in the propensity score matched analysis. There was no difference in hospital mortality between the groups. CONCLUSIONS The use of phosphate-containing versus phosphate-free continuous KRT solutions was independently associated with fewer ventilator days and shorter stay in the intensive care unit.
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Affiliation(s)
- Melissa L. Thompson Bastin
- Department of Pharmacy Services, University of Kentucky Medical Center, Lexington, Kentucky,Department of Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky
| | | | | | - Lucas J. Liu
- Department of Computer Science, University of Kentucky, Lexington, Kentucky
| | - Kirby P. Mayer
- Department of Physical Therapy, University of Kentucky, Lexington, Kentucky
| | - Kathleen D. Liu
- Division of Nephrology, Department of Medicine, University of California, San Francisco, California,Division of Nephrology, Department of Anesthesia, University of California, San Francisco, California
| | - Sean M. Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alberta, Canada
| | - Ron Wald
- Division of Nephrology, St. Michael’s Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Peter E. Morris
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky
| | - Javier A. Neyra
- Department of Internal Medicine, Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky
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12
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From the Bench to the Bedside: Branched Amino Acid and Micronutrient Strategies to Improve Mitochondrial Dysfunction Leading to Sarcopenia. Nutrients 2022; 14:nu14030483. [PMID: 35276842 PMCID: PMC8838610 DOI: 10.3390/nu14030483] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
With extended life expectancy, the older population is constantly increasing, and consequently, so too is the prevalence of age-related disorders. Sarcopenia, the pathological age-related loss of muscle mass and function; and malnutrition, the imbalance in nutrient intake and resultant energy production, are both commonly occurring conditions in old adults. Altered nutrition plays a crucial role in the onset of sarcopenia, and both these disorders are associated with detrimental consequences for patients (e.g., frailty, morbidity, and mortality) and society (e.g., healthcare costs). Importantly, sarcopenia and malnutrition also share critical molecular alterations, such as mitochondrial dysfunction, increased oxidative stress, and a chronic state of low grade and sterile inflammation, defined as inflammageing. Given the connection between malnutrition and sarcopenia, nutritional interventions capable of affecting mitochondrial health and correcting inflammageing are emerging as possible strategies to target sarcopenia. Here, we discuss mitochondrial dysfunction, oxidative stress, and inflammageing as key features leading to sarcopenia. Moreover, we examine the effects of some branched amino acids, omega-3 PUFA, and selected micronutrients on these pathways, and their potential role in modulating sarcopenia, warranting further clinical investigation.
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13
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Fogarty MJ, Losbanos LL, Craig TA, Reynolds CJ, Brown AD, Kumar R, Sieck GC. Muscle-specific deletion of the vitamin D receptor in mice is associated with diaphragm muscle weakness. J Appl Physiol (1985) 2021; 131:95-106. [PMID: 34013750 DOI: 10.1152/japplphysiol.00194.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diseases or conditions where diaphragm muscle (DIAm) function is impaired, including chronic obstructive pulmonary disease, cachexia, asthma, and aging, are associated with an increased risk of pulmonary symptoms, longer duration of hospitalizations, and increasing requirements for mechanical ventilation. Vitamin D deficiency is associated with proximal muscle weakness that resolves following therapy with vitamin D3. Skeletal muscle expresses the vitamin D receptor (VDR), which responds to the active form of vitamin D, 1,25-dihydroxyvitamin D3 by altering gene expression in target cells. In knockout mice without skeletal muscle VDRs, there is marked atrophy of muscle fibers and a change in skeletal muscle biochemistry. We used a tamoxifen-inducible skeletal muscle Cre recombinase in Vdrfl/fl mice (Vdrfl/fl actin.iCre+) to assess the role of muscle-specific VDR signaling on DIAm-specific force, fatigability, and fiber type-dependent morphology. Vdrfl/fl actin.iCre+ mice treated with vehicle and Vdrfl/fl mice treated with tamoxifen served as controls. Seven days following the final treatment, mice were euthanized, the DIAm was removed, and isometric force and fatigue were assessed in DIAm strips using direct muscle stimulation. The proportion and cross-sectional areas of DIAm fiber types were evaluated by immunolabeling with myosin heavy chain antibodies differentiating type I, IIa and IIx, and/or IIb fibers. We show that in mice with skeletal muscle-specific VDR deletion, maximum specific force and residual force following fatigue are impaired, along with a selective atrophy of type IIx and/or IIb fibers. These results show that the VDR has a significant biological effect on DIAm function independent of systemic effects on mineral metabolism.NEW & NOTEWORTHY Vitamin D deficiency and vitamin D receptor (VDR) polymorphisms are associated with adverse pulmonary and diaphragm muscle (DIAm)-associated respiratory outcomes. We used a skeletal muscle-specific tamoxifen-inducible VDR knockout to investigate DIAm dysfunction following reduced VDR signaling. Marked DIAm weakness and atrophy of type IIx and/or IIb fibers are present in muscle-specific tamoxifen-induced VDR knockout mice compared with controls. These results show that the VDR has a significant biological effect on DIAm function independent of systemic effects on mineral metabolism.
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Affiliation(s)
- Matthew J Fogarty
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Louis L Losbanos
- Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Theodore A Craig
- Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Carmen J Reynolds
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Alyssa D Brown
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Rajiv Kumar
- Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota
| | - Gary C Sieck
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
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14
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Biochemical analysis of serum mineral and vitamin levels in benign essential blepharospasm. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.924395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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15
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da Silva AB, do Carmo TS, Souza AP, Silva MR, Fernandes MS, Souza VO, Barros WM. The role of serum levels of vitamin D in children's muscle strength: A systematic review. Clinics (Sao Paulo) 2021; 76:e3200. [PMID: 34550211 PMCID: PMC8420842 DOI: 10.6061/clinics/2021/e3200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
This review aims to investigate the different levels of vitamin D and its role in muscle strength in healthy children and non-athletes. A search conducted in three databases (PubMed, Scopus, and Psycinfo) resulted in 655 articles, which were systematically analyzed and selected based on the following criteria: (a) original cross-sectional studies and clinical trials; (b) healthy children aged 5-11 years; (c) no language restriction or year of publication; and (d) studies that assessed the possible relationship between vitamin D levels and muscle strength. Six studies were included because they met all the inclusion criteria. According to the findings of this review, factors such as sex, skin color, and vitamin D supplementation early in life modulate the levels of vitamin D in the body, and there is a relationship between muscle strength and vitamin D levels. Interestingly, vitamin D supplementation is not always significantly associated with increased muscle grip strength. However, there is a scarcity of studies that aim to analyze the possible effects of different levels of vitamin D on muscle function and neuromuscular variables in physically inactive children and non-athletes without previously diagnosed disease. Further studies are warranted in the future to address the gap in the literature.
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Affiliation(s)
- Ana B.J. da Silva
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Universitario Facol / Centro Integrado de Tecnologias em Neurociencia (CITENC), Vitoria de Santo Antao, PE, BR
- Corresponding author. E-mail:
| | - Taciane S. do Carmo
- Centro Universitario Facol / Centro Integrado de Tecnologias em Neurociencia (CITENC), Vitoria de Santo Antao, PE, BR
| | - Ana P.S. Souza
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Universitario Facol / Centro Integrado de Tecnologias em Neurociencia (CITENC), Vitoria de Santo Antao, PE, BR
| | - Mariluce R.M. Silva
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Universitario Facol / Centro Integrado de Tecnologias em Neurociencia (CITENC), Vitoria de Santo Antao, PE, BR
| | - Matheus S.S. Fernandes
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Universidade Federal de Pernambuco, Recife, PE, BR
| | - Viviane O.N. Souza
- Universidade Federal de Pernambuco, Centro Academico Vitoria, Vitoria de Santo Antao, PE, BR
| | - Waleska M.A. Barros
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Universitario Facol / Centro Integrado de Tecnologias em Neurociencia (CITENC), Vitoria de Santo Antao, PE, BR
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16
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Jerkovich F, Nuñez S, Mocarbel Y, Pignatta A, Elías N, Cassinelli H, Díaz AG, Vigovich C, Balonga MC, Cohen AC, Mumbach G, Gonzalez S, Zanchetta JR, Zanchetta MB. Burden of Disease in Patients With Tumor-Induced Osteomalacia. JBMR Plus 2020; 5:e10436. [PMID: 33615105 PMCID: PMC7872334 DOI: 10.1002/jbm4.10436] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022] Open
Abstract
Tumor‐induced osteomalacia (TIO) is a chronic condition associated with muscle weakness and long‐term disability. We conducted a cross‐sectional study of patients diagnosed with TIO who had been referred to our institution between May 2018 and December 2019. Our aim was to assess health‐related quality of life (HRQoL), fatigue, pain, and muscle mass and strength in these patients. Detailed information was obtained regarding general characteristics, initial symptoms and biochemical parameters measured at diagnosis and on the first visit to our institution. Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy‐Fatigue (FACIT‐Fatigue) scale, pain using the Brief Pain Inventory–Short Form (BPI‐sf) scale and HRQoL by the 36‐item Short Form survey (SF‐36) questionnaire. Eight patients were included in the study: three without tumor localization, four with nonremission after surgery, and one with clinical recurrence 2 years after surgery. Fatigue experienced by patients with TIO was significantly higher compared to the general population (p ˂ .0001). The physical summary measure of the SF‐36 showed significantly lower values than those of the Argentinean population with chronic conditions (mean 20.4 versus 45.9, p < .0001). According to the BPI‐sf, patients with TIO have moderate average pain and the pain interferes severely with walking, general activities, work, and mood. Seven patients had a diagnosis of sarcopenia, four of which had severe sarcopenia. To our best knowledge, this is the first study aimed to quantify fatigue, pain, HRQoL, and muscle mass and strength in a group of patients with TIO. We hope our results contribute to a better understanding of the burden of disease and to establish a basis for future studies—with larger samples—which will make it possible to assess the efficacy of therapeutic interventions for these conditions. © 2020 American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Fernando Jerkovich
- Instituto Diagnóstico e Investigaciones Metabólicas, Universidad del Salvador Buenos Aires Argentina.,División Endocrinología, Hospital de Clínicas Universidad de Buenos Aires Buenos Aires Argentina
| | - Selva Nuñez
- Instituto Diagnóstico e Investigaciones Metabólicas, Universidad del Salvador Buenos Aires Argentina
| | - Yamile Mocarbel
- División Endocrinología, Hospital de Clínicas Universidad de Buenos Aires Buenos Aires Argentina
| | - Analía Pignatta
- Servicio de Endocrinología Hospital Interzonal San Juan Bautista San Fernando del Valle de Catamarca Argentina
| | - Natalia Elías
- Servicio de Endocrinología, Metabolismo, Nutrición y Diabetes Hospital Británico de Buenos Aires Buenos Aires Argentina
| | - Hamilton Cassinelli
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE) Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Fundación de Endocrinología Infantil (FEI) - División de Endocrinología Hospital de Niños Ricardo Gutiérrez Buenos Aires Argentina
| | - Adriana Graciela Díaz
- División Endocrinología, Hospital de Clínicas Universidad de Buenos Aires Buenos Aires Argentina
| | | | - María Celeste Balonga
- Instituto Diagnóstico e Investigaciones Metabólicas, Universidad del Salvador Buenos Aires Argentina
| | | | | | | | - José Rubén Zanchetta
- Instituto Diagnóstico e Investigaciones Metabólicas, Universidad del Salvador Buenos Aires Argentina
| | - María Belén Zanchetta
- Instituto Diagnóstico e Investigaciones Metabólicas, Universidad del Salvador Buenos Aires Argentina
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17
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Mason RS, Rybchyn MS, Brennan-Speranza TC, Fraser DR. Is it reasonable to ignore vitamin D status for musculoskeletal health? Fac Rev 2020; 9:19. [PMID: 33659951 PMCID: PMC7886074 DOI: 10.12703/r/9-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Severe vitamin D deficiency—25-hydroxyvitamin D (25OHD) concentrations below around 25–30 nmol/L—may lead to growth plate disorganization and mineralization abnormalities in children (rickets) and mineralization defects throughout the skeleton (osteomalacia) and proximal muscle weakness. Both problems are reversed with vitamin D treatment. Apart from this musculoskeletal dysfunction at very low vitamin D levels, there is apparent inconsistency in the available data about whether concentrations of 25OHD below around 50 nmol/L cause muscle function impairment and increase the risk of fracture. This narrative review provides evidence to support the contention that improving vitamin D status, up to around 50 nmol/L, plays a small causal role in optimizing bone and muscle function as well as reducing overall mortality.
