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Zhan H, Liu X, Piao S, Rong X, Guo J. Association between triglyceride-glucose index and bone mineral density in US adults: a cross sectional study. J Orthop Surg Res 2023; 18:810. [PMID: 37904197 PMCID: PMC10614394 DOI: 10.1186/s13018-023-04275-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/10/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE Disorders in glucose and lipid metabolism have been shown to exert an influence on bone metabolism. The TyG index, which combines measures of glucose and triglycerides, provides insights into the overall metabolic status. However, the investigation of concurrent disturbances in glucose and lipid metabolism and their specific implications for bone metabolism remains limited in the existing research literature. This study aimed to explore the correlation between the TyG index and bone mineral density (BMD) in US adults. METHODS In the National Health and Nutrition Examination Survey (NHANES), subjects were classified based on the TyG index into four groups (< 7.97, 7.97-8.39, 8.39-8.85, > 8.86). Linear regression analysis was conducted to determine the β value and 95% confidence interval (CI). Four multivariable models were constructed. Restricted cubic spline analyses and piecewise linear regression were employed to identify the association between the BMD and TyG index. An analysis of subgroups was also conducted in this study. RESULTS Significant variations in related characteristics were found among the US adult population, who were distributed into four groups based on the quartiles of the TyG index. A negative correlation between the TyG index and lumbar spine BMD was observed. In the multi-adjusted models, compared to Q1 of the TyG index, the β for Q4 of the TyG index for lumbar spine BMD was [β = - 0.008, 95% CI (- 0.017, 0)] in US adults. The association between the TyG index and lumbar spine BMD was found to be nonlinear (all nonlinear p < 0.001), with a threshold value based on restricted cubic spline analyses. Above the threshold point, the β for lumbar spine BMD was - 0.042 (95% CI, - 0.059, - 0.024). Below the threshold points, no significant difference was observed (p > 0.05). No significant interactions were observed among subgroups based on age, gender, presence of diabetes, BMI, and use of antidiabetic and antihyperlipidemic agents. Similar patterns of association were observed in total and subtotal bone density. CONCLUSIONS This study identified a nonlinear association between the TyG index and BMD in the US population. Furthermore, an increased level of the TyG index may indicate a higher risk of osteoporosis among US adults. These findings highlight the importance of considering glucose and lipid metabolism disturbances in understanding bone health and the potential for developing preventive strategies for osteoporosis.
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Affiliation(s)
- Huixia Zhan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Xinyu Liu
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shenghua Piao
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xianglu Rong
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jiao Guo
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China.
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China.
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China.
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China.
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Kim KJ, Kim MS, Hong N, Bae JH, Kim KJ, Kim NH, Rhee Y, Lee J, Kim SG. Cardiovascular risks associated with calcium supplementation in patients with osteoporosis: a nationwide cohort study. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2022; 8:568-577. [PMID: 34244740 DOI: 10.1093/ehjcvp/pvab054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 11/14/2022]
Abstract
AIMS This study aimed to evaluate the real effects of calcium supplementation on cardiovascular outcomes within a population-based cohort. METHODS AND RESULTS From a nationwide health screening database in South Korea, a total of 11 297 patients with osteoporosis who had taken calcium supplementation with or without vitamin D for at least 90 days [total calcium group; calcium supplementation only (CaO), n = 567; calcium supplementation in combination with vitamin D (CaD), n = 10 730] were matched at a 1:1 ratio to patients who had not taken calcium supplements (control group) by using propensity scores. The overall mean age was 59.9 ± 8.8 years and the percentage of women was 87.9% in our study population. Over a median follow-up of 54 months, the incidence rate of composite cardiovascular diseases (CVDs) per 1000 person-years was not different between the groups: 9.73 in the total calcium group and 8.97 in the control group [adjusted hazard ratio (HR): 1.12; 95% confidence interval (CI): 0.99-1.28; P = 0.08]. However, calcium supplementation without vitamin D was associated with an increased risk of composite CVD (HR: 1.54; 95% CI: 1.17-2.04; P < 0.01), especially non-fatal myocardial infarction (HR: 1.89; 95% CI: 1.23-2.91; P < 0.01), compared with no calcium supplementation. CONCLUSION Our population-based study supported that taking calcium supplementation combined with vitamin D did not appear to be harmful to cardiovascular health, but reminded that calcium supplementation without vitamin D should be used carefully even in populations with low dietary calcium intake.