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Affiliation(s)
- Rebecca S Mason
- Physiology, Bosch Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Mark S Rybchyn
- Physiology, Bosch Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Tara C Brennan-Speranza
- Physiology, Bosch Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - David R Fraser
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW 2006, Australia
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18
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Cheng L, Cai Z, Zhao J, Wang F, Lu M, Deng L, Cui W. Black phosphorus-based 2D materials for bone therapy. Bioact Mater 2020; 5:1026-1043. [PMID: 32695934 PMCID: PMC7355388 DOI: 10.1016/j.bioactmat.2020.06.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/22/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023] Open
Abstract
Since their discovery, Black Phosphorus (BP)-based nanomaterials have received extensive attentions in the fields of electromechanics, optics and biomedicine, due to their remarkable properties and excellent biocompatibility. The most essential feature of BP is that it is composed of a single phosphorus element, which has a high degree of homology with the inorganic components of natural bone, therefore it has a full advantage in the treatment of bone defects. This review will first introduce the source, physicochemical properties, and degradation products of BP, then introduce the remodeling process of bone, and comprehensively summarize the progress of BP-based materials for bone therapy in the form of hydrogels, polymer membranes, microspheres, and three-dimensional (3D) printed scaffolds. Finally, we discuss the challenges and prospects of BP-based implant materials in bone immune regulation and outlook the future clinical application.
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Affiliation(s)
- Liang Cheng
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Zhengwei Cai
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
- Jiaxing Key Laboratory of Basic Research and Clinical Translation on Orthopedic Biomaterials, Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University, 1518 North Huancheng Road, Jiaxing 314000, PR China
| | - Jingwen Zhao
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Fei Wang
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Min Lu
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Lianfu Deng
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Wenguo Cui
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
- Jiaxing Key Laboratory of Basic Research and Clinical Translation on Orthopedic Biomaterials, Department of Orthopaedics, The Second Affiliated Hospital of Jiaxing University, 1518 North Huancheng Road, Jiaxing 314000, PR China
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19
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Ribbans WJ, Aujla R, Dalton S, Nunley JA. Vitamin D and the athlete-patient: state of the art. J ISAKOS 2020; 6:46-60. [PMID: 33833045 DOI: 10.1136/jisakos-2020-000435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/20/2020] [Accepted: 07/28/2020] [Indexed: 11/04/2022]
Abstract
Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of 'bioavailable' vitamin to the cells. Vitamin D should be regarded as a hormone and influences between 5% and 10% of our total genome. Determining the precise effect of the vitamin, isolated from the actions of other cofactors, is not straightforward and restricts our complete understanding of all of its actions. Deficiency has harmful effects on not only bone and muscle but also wider areas, including immunity and respiratory and neurological activities. More caution should be applied regarding the ability of supranormal vitamin D levels to elevate athletic performance. Hopefully, future research will shed more light on optimal levels of vitamin D and supplementation regimes, and improved understanding of its intracellular control of our genetic mechanisms and how extrinsic influences modify its activity.
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Affiliation(s)
- William J Ribbans
- Faculty of Health, Education and Society, University of Northampton, Northampton, Northamptonshire, UK
| | - Randeep Aujla
- Perth Orthopaedic and Sports Medicine Centre, West Perth, Western Australia, Australia
| | - Seamus Dalton
- North Sydney Sports Medicine, Sydney, New South Wales, Australia
| | - James A Nunley
- Duke Orthopedics, Duke University, Durham, North Carolina, USA
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20
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Bewegungsstörungen bei chronischen Erkrankungen. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Yang A, Lv Q, Chen F, Wang Y, Liu Y, Shi W, Liu Y, Wang D. The effect of vitamin D on sarcopenia depends on the level of physical activity in older adults. J Cachexia Sarcopenia Muscle 2020; 11:678-689. [PMID: 32020783 PMCID: PMC7296263 DOI: 10.1002/jcsm.12545] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 12/09/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Sarcopenia in older adults is closely related to vitamin D deficiency and reduced levels of physical activity, but little has been reported on the interaction between physical activity and the positive effects of vitamin D. The purpose of this study was to explore the interactive effect of vitamin D and physical activity on muscle mass and function through animal experiments and population surveys. METHODS Male 4-week-old C57BL/6J mice were fed different purified diets: a vitamin D-deficient diet (with increased calcium and phosphorus to prevent the effects of abnormal mineral levels on muscle) or a 1,25-dihydroxyvitamin D3 (1,25D)-supplemented diet. After 24 weeks on the assigned diets, the mice were immobilized. The level of skeletal muscle atrophy in the mice was determined by grip strength, gastrocnemius (GA) muscle mass and muscle fiber cross-sectional area (CSA); additionally, the protein expression levels of FOXO3a and the E3 ubiquitin ligases MuRF1 and MAFbx were detected. A cross-sectional study included data from 4139 older adults (64.9% women, 67.9 ± 6.7 years) as part of a survey in Shenyang, Northeast China. The associations of serum 25(OH)D3 and physical activity with timed up and go test (TUG) performance, handgrip strength, calf circumference, and body muscle mass were assessed by a linear regression analysis that was adjusted for covariates. RESULTS In activity-limited mice, vitamin D deficiency accelerated the decrease in GA muscle weight, muscle fiber CSA, and grip strength and increased the protein expression of MuRF1, MAFbx, and FOXO3a (all P < 0.05). In addition, 1,25D supplementation may inhibit the grip-strength reduction induced by limited activity (P = 0.069). Serum 25(OH)D3 and physical activity were linearly related to TUG time (P < 0.001) and handgrip strength (P < 0.05) after adjustment for sex, age, body mass index (BMI), education level, smoking status, and serum calcium level. Serum 25(OH)D3 and physical activity had interactive effects on TUG (P < 0.001) and handgrip strength (P < 0.05) but not calf circumference or body muscle mass in older adults. CONCLUSIONS The effect of vitamin D on muscle strength and physical performance depends on physical activity level in the elderly. It is recommended that older adults strive to avoid both physical inactivity and vitamin D deficiency. Because physical inactivity and vitamin D deficiency may exacerbate muscle atrophy, the biological mechanism may involve synergistic effects of vitamin D and physical activity on the promotion of muscle protein ubiquitination and degradation.
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Affiliation(s)
- Aolin Yang
- Nutrition Department, The First Hospital of China Medical University, Shenyang, China
| | - Qingqing Lv
- Nutrition Department, The First Hospital of China Medical University, Shenyang, China
| | - Feng Chen
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, China
| | - Yingfang Wang
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, China
| | - Yixuan Liu
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, China
| | - Wanying Shi
- Nutrition Department, The First Hospital of China Medical University, Shenyang, China
| | - Ying Liu
- Department of Biochemistry and Molecular Biology, China Medical University, Shenyang, China
| | - Difei Wang
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, China
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22
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Serefoglu Cabuk K, Tunc U, Ozturk Karabulut G, Fazil K, Karaagac Gunaydin Z, Asik Nacaroglu S, Taskapili M. Serum calcium, magnesium, phosphorus, and vitamin D in benign essential blepharospasm. Graefes Arch Clin Exp Ophthalmol 2020; 258:1293-1297. [PMID: 32236706 DOI: 10.1007/s00417-020-04650-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/03/2020] [Accepted: 03/13/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study aims to compare serum calcium, magnesium, phosphorus, and 25-hydroxy (OH)-vitamin D levels in patients with benign essential blepharospasm (BEB) and healthy subjects and to determine their association with disease severity and frequency. METHODS This is a prospective study conducted in a tertiary care hospital. Fifty patients (female, 39; male, 11) with BEB and 22 healthy subjects (female, 15; male, 7) included in the study. Serum calcium, magnesium, phosphorus, and vitamin D levels of BEB and healthy groups were measured. Blepharospasm severity and frequency were assessed using scales ranging from 0 to 4 by following the Jankovic Rating Scale (JRS). RESULTS Though there was no significant difference regarding magnesium, phosphorus, and 25(OH)-vitamin D levels between the two groups, serum calcium levels of the BEB group were significantly lower than the control group (9.5 ± 0.4 and 9.9 ± 0.4 mg/dl, respectively; P = 0.002), although in the normal range (9-10.5 mg/dl). In the BEB group, the mean Jankovic severity and frequency scores were 3.29 ± 0.54 and 3.59 ± 0.61, respectively. There was a moderate negative correlation between serum 25(OH)-vitamin D levels and Jankovic severity score (r = - 0.332; P = 0.022). CONCLUSION Serum calcium levels of the BEB group were significantly lower than the healthy group. Serum vitamin D levels showed a moderate negative correlation with disease severity. The role of calcium and vitamin D in the evolution of the BEB need further investigation at the cellular and anatomical levels.
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Affiliation(s)
- Kubra Serefoglu Cabuk
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey.
| | - Ugur Tunc
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
| | - Gamze Ozturk Karabulut
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
| | - Korhan Fazil
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
| | - Zehra Karaagac Gunaydin
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
| | - Senay Asik Nacaroglu
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
| | - Muhittin Taskapili
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mahallesi, Bereketzade Camii Sokak, NO:2, Pbx: 34420 Beyoğlu, Istanbul, Turkey
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23
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Chande S, Caballero D, Ho BB, Fetene J, Serna J, Pesta D, Nasiri A, Jurczak M, Chavkin NW, Hernando N, Giachelli CM, Wagner CA, Zeiss C, Shulman GI, Bergwitz C. Slc20a1/Pit1 and Slc20a2/Pit2 are essential for normal skeletal myofiber function and survival. Sci Rep 2020; 10:3069. [PMID: 32080237 PMCID: PMC7033257 DOI: 10.1038/s41598-020-59430-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 01/29/2020] [Indexed: 01/25/2023] Open
Abstract
Low blood phosphate (Pi) reduces muscle function in hypophosphatemic disorders. Which Pi transporters are required and whether hormonal changes due to hypophosphatemia contribute to muscle function is unknown. To address these questions we generated a series of conditional knockout mice lacking one or both house-keeping Pi transporters Pit1 and Pit2 in skeletal muscle (sm), using the postnatally expressed human skeletal actin-cre. Simultaneous conditional deletion of both transporters caused skeletal muscle atrophy, resulting in death by postnatal day P13. smPit1-/-, smPit2-/- and three allele mutants are fertile and have normal body weights, suggesting a high degree of redundance for the two transporters in skeletal muscle. However, these mice show a gene-dose dependent reduction in running activity also seen in another hypophosphatemic model (Hyp mice). In contrast to Hyp mice, grip strength is preserved. Further evaluation of the mechanism shows reduced ERK1/2 activation and stimulation of AMP kinase in skeletal muscle from smPit1-/-; smPit2-/- mice consistent with energy-stress. Similarly, C2C12 myoblasts show a reduced oxygen consumption rate mediated by Pi transport-dependent and ERK1/2-dependent metabolic Pi sensing pathways. In conclusion, we here show that Pit1 and Pit2 are essential for normal myofiber function and survival, insights which may improve management of hypophosphatemic myopathy.
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Affiliation(s)
- Sampada Chande
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Daniel Caballero
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Bryan B Ho
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Jonathan Fetene
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Juan Serna
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Dominik Pesta
- Department of Cellular&Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
- German Diabetes Center, Düsseldorf, Germany, University of Washington, Box 355061, Foege Hall Seattle, WA, 98195, USA
| | - Ali Nasiri
- Department of Cellular&Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
| | - Michael Jurczak
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, University of Washington, Box 355061, Foege Hall Seattle, WA, 98195, USA
| | - Nicholas W Chavkin
- Department of Bioengineering, University of Washington, Box 355061, Foege Hall Seattle, WA, 98195, USA
| | - Nati Hernando
- Institute of Physiology, University of Zürich, Switzerland and National Center of Competence in Research NCCR Kidney.CH, Zürich, Switzerland
| | - Cecilia M Giachelli
- Department of Bioengineering, University of Washington, Box 355061, Foege Hall Seattle, WA, 98195, USA
| | - Carsten A Wagner
- Institute of Physiology, University of Zürich, Switzerland and National Center of Competence in Research NCCR Kidney.CH, Zürich, Switzerland
| | - Caroline Zeiss
- Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Gerald I Shulman
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
- Department of Cellular&Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
| | - Clemens Bergwitz
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
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24
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Abiri B, Vafa M. The Role of Nutrition in Attenuating Age-Related Skeletal Muscle Atrophy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:297-318. [PMID: 32304039 DOI: 10.1007/978-3-030-42667-5_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The elderly population is increasing rapidly worldwide, and we are faced with the significant challenge for maintaining or improving physical activity, independence, and quality of life. Sarcopenia, the age-related decline of skeletal muscle mass, is characterized by loss of muscle quantity and quality resulting to a gradual slowing of movement, a decrease in strength and power, elevated risk of fall-related injury, and often frailty. Supplemental, hormonal, and pharmacological approaches have been attempted to attenuate sarcopenia but these have not achieved outstanding results. In this review, we summarize the current knowledge of nutrition-based therapies for counteracting sarcopenia.
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Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. .,Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
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25
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Abstract
Sarcopenia, the age-dependent decline of muscle mass and performance, is a common condition among elderly population and is related to numerous adverse health outcomes. Due to the effect of sarcopenia on quality of life, disability, and mortality, a greater awareness is important in order to correctly recognize the condition both in community and geriatric settings. Research on sarcopenia prevention and treatment is growing quickly, but many questions are still unanswered. The core of the sarcopenia state includes quantitative and qualitative declines of skeletal muscle. These two aspects should therefore be considered when designing and examining preventive and therapeutic interventions. The role of vitamin D in skeletal muscle metabolism has been highlighted in recent years. The interest arises from the important findings of studies indicating multiple impacts of vitamin D on this tissue, which can be divided into genomic (direct impacts) and non-genomic impacts (indirect impacts). Another important dimension to be considered in the study of vitamin D and muscle fiber metabolism is associated with different expressions of the vitamin D receptor, which differs in muscle tissue, depending on age, gender, and pathology. Vitamin D inadequacy or deficiency is related to muscle fiber atrophy, elevated risk of chronic musculoskeletal pain, sarcopenia, and falls. This review describes the effect of vitamin D in skeletal muscle tissue function and metabolism and includes discussion of possible mechanisms in skeletal muscle.
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26
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Girgis CM. Vitamin D and Skeletal Muscle: Emerging Roles in Development, Anabolism and Repair. Calcif Tissue Int 2020; 106:47-57. [PMID: 31312865 DOI: 10.1007/s00223-019-00583-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/29/2019] [Indexed: 12/17/2022]
Abstract
This special issue article will focus on morphologic and functional roles of vitamin D in muscle, from strength to contraction to development and ageing and will characterise the controversy of VDR's expression in skeletal muscle, central to our understanding of vitamin D's effects on this tissue.
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Affiliation(s)
- Christian M Girgis
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, Australia.
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, NSW, Australia.
- University of Sydney, Sydney, NSW, Australia.
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27
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Girgis CM, Cha KM, So B, Tsang M, Chen J, Houweling PJ, Schindeler A, Stokes R, Swarbrick MM, Evesson FJ, Cooper ST, Gunton JE. Mice with myocyte deletion of vitamin D receptor have sarcopenia and impaired muscle function. J Cachexia Sarcopenia Muscle 2019; 10:1228-1240. [PMID: 31225722 PMCID: PMC6903451 DOI: 10.1002/jcsm.12460] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It has long been recognized that vitamin D deficiency is associated with muscle weakness and falls. Vitamin D receptor (VDR) is present at very low levels in normal muscle. Whether vitamin D plays a direct role in muscle function is unknown and is a subject of hot debate. Myocyte-specific deletion of VDR would provide a strategy to answer this question. METHODS Myocyte-specific vitamin D receptor (mVDR) null mice were generated by crossing human skeletal actin-Cre mice with floxed VDR mice. The effects of gene deletion on the muscle phenotype were studied in terms of body tissue composition, muscle tissue histology, and gene expression by real-time PCR. RESULTS Unlike whole-body VDR knockout mice, mVDR mice showed a normal body size. The mVDR showed a distinct muscle phenotype featuring reduced proportional lean mass (70% vs. 78% of lean mass), reduced voluntary wheel-running distance (22% decrease, P = 0.009), reduced average running speed, and reduced grip strength (7-16% reduction depending on age at testing). With their decreased voluntary exercise, and decreased lean mass, mVDR have increased proportional fat mass at 20% compared with 13%. Surprisingly, their muscle fibres showed slightly increased diameter, as well as the presence of angular fibres and central nuclei suggesting ongoing remodelling. There were, however, no clear changes in fibre type and there was no increase in muscle fibrosis. VDR is a transcriptional regulator, and changes in the expression of candidate genes was examined in RNA extracted from skeletal muscle. Alterations were seen in myogenic gene expression, and there was decreased expression of cell cycle genes cyclin D1, D2, and D3 and cyclin-dependent kinases Cdk-2 and Cdk-4. Expression of calcium handling genes sarcoplasmic/endoplasmic reticulum calcium ATPases (SERCA) Serca2b and Serca3 was decreased and Calbindin mRNA was lower in mVDR muscle. CONCLUSIONS This study demonstrates that vitamin D signalling is needed for myocyte function. Despite the low level of VDR protein normally found muscle, deleting myocyte VDR had important effects on muscle size and strength. Maintenance of normal vitamin D signalling is a useful strategy to prevent loss of muscle function and size.