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Affiliation(s)
- Kyoung Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Min Sun Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
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Hamam M, Di Vita G, Zanchini R, Spina D, Raimondo M, Pilato M, D’Amico M. Consumers' Attitudes and Purchase Intention for a Vitamin-Enriched Extra Virgin Olive Oil. Nutrients 2022; 14:nu14081658. [PMID: 35458217 PMCID: PMC9027912 DOI: 10.3390/nu14081658] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 01/27/2023] Open
Abstract
This study aims to examine Italian consumer preferences for extra virgin olive oil (EVOO) enriched with vitamins and to analyze the key drivers that affect consumer choices for this product. Specifically, we assessed consumers' intention to purchase the enriched product compared to the conventional one. The methodology adopted inferential and multivariate statistical techniques: (1) exploratory factor analysis (EFA), (2) ordinary least squares regression (OLS) and (3) non-hierarchical clustering. This study appears to be the first research project related to exploring consumers' interest in an extra virgin olive oil enhanced with vitamins, thereby providing preliminary indications. The main results represent a significant starting point for the development of new marketing strategies for the food industry.
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Affiliation(s)
- Manal Hamam
- Department of Agriculture, Food and Environment (Di3A), University of Catania, 95123 Catania, Italy; (M.H.); (M.D.)
| | - Giuseppe Di Vita
- Department of Agricultural, Forest and Food Science (Disafa), University of Turin, Largo Braccini, 10095 Grugliasco, Italy; (G.D.V.); (R.Z.)
| | - Raffaele Zanchini
- Department of Agricultural, Forest and Food Science (Disafa), University of Turin, Largo Braccini, 10095 Grugliasco, Italy; (G.D.V.); (R.Z.)
| | - Daniela Spina
- Department of Agriculture, Food and Environment (Di3A), University of Catania, 95123 Catania, Italy; (M.H.); (M.D.)
- Correspondence:
| | - Maria Raimondo
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy;
| | - Manuela Pilato
- Department of Marketing, Events Management, and Project Management, University of Winchester, Winchester SO22 5HT, UK;
| | - Mario D’Amico
- Department of Agriculture, Food and Environment (Di3A), University of Catania, 95123 Catania, Italy; (M.H.); (M.D.)
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4
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Jin J, Lee Y, Park Y. Validation of the Updated Korean Calcium Assessment Tool. J Bone Metab 2021; 28:325-332. [PMID: 34905679 PMCID: PMC8671026 DOI: 10.11005/jbm.2021.28.4.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background We previously developed the Korean Calcium Assessment Tool (KCAT) for assessing the intake of calcium and vitamin D in Korean women. However, based on the Korea National Health and Nutrition Examination Survey (KNHANES) VI and VII (2013–2018), major food sources for calcium and vitamin D have changed, and the National Standard Food Composition database was updated. Therefore, the present study aimed to update the KCAT and validate the Updated KCAT. Methods A total of 285 women aged >19 years were asked to complete questionnaires of the KCAT and the Updated KCAT. Results Calcium intake did not differ significantly between the KCAT (566±245 mg/day) and the Updated KCAT (569±248 mg/day; P=0.343). A correlation coefficient of 0.99 indicated a positive correlation on calcium intake between the KCAT and the Updated KCAT, with an almost perfect agreement by Cohen’s κ coefficients (0.95). Vitamin D intake assessed by the Updated KCAT was significantly higher than that assessed by the KCAT, which was positively correlated with a moderate agreement measured by Cohen’s κ coefficients (0.41). Conclusions The present study demonstrated that the Updated KCAT was a valid tool for the rapid evaluation of calcium and vitamin D intake for Korean women.