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Affiliation(s)
- Christian M Girgis
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Department of Diabetes and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Kuan Minn Cha
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin So
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Tsang
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer Chen
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter J Houweling
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Aaron Schindeler
- Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,Orthopaedic Research and Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Westmead, Australia
| | - Rebecca Stokes
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael M Swarbrick
- Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Frances J Evesson
- Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,Kids Neuroscience Centre, The Children's Hospital at Westmead, The Discipline of Child and Adolescent Health, Children's Medical Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Sandra T Cooper
- Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,Kids Neuroscience Centre, The Children's Hospital at Westmead, The Discipline of Child and Adolescent Health, Children's Medical Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Jenny E Gunton
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Division of Immunology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
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28
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Verde Z, Giaquinta A, Moreno Sainz C, Díaz Ondina M, Fernández Araque A. Bone Mineral Metabolism Status, Quality of Life, and Muscle Strength in Older People. Nutrients 2019; 11:E2748. [PMID: 31726780 PMCID: PMC6893588 DOI: 10.3390/nu11112748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 02/07/2023] Open
Abstract
As the relationship between vitamin D and various diseases or health conditions has become known, interest in the contribution of vitamin D to overall health-related quality of life (QoL) has increased. We examined the relationship between vitamin D status and QoL in 273 participants aged 65 years and older. Serum levels of total calcium, phosphorus, intact parathyroid hormone, albumin, and 25-hydroxyvitaminD3 were analyzed. We also recruited data for QoL, physical activity, nutritional impairment, and muscular strength. Ninety percent of the subjects were classified as vitamin D deficient or insufficient. Participants with higher serum 25(OH)D3, calcium, phosphorous, and Alb levels were significantly less likely to self-report depression or anxiety after adjustment (p = 0.009, p = 0.005, p = 0.003, and p = 0.005, respectively). Additionally, we found an association between lower levels of albumin and self-reported problems with mobility or usual activities (p = 0.01). We also found associations between better muscle strength and higher levels of vitamin D, calcium, phosphorous, and albumin (p = 0.006, p = 0.003, p = 0.004 and p = 0.002, respectively). Overall, our data provide evidence that serum vitamin D and Alb levels are negatively related to self-reported anxiety or depression, usual activities, mobility, and three dimensions of QoL in older adults. Furthermore, vitamin D levels are positively related to hand grip strength in adults over 65 years old.
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Affiliation(s)
- Zoraida Verde
- Department of Biochemistry, Molecular Biology and Physiology, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain
| | - Andrea Giaquinta
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain; (A.G.); (A.F.A.)
| | - Carmelo Moreno Sainz
- Department of Clinic Biochemistry, Hospital Santa Bárbara, 42002 Soria, Spain; (C.M.S.); (M.D.O.)
| | - Marta Díaz Ondina
- Department of Clinic Biochemistry, Hospital Santa Bárbara, 42002 Soria, Spain; (C.M.S.); (M.D.O.)
| | - Ana Fernández Araque
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain; (A.G.); (A.F.A.)
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29
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Bezrati I, Ben Fradj MK, Hammami R, Ouerghi N, Padulo J, Feki M. A single mega dose of vitamin D 3 improves selected physical variables in vitamin D-deficient young amateur soccer players: a randomized controlled trial. Appl Physiol Nutr Metab 2019; 45:478-485. [PMID: 31597046 DOI: 10.1139/apnm-2019-0525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This randomized controlled trial aimed to test whether vitamin D (VD) supplementation affects measures of physical performance in VD-deficient, mildly trained children. Thirty-six recreationally soccer player boys were randomly assigned to single dose (200 000 IU) of VD3 (n = 19) or placebo (n = 17). Plasma 25-hydroxyvitamin D (25-OHD) was assessed and measures of physical performance (i.e., vertical and standing broad jumps, triple hop, 10-m and 30-m sprints, shuttle run) were performed before and 12 weeks after the loading dose. Mixed ANCOVA models were performed and effect size was estimated by partial eta squared (ηp2). Baseline 25-OHD and physical variables were equivalent in the 2 groups. Twelve weeks after VD loading, plasma 25-OHD increased and physical variables improved only in the VD group. There was a significant interaction effects for group by time for vertical jump (F = 14.9, p = 0.001, ηp2 = 0.394), triple hop jump (F = 24.2, p < 0.001, ηp2 = 0.513), 10-m (F = 4.46, p = 0.046, ηp2 = 0.162) and 30-m (F = 6.56, p = 0.017, ηp2 = 0.222) sprints, and shuttle run (F = 13.4, p = 0.001, ηp2 = 0.369). In conclusion, a single bolus of VD3 resulted in significant improvements in jumping ability, agility, and running speed in mildly trained children that are deficient in VD. The findings suggest that correcting VD deficit might be beneficial for physical performance. Novelty A mega dose of VD3 improves jumping ability, agility, and running speed in VD-deficient, mildly trained children. Effect of VD on measures of physical performance is noticeable 3 months after the loading dose.
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Affiliation(s)
- Ikram Bezrati
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES11, Rabta Hospital, Laboratory of Biochemistry, 1007 Tunis, Tunisia.,National Center of Medicine and Sciences in Sports, Tunisian Research Laboratory "Sport Performance Optimization", 2010 Tunis, Tunisia
| | - Mohamed Kacem Ben Fradj
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES11, Rabta Hospital, Laboratory of Biochemistry, 1007 Tunis, Tunisia
| | - Raouf Hammami
- National Center of Medicine and Sciences in Sports, Tunisian Research Laboratory "Sport Performance Optimization", 2010 Tunis, Tunisia
| | - Nejmeddine Ouerghi
- University of Jendouba, High Institute of Sports and Physical Education of Kef, Research Unit Sportive Performance and Physical Rehabilitation, Kef, Tunisia
| | - Johnny Padulo
- Università degli Studi di Milano, Department of Biomedical Sciences for Health, Milan, Italy
| | - Moncef Feki
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES11, Rabta Hospital, Laboratory of Biochemistry, 1007 Tunis, Tunisia
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30
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Conzade R, Grill E, Bischoff-Ferrari HA, Ferrari U, Horsch A, Koenig W, Peters A, Thorand B. Vitamin D in Relation to Incident Sarcopenia and Changes in Muscle Parameters Among Older Adults: The KORA-Age Study. Calcif Tissue Int 2019; 105:173-182. [PMID: 31069442 DOI: 10.1007/s00223-019-00558-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/25/2019] [Indexed: 01/06/2023]
Abstract
Effects of low serum 25OHD on age-related changes in muscle mass and function remain unclear. Our aims were to explore associations of baseline 25OHD levels with prevalent and incident sarcopenia and changes in muscle parameters, and to examine the role of parathyroid hormone (PTH) therein. Cross-sectional (n = 975) and prospective analyses (n = 702) of older adults aged 65-93 years participating in the KORA-Age study. Sarcopenia was defined using the 2010 European Working Group on Sarcopenia in Older People (EWGSOP) criteria as low muscle mass combined with low grip strength or low physical performance. Associations with baseline 25OHD were examined in multiple regression analyses. Low vitamin D status was linked to increased odds of prevalent sarcopenia. Over three years, low baseline 25OHD < 25 vs. ≥ 50 nmol/L were associated with greater loss of muscle mass and increased time for the Timed Up and Go test. The risk for developing incident sarcopenia was not significantly elevated in individuals with low baseline 25OHD but when including death as combined outcome alongside incident sarcopenia, there was a strong positive association in multivariable analysis [OR (95% CI) 3.19 (1.54-6.57) for 25OHD < 25 vs. ≥ 50 nmol/L]. There was no evidence for a PTH-mediating effect. Low baseline 25OHD levels were associated with unfavorable changes in muscle mass and physical performance, but not with incident sarcopenia. Future randomized trials are needed to assess causality and to address the issue of competing risks such as mortality in older cohorts.
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Affiliation(s)
- Romy Conzade
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig Maximilian University of Munich, 81377, Munich, Germany
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University of Zurich and University Hospital Zurich, 8091, Zurich, Switzerland
| | - Uta Ferrari
- Department of Medicine IV, University Hospital, Ludwig Maximilian University of Munich, 80336, Munich, Germany
| | - Alexander Horsch
- Department of Computer Science, UiT - The Arctic University of Norway, 9037, Tromsø, Norway
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, 80636, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80802, Munich, Germany
- Institute of Epidemiology and Biostatistics, University of Ulm, 89081, Ulm, Germany
| | - Annette Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany
| | - Barbara Thorand
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany.