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Affiliation(s)
- Joowon Jin
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Yunjung Lee
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
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Almeida-Afonso R, Finamor D, Fonseca LAM, Veiga APR, Monteiro MA, Magri M, Duarte AJ, Casseb J. Efficacy of vitamin D supplementation among persons living with HIV/AIDS in São Paulo city, Brazil. Braz J Infect Dis 2021; 25:101598. [PMID: 34280356 PMCID: PMC9392205 DOI: 10.1016/j.bjid.2021.101598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/31/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022] Open
Abstract
Hypovitaminosis D is now considered a pandemic, especially among more vulnerable populations and in HIV-infected subjects, with 80% presenting levels below 30 ng/mL. As there is no consensus on the more adequate dosage needed to correct such deficiency, the objective of this study was to evaluate 25 (OH) vitamin D supplementation in HIV-1 patients deficient of vitamin D. A total of 73 HIV-1-infected patients were included, drawn from a cohort of 435 patients; 37 patients were randomized to the active group, supplemented once a week with 50,000 UI vitamin D by mouth (group 1) and 36 to the placebo group (group 2). The study period ranged from June 2016 to September 2017. Variables involved in vitamin D metabolism and risk factors associated with hypovitaminosis were evaluated. The mean age was 45 years and 31.5 % were women. Vitamin D supplementation was effective in normalizing serum levels after six months in group 1 (mean 35 ng/mL compared to 21 ng/mL for the placebo group; p = 0.04). No patient reached blood levels considered toxic (>100 UI). Efavirenz use can negatively influence vitamin D levels and supplementation is necessary as a likely adjunct to improving CD4+ T cells, resulting in greater effectiveness of the treatment. A weekly oral dose of 50,000 IU of vitamin D was sufficient to normalize the vitamin deficiency, safely and with good adherence among persons living with HIV/AIDS in Brazil.
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Affiliation(s)
- Rosa Almeida-Afonso
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil; Centro de Referência em IST/AIDS, São Paulo, SP, Brazil
| | | | - Luiz Augusto M Fonseca
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil
| | - Ana P Rocha Veiga
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil
| | - Mariana A Monteiro
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil
| | - Marcello Magri
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil
| | - Alberto Js Duarte
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil
| | - Jorge Casseb
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil.
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Dey DK, Chang SN, Gu JY, Kim KM, Lee JJ, Kim TH, Kang SC. Ultraviolet B-irradiated mushroom supplementation increased the Ca ++ uptake and ameliorated the LPS-induced inflammatory responses in zebrafish larvae. J Food Biochem 2021; 45:e13742. [PMID: 33931887 DOI: 10.1111/jfbc.13742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/05/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022]
Abstract
The harmful effects of excessive ultraviolet (UV) exposure are well known. However, moderate exposure to UV radiation is beneficial and required for active vitamin D synthesis in our body. People living in the coldest regions on the earth are unable to expose their skin to the solar UV radiation and, therefore, additional supplementation of Vitamin D2 is recommended. Mushrooms are one such consumable macrofungi, which has high vitamin content and therefore used in various traditional medicines. Particularly, UVB-irradiated mushrooms are rich in active vitamin D content and that is why recommended to include in the daily diets for the patients suffering from the problems associated with bone mineralization. In the present study, we evaluated the cytotoxic effect of mushroom extract (UVB-ME) (Lentinus edodes) treatment against MG-63 cells, HepG2 cells, and CCD 841 CoN cells. Furthermore, we elucidated the potential of UVB-ME on Ca++ uptake in osteoblast-like MG-63 cells. Next, we validated the response of Ca++ uptake on the growth and development of zebrafish larvae. In addition, the anti-inflammatory and immunomodulatory potential of UVB-ME treatment against lipopolysaccharide-induced inflammatory response was also analyzed in vivo. Collectively, the study suggested that dietary supplementation of UVB-irradiated mushroom is beneficial for bone calcification and could modulate the host immune system.