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31
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Hangelbroek RWJ, Vaes AMM, Boekschoten MV, Verdijk LB, Hooiveld GJEJ, van Loon LJC, de Groot LCPGM, Kersten S. No effect of 25-hydroxyvitamin D supplementation on the skeletal muscle transcriptome in vitamin D deficient frail older adults. BMC Geriatr 2019; 19:151. [PMID: 31138136 PMCID: PMC6540468 DOI: 10.1186/s12877-019-1156-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/10/2019] [Indexed: 12/19/2022] Open
Abstract
Objective Vitamin D deficiency is common among older adults and has been linked to muscle weakness. Vitamin D supplementation has been proposed as a strategy to improve muscle function in older adults. The aim of this study was to investigate the effect of calcifediol (25-hydroxycholecalciferol) on whole genome gene expression in skeletal muscle of vitamin D deficient frail older adults. Methods A double-blind placebo-controlled trial was conducted in vitamin D deficient frail older adults (aged above 65), characterized by blood 25-hydroxycholecalciferol concentrations between 20 and 50 nmol/L. Subjects were randomized across the placebo group and the calcifediol group (10 μg per day). Muscle biopsies were obtained before and after 6 months of calcifediol (n = 10) or placebo (n = 12) supplementation and subjected to whole genome gene expression profiling using Affymetrix HuGene 2.1ST arrays. Results Expression of the vitamin D receptor gene was virtually undetectable in human skeletal muscle biopsies, with Ct values exceeding 30. Blood 25-hydroxycholecalciferol levels were significantly higher after calcifediol supplementation (87.3 ± 20.6 nmol/L) than after placebo (43.8 ± 14.1 nmol/L). No significant difference between treatment groups was observed on strength outcomes. The whole transcriptome effects of calcifediol and placebo were very weak, as indicated by the fact that correcting for multiple testing using false discovery rate did not yield any differentially expressed genes using any reasonable cut-offs (all q-values ~ 1). P-values were uniformly distributed across all genes, suggesting that low p-values are likely to be false positives. Partial least squares-discriminant analysis and principle component analysis was unable to separate treatment groups. Conclusion Calcifediol supplementation did not significantly affect the skeletal muscle transcriptome in frail older adults. Our findings indicate that vitamin D supplementation has no effects on skeletal muscle gene expression, suggesting that skeletal muscle may not be a direct target of vitamin D in older adults. Trial registration This study was registered at clinicaltrials.gov as NCT02349282 on January 28, 2015.
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Affiliation(s)
- Roland W J Hangelbroek
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands
| | - Anouk M M Vaes
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands
| | - Mark V Boekschoten
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands
| | - Lex B Verdijk
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Guido J E J Hooiveld
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands
| | - Luc J C van Loon
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Lisette C P G M de Groot
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands
| | - Sander Kersten
- Top Institute Food and Nutrition, P.O. Box 557, 6700, AN, Wageningen, The Netherlands. .,Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708, WE, Wageningen, The Netherlands.
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Beck-Nielsen SS, Mughal Z, Haffner D, Nilsson O, Levtchenko E, Ariceta G, de Lucas Collantes C, Schnabel D, Jandhyala R, Mäkitie O. FGF23 and its role in X-linked hypophosphatemia-related morbidity. Orphanet J Rare Dis 2019; 14:58. [PMID: 30808384 PMCID: PMC6390548 DOI: 10.1186/s13023-019-1014-8] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/30/2019] [Indexed: 12/29/2022] Open
Abstract
Background X-linked hypophosphatemia (XLH) is an inherited disease of phosphate metabolism in which inactivating mutations of the Phosphate Regulating Endopeptidase Homolog, X-Linked (PHEX) gene lead to local and systemic effects including impaired growth, rickets, osteomalacia, bone abnormalities, bone pain, spontaneous dental abscesses, hearing difficulties, enthesopathy, osteoarthritis, and muscular dysfunction. Patients with XLH present with elevated levels of fibroblast growth factor 23 (FGF23), which is thought to mediate many of the aforementioned manifestations of the disease. Elevated FGF23 has also been observed in many other diseases of hypophosphatemia, and a range of animal models have been developed to study these diseases, yet the role of FGF23 in the pathophysiology of XLH is incompletely understood. Methods The role of FGF23 in the pathophysiology of XLH is here reviewed by describing what is known about phenotypes associated with various PHEX mutations, animal models of XLH, and non-nutritional diseases of hypophosphatemia, and by presenting molecular pathways that have been proposed to contribute to manifestations of XLH. Results The pathophysiology of XLH is complex, involving a range of molecular pathways that variously contribute to different manifestations of the disease. Hypophosphatemia due to elevated FGF23 is the most obvious contributor, however localised fluctuations in tissue non-specific alkaline phosphatase (TNAP), pyrophosphate, calcitriol and direct effects of FGF23 have been observed to be associated with certain manifestations. Conclusions By describing what is known about these pathways, this review highlights key areas for future research that would contribute to the understanding and clinical treatment of non-nutritional diseases of hypophosphatemia, particularly XLH.
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Affiliation(s)
| | - Zulf Mughal
- Royal Manchester Children's Hospital, Manchester, UK
| | | | - Ola Nilsson
- Karolinska Institutet, Stockholm, Sweden and Örebro University, Örebro, Sweden
| | | | - Gema Ariceta
- Hospital Universitario Materno-Infantil Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Dirk Schnabel
- University Children's Hospital of Berlin, Berlin, Germany
| | | | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Rubio-Ruiz ME, Guarner-Lans V, Pérez-Torres I, Soto ME. Mechanisms Underlying Metabolic Syndrome-Related Sarcopenia and Possible Therapeutic Measures. Int J Mol Sci 2019; 20:ijms20030647. [PMID: 30717377 PMCID: PMC6387003 DOI: 10.3390/ijms20030647] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/15/2022] Open
Abstract
Although there are several reviews that report the interrelationship between sarcopenia and obesity and insulin resistance, the relation between sarcopenia and the other signs that compose the metabolic syndrome (MetS) has not been extensively revised. Here, we review the mechanisms underlying MetS-related sarcopenia and discuss the possible therapeutic measures proposed. A vicious cycle between the loss of muscle and the accumulation of intramuscular fat might be associated with MetS via a complex interplay of factors including nutritional intake, physical activity, body fat, oxidative stress, proinflammatory cytokines, insulin resistance, hormonal changes, and mitochondrial dysfunction. The enormous differences in lipid storage capacities between the two genders and elevated amounts of endogenous fat having lipotoxic effects that lead to the loss of muscle mass are discussed. The important repercussions of MetS-related sarcopenia on other illnesses that lead to increased disability, morbidity, and mortality are also addressed. Additional research is needed to better understand the pathophysiology of MetS-related sarcopenia and its consequences. Although there is currently no consensus on the treatment, lifestyle changes including diet and power exercise seem to be the best options.
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Affiliation(s)
- María Esther Rubio-Ruiz
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Verónica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Israel Pérez-Torres
- Department of Pathology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - María Elena Soto
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
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Iolascon G, Mauro GL, Fiore P, Cisari C, Benedetti MG, Panella L, De Sire A, Calafiore D, Moretti A, Gimigliano F. Can vitamin D deficiency influence muscle performance in postmenopausal women? A multicenter retrospective study. Eur J Phys Rehabil Med 2018; 54:676-682. [PMID: 28696084 DOI: 10.23736/s1973-9087.17.04533-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The presence of the vitamin D receptor (VDR) has been recently demonstrated in human muscle supporting the theory of a role of vitamin D in the proliferation and differentiation of muscle cells. So far only few studies investigated the association between vitamin D and muscle performance in postmenopausal women. AIM To define the functional impact of vitamin D deficiency. DESIGN Multicenter retrospective study. SETTING Five Italian outpatient services of Physical and Rehabilitation Medicine (PRM). POPULATION Postmenopausal women. METHODS We divided the population in two groups based on the threshold of 30 ng/mL as cut-off to define sufficient and insufficient serum levels of 25-hydroxyvitamin D3 [25(OH)D3]. Outcome measures were: appendicular lean mass (ALM); ALM-to-BMI ratio (ALMBMI); total fat mass (FM); visceral adipose tissue (VAT); Hand Grip Strength (HGS); Knee Isometric Extension Strength (KES); Short Physical Performance Battery (SPPB); 4-meter gait speed (4MGS). RESULTS We analyzed the data records of 401 postmenopausal women (mean age 66.93±8.47 years): 203 with hypovitaminosis D (mean age 66.81±8.11 years) and 198 with normal levels of 25(OH)D3 (mean age 67.04±8.84 years). The analysis showed a significant difference between the two groups in terms of: ALMBMI (0.002), FM (P<0.001), VAT mass (0.010), VAT volume (P=0.006), HGS (P<0.001), KES (P<0.001), SPPB score (P<0.001), percentage of people with a 4MGS≤0.8 m/s (P<0.001). Furthermore, there were significant correlations (P<0.001) between serum levels of 25(OH)D3 and HGS (r=0.323), KES (r=0.510), and SPPB sit to stand (r=-0.362) and walking sub-scores (r=-0.312). CONCLUSIONS This multicenter study demonstrated that postmenopausal women with vitamin D deficiency had a significant reduction of appendicular muscle strength and physical performance. CLINICAL REHABILITATION IMPACT This study reported the frequency of hypovitaminosis D in postmenopausal women and its influence on the reduction of muscle mass, strength, and physical performance in a typical population referring to the physiatrist for musculoskeletal disorders.
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Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy -
| | - Giulia L Mauro
- Department of Surgical, Oncologic and Stomatologic Disciplines, University of Palermo, Palermo, Italy
| | - Pietro Fiore
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Carlo Cisari
- Department of Physical Medicine and Rehabilitation, University Hospital "Maggiore della Carità", Novara, Italy
| | - Maria G Benedetti
- Unit of Physical Medicine and Rehabilitation, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Lorenzo Panella
- Department of Rehabilitation and Functional Recovery, Gaetano Pini Orthopedic Institute, Milan, Italy
| | - Alessandro De Sire
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dario Calafiore
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Kim SW, Hong N, Rhee Y, Choi YC, Shin HY, Kim SM. Clinical and laboratory features of patients with osteomalacia initially presenting with neurological manifestations. Osteoporos Int 2018; 29:1617-1626. [PMID: 29623355 DOI: 10.1007/s00198-018-4501-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED Patients with osteomalacia often visit the neurology department with conditions mimicking other myopathies. We analyzed clinical features of osteomalacia patients who visited the neurology department. These patients frequently presented with hypocalcemia, hypovitaminosis D, and pain with less severe weakness. Osteomalacia should be considered when patients present with pain and weakness. INTRODUCTION Osteomalacia is a disease of bone metabolism; however, some patients with osteomalacia initially visit the neurology department. As these patients often complain of weakness and gait disturbance, osteomalacia can be confused with other myopathies. We analyzed the clinical features of patients with osteomalacia who visited the neurology department. METHODS We retrospectively reviewed the medical records. Osteomalacia was diagnosed based on symptoms, laboratory features, and imaging results. We compared the characteristics of patients with osteomalacia who visited the neurology department with (1) those who did not visit the neurology department and (2) patients with idiopathic inflammatory myopathy. RESULTS Eighteen patients with osteomalacia visited the neurology department (NR group). The common etiologies in the NR group included tumors or antiepileptic medication, whereas antiviral medication was the most common in patients who did not visit the neurology department (non-NR group). The NR group showed lower serum calcium (p = 0.004) and 25-hydroxyvitamin D (p = 0.006) levels than the non-NR group. When compared with patients with inflammatory myopathy, both groups showed proximal dominant weakness. However, pain was more common in osteomalacia than in myopathy (p = 0.008), and patients with osteomalacia showed brisk deep tendon reflex more often (p = 0.017). Serum calcium (p = 0.003) and phosphate (p < 0.001) levels were lower in osteomalacia than in myopathy. CONCLUSIONS It was not uncommon for patients with osteomalacia to visit the neurology department. The clinical presentation of these patients can be more complex owing the superimposed neurological disease and accompanying hypocalcemia. Osteomalacia should be considered when patients present with pain and weakness.