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Affiliation(s)
- Debasish Kumar Dey
- Department of Biotechnology, Daegu University, Gyeongsan, Republic of Korea
| | | | - Ji Ye Gu
- Department of Pharmaceutical Science and Technology, Kyungsung University, Busan, Republic of Korea
| | - Kang Min Kim
- Department of Pharmaceutical Science and Technology, Kyungsung University, Busan, Republic of Korea
| | | | - Tae Hee Kim
- Naturetech Co. Ltd., Chungbuk, Republic of Korea
| | - Sun Chul Kang
- Department of Biotechnology, Daegu University, Gyeongsan, Republic of Korea
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Bass JJ, Kazi AA, Deane CS, Nakhuda A, Ashcroft SP, Brook MS, Wilkinson DJ, Phillips BE, Philp A, Tarum J, Kadi F, Andersen D, Garcia AM, Smith K, Gallagher IJ, Szewczyk NJ, Cleasby ME, Atherton PJ. The mechanisms of skeletal muscle atrophy in response to transient knockdown of the vitamin D receptor in vivo. J Physiol 2021; 599:963-979. [PMID: 33258480 PMCID: PMC7986223 DOI: 10.1113/jp280652] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Reduced vitamin D receptor (VDR) expression prompts skeletal muscle atrophy. Atrophy occurs through catabolic processes, namely the induction of autophagy, while anabolism remains unchanged. In response to VDR-knockdown mitochondrial function and related gene-set expression is impaired. In vitro VDR knockdown induces myogenic dysregulation occurring through impaired differentiation. These results highlight the autonomous role the VDR has within skeletal muscle mass regulation. ABSTRACT Vitamin D deficiency is estimated to affect ∼40% of the world's population and has been associated with impaired muscle maintenance. Vitamin D exerts its actions through the vitamin D receptor (VDR), the expression of which was recently confirmed in skeletal muscle, and its down-regulation is linked to reduced muscle mass and functional decline. To identify potential mechanisms underlying muscle atrophy, we studied the impact of VDR knockdown (KD) on mature skeletal muscle in vivo, and myogenic regulation in vitro in C2C12 cells. Male Wistar rats underwent in vivo electrotransfer (IVE) to knock down the VDR in hind-limb tibialis anterior (TA) muscle for 10 days. Comprehensive metabolic and physiological analysis was undertaken to define the influence loss of the VDR on muscle fibre composition, protein synthesis, anabolic and catabolic signalling, mitochondrial phenotype and gene expression. Finally, in vitro lentiviral transfection was used to induce sustained VDR-KD in C2C12 cells to analyse myogenic regulation. Muscle VDR-KD elicited atrophy through a reduction in total protein content, resulting in lower myofibre area. Activation of autophagic processes was observed, with no effect upon muscle protein synthesis or anabolic signalling. Furthermore, RNA-sequencing analysis identified systematic down-regulation of multiple mitochondrial respiration-related protein and genesets. Finally, in vitro VDR-knockdown impaired myogenesis (cell cycling, differentiation and myotube formation). Together, these data indicate a fundamental regulatory role of the VDR in the regulation of myogenesis and muscle mass, whereby it acts to maintain muscle mitochondrial function and limit autophagy.
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Affiliation(s)
- Joseph J. Bass
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Abid A. Kazi
- Department of Cellular and Molecular PhysiologyPennsylvania State University College of MedicineHersheyPAUSA
| | - Colleen S. Deane
- Department of Sport and Health SciencesUniversity of ExeterExeterUK
- Living Systems InstituteUniversity of ExeterExeterUK
| | - Asif Nakhuda
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Stephen P. Ashcroft
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Matthew S. Brook
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Daniel J. Wilkinson
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Bethan E. Phillips
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Andrew Philp
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- Mitochondrial Metabolism & Ageing Laboratory, Diabetes and Metabolism DivisionGarvan Institute of Medical ResearchNew South WalesAustralia
- St Vincent's Medical School, UNSW Medicine, UNSWSydneyAustralia
| | - Janelle Tarum
- School of Health SciencesÖrebro UniversityÖrebroSweden
| | - Fawzi Kadi
- School of Health SciencesÖrebro UniversityÖrebroSweden
| | - Ditte Andersen
- Molecular Physiology of Diabetes LaboratoryDepartment of Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
| | - Amadeo Muñoz Garcia
- Institute of Metabolism and Systems ResearchThe University of BirminghamBirminghamUK
- Department of Bioinformatics – BiGCaTNUTRIM School of Nutrition and Metabolism in Translational ResearchMaastricht UniversityMaastrichtThe Netherlands
| | - Ken Smith
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Iain J. Gallagher
- Physiology, Exercise and Nutrition Research GroupFaculty of Health Sciences and SportUniversity of StirlingStirlingUK
| | - Nathaniel J. Szewczyk
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
| | - Mark E. Cleasby
- Molecular Physiology of Diabetes LaboratoryDepartment of Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
| | - Philip J Atherton
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR)Nottingham Biomedical Research Centre (BRC)School of MedicineUniversity of NottinghamNottinghamUK
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Bass JJ, Nakhuda A, Deane CS, Brook MS, Wilkinson DJ, Phillips BE, Philp A, Tarum J, Kadi F, Andersen D, Garcia AM, Smith K, Gallagher IJ, Szewczyk NJ, Cleasby ME, Atherton PJ. Overexpression of the vitamin D receptor (VDR) induces skeletal muscle hypertrophy. Mol Metab 2020; 42:101059. [PMID: 32771696 PMCID: PMC7475200 DOI: 10.1016/j.molmet.2020.101059] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The Vitamin D receptor (VDR) has been positively associated with skeletal muscle mass, function and regeneration. Mechanistic studies have focused on the loss of the receptor, with in vivo whole-body knockout models demonstrating reduced myofibre size and function and impaired muscle development. To understand the mechanistic role upregulation of the VDR elicits in muscle mass/health, we studied the impact of VDR over-expression (OE) in vivo before exploring the importance of VDR expression upon muscle hypertrophy in humans. METHODS Wistar rats underwent in vivo electrotransfer (IVE) to overexpress the VDR in the Tibialis anterior (TA) muscle for 10 days, before comprehensive physiological and metabolic profiling to characterise the influence of VDR-OE on muscle protein synthesis (MPS), anabolic signalling and satellite cell activity. Stable isotope tracer (D2O) techniques were used to assess sub-fraction protein synthesis, alongside RNA-Seq analysis. Finally, human participants underwent 20 wks of resistance exercise training, with body composition and transcriptomic analysis. RESULTS Muscle VDR-OE yielded total protein and RNA accretion, manifesting in increased myofibre area, i.e., hypertrophy. The observed increases in MPS were associated with enhanced anabolic signalling, reflecting translational efficiency (e.g., mammalian target of rapamycin (mTOR-signalling), with no effects upon protein breakdown markers being observed. Additionally, RNA-Seq illustrated marked extracellular matrix (ECM) remodelling, while satellite cell content, markers of proliferation and associated cell-cycled related gene-sets were upregulated. Finally, induction of VDR mRNA correlated with muscle hypertrophy in humans following long-term resistance exercise type training. CONCLUSION VDR-OE stimulates muscle hypertrophy ostensibly via heightened protein synthesis, translational efficiency, ribosomal expansion and upregulation of ECM remodelling-related gene-sets. Furthermore, VDR expression is a robust marker of the hypertrophic response to resistance exercise in humans. The VDR is a viable target of muscle maintenance through testable Vitamin D molecules, as active molecules and analogues.