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Affiliation(s)
- S W Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - N Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Y Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Y-C Choi
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - H Y Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - S M Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
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Ahmad N, Mohamed Sobaihi M, Al-Jabri M, Al –Esaei NA, Al Zaydi AM. Acute respiratory failure and generalized hypotonia secondary to vitamin D dependent rickets type 1A. Int J Pediatr Adolesc Med 2018; 5:78-81. [PMID: 30805538 PMCID: PMC6363249 DOI: 10.1016/j.ijpam.2018.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/06/2018] [Accepted: 05/13/2018] [Indexed: 06/09/2023]
Abstract
Vitamin D dependent rickets is a rare autosomal recessive disorder secondary to mutation in 1 α hydroxylase enzyme gene. We are presenting a case of a two-year-old boy with vitamin D dependent rickets type 1A whose diagnosis was missed for a long period and he was treated as nutritional rickets. He suffered with severe hypotonia and regressing milestones. Severe hypotonia with proximal muscle weakness caused respiratory failure which required intensive care admission and mechanical ventilation. DNA analysis revealed previously reported homozygous mutation in CYP27B1 gene (p.Arg429Pro (R429P) at exon c.1286 G > C). Rare genetic disorders of rickets are not considered in early course of disease in regions with high prevalence of vitamin D deficiency. This severe presentation of rickets highlights the need of close monitoring of treatment response and consideration of other differential diagnosis in children who are not responding to vitamin D supplements. There is a high prevalence of genetic disorders particularly autosomal recessive conditions in societies having high rate of inter-family and consanguineous marriages.
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Affiliation(s)
- Noman Ahmad
- Corresponding author. Department of Pediatrics, King Faisal Specialist Hospital and Research Centre Prince Saud Al-Faisal Road, P O Box 40047, Jeddah, 21499; Saudi Arabia
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Exploring the Link between Serum Phosphate Levels and Low Muscle Strength, Dynapenia, and Sarcopenia. Sci Rep 2018; 8:3573. [PMID: 29476104 PMCID: PMC5824959 DOI: 10.1038/s41598-018-21784-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/09/2018] [Indexed: 11/09/2022] Open
Abstract
Emerging evidences addressed an association between phosphate and muscle function. Because little attention was focused on this issue, the objective of our study was to explore the relationship of phosphate with muscle strength, dynapenia, and sarcopenia. From the National Health and Nutrition Examination Survey, a total of 7421 participants aged 20 years or older were included in our study with comprehensive examinations included anthropometric parameters, strength of the quadriceps muscle, and appendicular lean masses. Within the normal range of serum phosphate, we used quartile-based analyses to determine the potential relationships of serum phosphate with dynapenia, and sarcopenia through multivariate regression models. After adjusting for the pertinent variables, an inverse association between the serum phosphate quartiles and muscle strength was observed and the linear association was stronger than other anthropometric parameters. Notably, the significant association between phosphate and muscle strength was existed in >65 years old age group, not in 20-65 years old. The higher quartiles of phosphate had higher likelihood for predicting the presence of dynapenia rather than sarcopenia in entire population. Our study highlighted that higher quartiles of phosphate had significant association with lower muscle strength and higher risks for predicting the presence of dynapenia.
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38
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Vitamin D supplementation restores the blunted muscle protein synthesis response in deficient old rats through an impact on ectopic fat deposition. J Nutr Biochem 2017; 46:30-38. [DOI: 10.1016/j.jnutbio.2017.02.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/23/2017] [Accepted: 02/28/2017] [Indexed: 02/06/2023]
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Gifondorwa DJ, Thompson TD, Wiley J, Culver AE, Shetler PK, Rocha GV, Ma YL, Krishnan V, Bryant HU. Vitamin D and/or calcium deficient diets may differentially affect muscle fiber neuromuscular junction innervation. Muscle Nerve 2016; 54:1120-1132. [PMID: 27074419 DOI: 10.1002/mus.25146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2016] [Indexed: 11/06/2022]
Abstract
INTRODUCTION There is evidence that supports a role for Vitamin D (Vit. D) in muscle. The exact mechanism by which Vit. D deficiency impairs muscle strength and function is not clear. METHODS Three-week-old mice were fed diets with varied combinations of Vit. D and Ca2+ deficiency. Behavioral testing, genomic and protein analysis, and muscle histology were performed with a focus on neuromuscular junction (NMJ) -related genes. RESULTS Vit. D and Ca2+ deficient mice performed more poorly on given behavioral tasks than animals with Vit. D deficiency alone. Genomic and protein analysis of the soleus and tibialis anterior muscles revealed changes in several Vit. D metabolic, NMJ-related, and protein chaperoning and refolding genes. CONCLUSIONS These data suggest that detrimental effects of a Vit. D deficient or a Vit. D and Ca2+ deficient diet may be a result of differential alterations in the structure and function of the NMJ and a lack of a sustained stress response in muscles. Muscle Nerve 54: 1120-1132, 2016.
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Affiliation(s)
- David J Gifondorwa
- Eli Lilly and Company Research Laboratories, Laboratory for Experimental Medicine, Indianapolis, Indiana, USA
| | - Tyran D Thompson
- Eli Lilly and Company Research Laboratories, Cardiovascular Research, Indianapolis, Indiana, USA
| | - June Wiley
- College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Alexander E Culver
- Eli Lilly and Company Research Laboratories, Musculoskeletal Research, Indianapolis, Indiana, USA
| | - Pamela K Shetler
- Eli Lilly and Company Research Laboratories, Musculoskeletal Research, Indianapolis, Indiana, USA
| | - Guilherme V Rocha
- Eli Lilly and Company Research Laboratories, Statistics - Discovery/Development, Indianapolis, Indiana, USA
| | - Yanfei L Ma
- Eli Lilly and Company Research Laboratories, Musculoskeletal Research, Indianapolis, Indiana, USA
| | - Venkatesh Krishnan
- Eli Lilly and Company Research Laboratories, Musculoskeletal Research, Indianapolis, Indiana, USA
| | - Henry U Bryant
- Eli Lilly and Company Research Laboratories, Musculoskeletal Research, Indianapolis, Indiana, USA
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Pesta DH, Tsirigotis DN, Befroy DE, Caballero D, Jurczak MJ, Rahimi Y, Cline GW, Dufour S, Birkenfeld AL, Rothman DL, Carpenter TO, Insogna K, Petersen KF, Bergwitz C, Shulman GI. Hypophosphatemia promotes lower rates of muscle ATP synthesis. FASEB J 2016; 30:3378-3387. [PMID: 27338702 PMCID: PMC5024687 DOI: 10.1096/fj.201600473r] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/14/2016] [Indexed: 12/13/2022]
Abstract
Hypophosphatemia can lead to muscle weakness and respiratory and heart failure, but the mechanism is unknown. To address this question, we noninvasively assessed rates of muscle ATP synthesis in hypophosphatemic mice by using in vivo saturation transfer [31P]-magnetic resonance spectroscopy. By using this approach, we found that basal and insulin-stimulated rates of muscle ATP synthetic flux (VATP) and plasma inorganic phosphate (Pi) were reduced by 50% in mice with diet-induced hypophosphatemia as well as in sodium-dependent Pi transporter solute carrier family 34, member 1 (NaPi2a)-knockout (NaPi2a-/-) mice compared with their wild-type littermate controls. Rates of VATP normalized in both hypophosphatemic groups after restoring plasma Pi concentrations. Furthermore, VATP was directly related to cellular and mitochondrial Pi uptake in L6 and RC13 rodent myocytes and isolated muscle mitochondria. Similar findings were observed in a patient with chronic hypophosphatemia as a result of a mutation in SLC34A3 who had a 50% reduction in both serum Pi content and muscle VATP After oral Pi repletion and normalization of serum Pi levels, muscle VATP completely normalized in the patient. Taken together, these data support the hypothesis that decreased muscle ATP synthesis, in part, may be caused by low blood Pi concentrations, which may explain some aspects of muscle weakness observed in patients with hypophosphatemia.-Pesta, D. H., Tsirigotis, D. N., Befroy, D. E., Caballero, D., Jurczak, M. J., Rahimi, Y., Cline, G. W., Dufour, S., Birkenfeld, A. L., Rothman, D. L., Carpenter, T. O., Insogna, K., Petersen, K. F., Bergwitz, C., Shulman, G. I. Hypophosphatemia promotes lower rates of muscle ATP synthesis.