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Affiliation(s)
- Joseph J Bass
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Asif Nakhuda
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Colleen S Deane
- Department of Sport and Health Sciences, University of Exeter, EX1 2LU, UK
| | - Matthew S Brook
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Daniel J Wilkinson
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Bethan E Phillips
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Andrew Philp
- Mitochondrial Metabolism and Ageing Laboratory, Diabetes and Metabolism Division, Garvan Institute of Medical Research, NSW, 2010, Australia; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, B15 2TT, UK
| | - Janelle Tarum
- School of Health Sciences, Örebro University, 70182, Sweden
| | - Fawzi Kadi
- School of Health Sciences, Örebro University, 70182, Sweden
| | - Ditte Andersen
- Molecular Physiology of Diabetes Laboratory, Dept. of Comparative Biomedical Sciences, Royal Veterinary College, NW1 0TU, UK
| | - Amadeo Muñoz Garcia
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, UK; Department of Bioinformatics - BiGCaT, NUTRIM School of Nutrition and Metabolism in Translational Research, Maastricht University, Maastricht, the Netherlands
| | - Ken Smith
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Iain J Gallagher
- Physiology, Exercise and Nutrition Research Group, Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, UK
| | - Nathaniel J Szewczyk
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK
| | - Mark E Cleasby
- Molecular Physiology of Diabetes Laboratory, Dept. of Comparative Biomedical Sciences, Royal Veterinary College, NW1 0TU, UK
| | - Philip J Atherton
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, DE22 3DT, UK.
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Erdogmus S, Ates D, Nemli S, Yagmur B, Asciogul TK, Ozkuru E, Karaca N, Yilmaz H, Esiyok D, Tanyolac MB. Genome-wide association studies of Ca and Mn in the seeds of the common bean (Phaseolus vulgaris L.). Genomics 2020; 112:4536-4546. [PMID: 32763354 DOI: 10.1016/j.ygeno.2020.03.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 12/16/2022]
Abstract
SNP markers linked to genes controlling Ca and Mn uptake were identified in the common bean seeds using DArT-based association mapping (AM). The Ca concentration in the seeds varied between 475 and 3,100 mg kg-1 with an average of 1,280.9 mg kg-1 and the Mn concentration ranged from 4.87 to 27.54 mg kg-1 with a mean of 11.76 mg kg-1. A total of 19,204 SNP markers were distributed across 11 chromosomes that correspond to the haploid genome number of the common bean. The highest value of ΔK was determined as K = 2, and 173 common bean genotypes were split into two main subclusters as POP1 (Mesoamerican) and POP2 (Andean). The results of the UPGMA dendrogram and PCA confirmed those of STRUCTURE analysis. MLM based on the Q + K model identified a large number of markers-trait associations. Of the 19,204 SNPs, five (on Pv2, 3, 8, 10 and 11) and four (on Pv2, 3, 8 and 11) SNPs were detected to be significantly related to the Ca content of the beans grown in Bornova and Menemen, respectively in 2015. In 2016, six SNPs (on Pv1-4, 8 and 10) were identified to be significantly associated with the Ca content of the seeds obtained from Bornova and six SNPs (on Pv1-4, 8 and 10) from Menemen. Eight (on Pv3, 5 and 11) and four (on Pv2, 5 and 11) SNPs had a significant association with Mn content in Bornova in 2015 and 2016, respectively. In Menemen, eight (on Pv3, 5, 8 and 11) and 11 (on Pv1, 2, 5, 10 and 11) SNPs had a significant correlation with Mn content in 2015 and 2016, respectively.