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Affiliation(s)
- Dominik H Pesta
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dimitrios N Tsirigotis
- Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Douglas E Befroy
- Department of Radiology and Biomedical Engineering, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Daniel Caballero
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael J Jurczak
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yasmeen Rahimi
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gary W Cline
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sylvie Dufour
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Andreas L Birkenfeld
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Douglas L Rothman
- Department of Radiology and Biomedical Engineering, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Thomas O Carpenter
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA; and
| | - Karl Insogna
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kitt Falk Petersen
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Clemens Bergwitz
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gerald I Shulman
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut, USA; Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut, USA; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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Gluba-Brzozka A, Franczyk B, Toth PP, Rysz J, Banach M. Molecular mechanisms of statin intolerance. Arch Med Sci 2016; 12:645-58. [PMID: 27279860 PMCID: PMC4889699 DOI: 10.5114/aoms.2016.59938] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 03/29/2016] [Indexed: 01/13/2023] Open
Abstract
Statins reduce cardiovascular morbidity and mortality in primary and secondary prevention. Despite their efficacy, many persons are unable to tolerate statins due to adverse events such as hepatotoxicity and myalgia/myopathy. In the case of most patients, it seems that mild-to-moderate abnormalities in liver and muscle enzymes are not serious adverse effects and do not outweigh the benefits of coronary heart disease risk reduction. The risk for mortality or permanent organ damage ascribed to statin use is very small and limited to cases of myopathy and rhabdomyolysis. Statin-induced muscle-related adverse events comprise a highly heterogeneous clinical disorder with numerous, complex etiologies and a variety of genetic backgrounds. Every patient who presents with statin-related side effects cannot undergo the type of exhaustive molecular characterization that would include all of these mechanisms. Frequently the only solution is to either discontinue statin therapy/reduce the dose or attempt intermittent dosing strategies at a low dose.
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Affiliation(s)
- Anna Gluba-Brzozka
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital, Lodz, Poland
- Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland
| | - Beata Franczyk
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Poland
| | - Peter P. Toth
- CGH Medical Center, Sterling, Illinois, and Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jacek Rysz
- Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Poland
| | - Maciej Banach
- Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
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Wacker MJ, Touchberry CD, Silswal N, Brotto L, Elmore CJ, Bonewald LF, Andresen J, Brotto M. Skeletal Muscle, but not Cardiovascular Function, Is Altered in a Mouse Model of Autosomal Recessive Hypophosphatemic Rickets. Front Physiol 2016; 7:173. [PMID: 27242547 PMCID: PMC4866514 DOI: 10.3389/fphys.2016.00173] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/28/2016] [Indexed: 01/29/2023] Open
Abstract
Autosomal recessive hypophosphatemic rickets (ARHR) is a heritable disorder characterized by hypophosphatemia, osteomalacia, and poor bone development. ARHR results from inactivating mutations in the DMP1 gene with the human phenotype being recapitulated in the Dmp1 null mouse model which displays elevated plasma fibroblast growth factor 23. While the bone phenotype has been well-characterized, it is not known what effects ARHR may also have on skeletal, cardiac, or vascular smooth muscle function, which is critical to understand in order to treat patients suffering from this condition. In this study, the extensor digitorum longus (EDL-fast-twitch muscle), soleus (SOL–slow-twitch muscle), heart, and aorta were removed from Dmp1 null mice and ex-vivo functional tests were simultaneously performed in collaboration by three different laboratories. Dmp1 null EDL and SOL muscles produced less force than wildtype muscles after normalization for physiological cross sectional area of the muscles. Both EDL and SOL muscles from Dmp1 null mice also produced less force after the addition of caffeine (which releases calcium from the sarcoplasmic reticulum) which may indicate problems in excitation contraction coupling in these mice. While the body weights of the Dmp1 null were smaller than wildtype, the heart weight to body weight ratio was higher. However, there were no differences in pathological hypertrophic gene expression compared to wildtype and maximal force of contraction was not different indicating that there may not be cardiac pathology under the tested conditions. We did observe a decrease in the rate of force development generated by cardiac muscle in the Dmp1 null which may be related to some of the deficits observed in skeletal muscle. There were no differences observed in aortic contractions induced by PGF2α or 5-HT or in endothelium-mediated acetylcholine-induced relaxations or endothelium-independent sodium nitroprusside-induced relaxations. In summary, these results indicate that there are deficiencies in both fast twitch and slow twitch muscle fiber type contractions in this model of ARHR, while there was less of a phenotype observed in cardiac muscle, and no differences observed in aortic function. These results may help explain skeletal muscle weakness reported by some patients with osteomalacia and need to be further investigated.
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Affiliation(s)
- Michael J Wacker
- Muscle Biology Research Group, School of Medicine, University of Missouri-Kansas City Kansas City, MO, USA
| | | | - Neerupma Silswal
- Muscle Biology Research Group, School of Medicine, University of Missouri-Kansas City Kansas City, MO, USA
| | - Leticia Brotto
- Bone-Muscle Collaborative Science, College of Nursing and Health Innovation, University of Texas at Arlington Arlington, TX, USA
| | - Chris J Elmore
- Muscle Biology Research Group, School of Medicine, University of Missouri-Kansas City Kansas City, MO, USA
| | - Lynda F Bonewald
- Bone Biology Research Group, School of Dentistry, University of Missouri-Kansas City Kansas City, MO, USA
| | - Jon Andresen
- Muscle Biology Research Group, School of Medicine, University of Missouri-Kansas City Kansas City, MO, USA
| | - Marco Brotto
- Bone-Muscle Collaborative Science, College of Nursing and Health Innovation, University of Texas at Arlington Arlington, TX, USA
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43
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Cielen N, Heulens N, Maes K, Carmeliet G, Mathieu C, Janssens W, Gayan-Ramirez G. Vitamin D deficiency impairs skeletal muscle function in a smoking mouse model. J Endocrinol 2016; 229:97-108. [PMID: 26906744 PMCID: PMC5064769 DOI: 10.1530/joe-15-0491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/23/2016] [Indexed: 12/18/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with skeletal muscle dysfunction. Vitamin D plays an important role in muscle strength and performance in healthy individuals. Vitamin D deficiency is highly prevalent in COPD, but its role in skeletal muscle dysfunction remains unclear. We examined the time-course effect of vitamin D deficiency on limb muscle function in mice with normal or deficient vitamin D serum levels exposed to air or cigarette smoke for 6, 12 or 18 weeks. The synergy of smoking and vitamin D deficiency increased lung inflammation and lung compliance from 6 weeks on with highest emphysema scores observed at 18 weeks. Smoking reduced body and muscle mass of the soleus and extensor digitorum longus (EDL), but did not affect contractility, despite type II atrophy. Vitamin D deficiency did not alter muscle mass but reduced muscle force over time, downregulated vitamin D receptor expression, and increased muscle lipid peroxidation but did not alter actin and myosin expression, fiber dimensions or twitch relaxation time. The combined effect of smoking and vitamin D deficiency did not further deteriorate muscle function but worsened soleus mass loss and EDL fiber atrophy at 18 weeks. We conclude that the synergy of smoking and vitamin D deficiency in contrast to its effect on lung disease, had different, independent but important noxious effects on skeletal muscles in a mouse model of mild COPD.
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Affiliation(s)
- Nele Cielen
- Laboratory of Respiratory DiseasesDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Nele Heulens
- Laboratory of Respiratory DiseasesDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Karen Maes
- Laboratory of Respiratory DiseasesDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Geert Carmeliet
- Laboratory of Clinical and Experimental EndocrinologyDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Chantal Mathieu
- Laboratory of Clinical and Experimental EndocrinologyDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Wim Janssens
- Laboratory of Respiratory DiseasesDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
| | - Ghislaine Gayan-Ramirez
- Laboratory of Respiratory DiseasesDepartment of Clinical and Experimental Medicine, KULeuven, Leuven, Belgium
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44
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Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol 2016; 229:R67-81. [PMID: 26931135 DOI: 10.1530/joe-15-0533] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Abstract
Insulin resistance (IR) in skeletal muscle is a key defect mediating the link between obesity and type 2 diabetes, a disease that typically affects people in later life. Sarcopenia (age-related loss of muscle mass and quality) is a risk factor for a number of frailty-related conditions that occur in the elderly. In addition, a syndrome of 'sarcopenic obesity' (SO) is now increasingly recognised, which is common in older people and is applied to individuals that simultaneously show obesity, IR and sarcopenia. Such individuals are at an increased risk of adverse health events compared with those who are obese or sarcopenic alone. However, there are no licenced treatments for sarcopenia or SO, the syndrome is poorly defined clinically and the mechanisms that might explain a common aetiology are not yet well characterised. In this review, we detail the nature and extent of the clinical syndrome, highlight some of the key physiological processes that are dysregulated and discuss some candidate molecular pathways that could be implicated in both metabolic and anabolic defects in skeletal muscle, with an eye towards future therapeutic options. In particular, the potential roles of Akt/mammalian target of rapamycin signalling, AMP-activated protein kinase, myostatin, urocortins and vitamin D are discussed.
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Affiliation(s)
- Mark E Cleasby
- Department of Comparative Biomedical SciencesRoyal Veterinary College, University of London, London, UK
| | - Pauline M Jamieson
- Centre for Cardiovascular ScienceQueen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Philip J Atherton
- Division of Medical Sciences and Graduate Entry MedicineUniversity of Nottingham, Medical School, Royal Derby Hospital, Derby, UK
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45
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Ray AD, Personius KE, Williamson DL, Dungan CM, Dhillon SS, Hershberger PA. Vitamin D3 intake modulates diaphragm but not peripheral muscle force in young mice. J Appl Physiol (1985) 2016; 120:1124-31. [PMID: 26968027 DOI: 10.1152/japplphysiol.00643.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 03/09/2016] [Indexed: 12/16/2022] Open
Abstract
Recent data support an important role for vitamin D in respiratory health. We tested the hypothesis that dietary vitamin D3 (VD3) intake modulates diaphragm (DIA) strength. Four-week-old female A/J mice (n = 10/group) were randomized to receive diets containing 100 IU VD3/kg (low), 1,000 IU VD3/kg (reference), or 10,000 IU VD3/kg (pharmacologic). After 6 wk of dietary intervention, plasma 25-hydroxyvitamin D3 (25D3) levels, DIA and extensor digitorum longus (EDL) in vitro contractile properties, and fiber cross-sectional area (CSA) were measured. Myosin heavy chain (MHC) composition and Akt/Foxo3A growth signaling were studied in the DIA and tibialis anterior. Mice fed the low, reference, and pharmacologic diets had average 25D3 levels of 7, 21, and 59 ng/ml, respectively. Maximal DIA force, twitch force, and fiber CSA were reduced 26%, 28%, and 10% (P < 0.01), respectively, in mice receiving the low-VD3 diet compared with the reference and pharmacologic diets. EDL force parameters were unaltered by diet. Effects of VD3 intake on DIA force were not observed in mice that began dietary intervention at 12 wk of age. VD3 intake did not alter the MHC composition of the DIA, indicating that decreases in force and CSA in young mice were not due to a switch in fiber type. Paradoxically, low VD3 intake was associated with activation of anabolic signaling in muscle (hyperphosphorylation of Akt and Foxo3A and decreased expression of autophagy marker LC3). These studies identify a potential role of dietary VD3 in regulating DIA development and insulin sensitivity.
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Affiliation(s)
- Andrew D Ray
- Department of Rehabilitation Science, University at Buffalo, Buffalo, New York;
| | | | - David L Williamson
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Cory M Dungan
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Samjot S Dhillon
- Department of Medicine, Thoracic Oncology, Roswell Park Cancer Institute, Buffalo, New York; and
| | - Pamela A Hershberger
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, New York
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46
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Abstract
The classical clinical consequence of vitamin D deficiency is osteomalacia, presenting as rickets in children. This remains a common problem in parts of the Middle East and the Indian subcontinent, and occurs when serum 25-hydroxyvitamin D levels are <25 nmol/L. Osteomalacia remains the only problem that is unequivocally a consequence of vitamin D deficiency. Low levels of 25-hydroxyvitamin D are observed in a wide range of conditions, but consistent trial evidence of amelioration of these conditions with vitamin D is lacking. Monotherapy with vitamin D has not been found to be effective in meta-analyses of trials assessing its effects on bone density, fractures or falls. At present, supplements should be advised for individuals at risk of having serum 25-hydroxyvitamin D levels in the 25-40 nmol/L range, or below, with a view to prevention of osteomalacia.
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Affiliation(s)
- Ian R Reid
- University of Auckland, Auckland, New Zealand Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand
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47
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Girgis CM, Cha KM, Houweling PJ, Rao R, Mokbel N, Lin M, Clifton-Bligh RJ, Gunton JE. Vitamin D Receptor Ablation and Vitamin D Deficiency Result in Reduced Grip Strength, Altered Muscle Fibers, and Increased Myostatin in Mice. Calcif Tissue Int 2015; 97:602-10. [PMID: 26340892 DOI: 10.1007/s00223-015-0054-x] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 08/17/2015] [Indexed: 12/19/2022]
Abstract
Vitamin D deficiency is associated with muscle weakness, pain, and atrophy. Serum vitamin D predicts muscle strength and age-related muscle changes. However, precise mechanisms by which vitamin D affects skeletal muscle are unclear. To address this question, this study characterizes the muscle phenotype and gene expression of mice with deletion of vitamin D receptor (VDRKO) or diet-induced vitamin D deficiency. VDRKO and vitamin D-deficient mice had significantly weaker grip strength than their controls. Weakness progressed with age and duration of vitamin D deficiency, respectively. Histological assessment showed that VDRKO mice had muscle fibers that were significantly smaller in size and displayed hyper-nuclearity. Real-time PCR also indicated muscle developmental changes in VDRKO mice with dysregulation of myogenic regulatory factors (MRFs) and increased myostatin in quadriceps muscle (>2-fold). Vitamin D-deficient mice also showed increases in myostatin and the atrophy marker E3-ubiqutin ligase MuRF1. As a potential explanation for grip strength weakness, both groups of mice had down-regulation of genes encoding calcium-handling and sarco-endoplasmic reticulum calcium transport ATPase (Serca) channels. This is the first report of reduced strength, morphological, and gene expression changes in VDRKO and vitamin D-deficient mice where confounding by calcium, magnesium, and phosphate have been excluded by direct testing. Although suggested in earlier in vitro work, this study is the first to report an in vivo association between vitamin D, myostatin, and the regulation of muscle mass. These findings support a direct role for vitamin D in muscle function and corroborate earlier work on the presence of VDR in this tissue.
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Affiliation(s)
- Christian M Girgis
- Westmead Millennium Institute, 176 Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia.
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
- Garvan Institute of Medical Research, Sydney, NSW, Australia.
| | - Kuan Minn Cha
- Westmead Millennium Institute, 176 Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | | | - Renuka Rao
- Westmead Millennium Institute, 176 Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia
| | - Nancy Mokbel
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Mike Lin
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Roderick J Clifton-Bligh
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
- The Kolling Institute of Medical Research, Sydney, NSW, Australia
- Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jenny E Gunton
- Westmead Millennium Institute, 176 Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia.
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
- Garvan Institute of Medical Research, Sydney, NSW, Australia.
- Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, NSW, Australia.
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.
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48
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Gunton JE, Girgis CM, Baldock PA, Lips P. Bone muscle interactions and vitamin D. Bone 2015; 80:89-94. [PMID: 25745883 DOI: 10.1016/j.bone.2015.02.029] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 02/12/2015] [Accepted: 02/28/2015] [Indexed: 12/17/2022]
Abstract
Beyond the established roles of vitamin D in bone and mineral homeostasis, we are becoming increasingly aware of its diverse effects in skeletal muscle. Subjects with severe vitamin D deficiency or mutations of the vitamin D receptor develop generalized atrophy of muscle and bone, suggesting coordinated effects of vitamin D in musculoskeletal physiology. At a mechanistic level, vitamin D exerts wide-ranging effects in muscle and bone calcium handling, differentiation and development. Vitamin D also modulates muscle and bone-derived hormones, facilitating cross-talk between these tissues. In this review, we discuss emerging evidence that vitamin D regulates bone and muscle in a direct, integrated fashion, positioning the vitamin D pathway as a potential therapeutic target for musculoskeletal diseases. This article is part of a Special Issue entitled "Muscle Bone Interactions".
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Affiliation(s)
- Jenny E Gunton
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead Hospital, NSW, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - Christian M Girgis
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, NSW, Australia; Westmead Millennium Institute, Westmead Hospital, NSW, Australia
| | - Paul A Baldock
- Garvan Institute of Medical Research, Sydney, NSW, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Paul Lips
- Department of Internal Medicine/Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands
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49
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Girgis CM, Baldock PA, Downes M. Vitamin D, muscle and bone: Integrating effects in development, aging and injury. Mol Cell Endocrinol 2015; 410:3-10. [PMID: 25837735 DOI: 10.1016/j.mce.2015.03.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 12/14/2022]
Abstract
Beyond the established effects of muscle loading on bone, a complex network of hormones and growth factors integrates these adjacent tissues. One such hormone, vitamin D, exerts broad-ranging effects in muscle and bone calcium handling, differentiation and development. Vitamin D also modulates muscle and bone-derived hormones, potentially facilitating cross-talk between these tissues. In the clinical setting, vitamin D deficiency or mutations of the vitamin D receptor result in generalized atrophy of muscle and bone, suggesting coordinated effects of vitamin D at these sites. In this review, we discuss emerging evidence that vitamin D exerts specific effects throughout the life of the musculoskeletal system - in development, aging and injury. From this holistic viewpoint, we offer new insights into an old debate: whether vitamin D's effects in the musculoskeletal system are direct via local VDR signals or indirect via its systemic effects in calcium and phosphate homeostasis.
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Affiliation(s)
- Christian M Girgis
- Westmead Millennium Institute for Medical Research, Sydney, NSW, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia.
| | - Paul A Baldock
- Garvan Institute of Medical Research, Sydney, NSW, Australia
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50
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Pojednic RM, Ceglia L, Olsson K, Gustafsson T, Lichtenstein AH, Dawson-Hughes B, Fielding RA. Effects of 1,25-dihydroxyvitamin D3 and vitamin D3 on the expression of the vitamin d receptor in human skeletal muscle cells. Calcif Tissue Int 2015; 96:256-63. [PMID: 25479835 PMCID: PMC4429607 DOI: 10.1007/s00223-014-9932-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/15/2014] [Indexed: 12/28/2022]
Abstract
Vitamin D receptor (VDR) expression and action in non-human skeletal muscle have recently been reported in several studies, yet data on the activity and expression of VDR in human muscle cells are scarce. We conducted a series of studies to examine the (1) effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on VDR gene expression in human primary myoblasts, (2) effect of 16-week supplementation with vitamin D3 on intramuscular VDR gene expression in older women, and (3) association between serum 25-hydroxyvitamin D (25OHD) and intramuscular VDR protein concentration in older adults. Human primary myoblasts were treated with increasing concentrations of 1,25(OH)2D3 for 18 h. A dose-dependent treatment effect was noted with 1 nmol/L of 1,25OH2D3 increasing intramuscular VDR mRNA expression (mean fold change±SD 1.36±0.33; P=0.05). Muscle biopsies were obtained at baseline and 16 weeks after vitamin D3 supplementation (4,000 IU/day) in older adults. Intramuscular VDR mRNA was significantly different from placebo after 16 weeks of vitamin D3 (1.2±0.99; -3.2±1.7, respectively; P=0.04). Serum 25OHD and intramuscular VDR protein expression were examined by immunoblot. 25OHD was associated with intramuscular VDR protein concentration (R=0.67; P=0.0028). In summary, our study found VDR gene expression increases following treatment with 1,25OH2D3 in human myoblasts. 25OHD is associated with VDR protein and 16 weeks of supplementation with vitamin D3 resulted in a persistent increase in VDR gene expression of vitamin D3 in muscle tissue biopsies. These findings suggest treatment with vitamin D compounds results in sustained increases in VDR in human skeletal muscle.
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Affiliation(s)
- Rachele M Pojednic
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St., Boston, MA, 02111, USA,
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