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Affiliation(s)
- Semih Erdogmus
- Ege University, Department of Bioengineering, Bornova-Izmir 35100, Turkey
| | - Duygu Ates
- Ege University, Department of Bioengineering, Bornova-Izmir 35100, Turkey
| | - Seda Nemli
- Ege University, Faculty of Fisheries, Bornova-Izmir 35100, Turkey
| | - Bulent Yagmur
- Ege University, Department of Soil Science and Plant Nutrition, Bornova-Izmir 35100, Turkey
| | | | - Esin Ozkuru
- Ege University, Department of Bioengineering, Bornova-Izmir 35100, Turkey
| | - Nur Karaca
- Ege University, Department of Bioengineering, Bornova-Izmir 35100, Turkey
| | - Hasan Yilmaz
- Ege University, Department of Bioengineering, Bornova-Izmir 35100, Turkey
| | - Dursun Esiyok
- Ege University, Department of Horticulture, Bornova-Izmir, 35040, Turkey
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Polzonetti V, Pucciarelli S, Vincenzetti S, Polidori P. Dietary Intake of Vitamin D from Dairy Products Reduces the Risk of Osteoporosis. Nutrients 2020; 12:nu12061743. [PMID: 32532150 PMCID: PMC7353177 DOI: 10.3390/nu12061743] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Vitamin D and calcium are important dietary compounds that affect bone mass, even if other minerals (potassium, zinc, etc.) and vitamins (A, C and K) are also involved. Vitamin D and certain minerals, in fact, play an important role in calcium homeostasis and calcium absorption. Hip fracture incidence is higher in Europe and the United States, where calcium is frequently included in the human diet; while the occurrence of these fractures is lower in developing countries, where diets are often poor in calcium. This condition is named the “calcium paradox”, and may be partially explained by phosphate toxicity, which can negatively affect mineral metabolism. It is important to maintain correct dietary calcium-phosphate balance in order to have a healthy life, reducing the risk of osteoporotic fractures in older people. Vitamin D can also act as a hormone; vitamin D2 (ergocalciferol) is derived from the UV-B radiation of ergosterol, the natural vitamin D precursor detected in plants, fungi, and invertebrates. Vitamin D3 (cholecalciferol) is synthesized by sunlight exposure from 7-dehydrocholesterol, a precursor of cholesterol that can also act as provitamin D3. Dietary intake of vitamin D3 is essential when the skin is exposed for short periods to ultraviolet B light (UV-B), a category of invisible light rays such as UV-A and UV-C. This can be considered the usual situation in northern latitudes during the winter season, or the typical lifestyle for older people and/or for people with very white delicate skin. The actual recommended daily intake of dietary vitamin D is strictly correlated with age, ranging from 5 μg for infants, children, teenagers, and adults—including pregnant and lactating women—to 15 μg for people over 65 years.
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Affiliation(s)
- Valeria Polzonetti
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino (MC), Italy; (V.P.); (S.P.); (S.V.)
| | - Stefania Pucciarelli
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino (MC), Italy; (V.P.); (S.P.); (S.V.)
| | - Silvia Vincenzetti
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino (MC), Italy; (V.P.); (S.P.); (S.V.)
| | - Paolo Polidori
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Correspondence: ; Tel.: +39-0737-403426
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11
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Alibasic E, Ljuca F, Brkic S, Fazlic M, Husic D. Secondary Prevention of Osteoporosis Through Assessment of Individual and Multiple Risk Factors. Mater Sociomed 2020; 32:10-14. [PMID: 32410886 PMCID: PMC7219726 DOI: 10.5455/msm.2020.32.10-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Osteoporosis is a chronic progressive bone disease where the bone tissue resorption exceeds its regenerative capacities. Such a process leads to the reduction of bone mineral density (BMD), and distortion of trabecular microarchitectonics, which creates the basis for an increased fracture risk on a "low trauma" for osteoporosis patients. The notion of low trauma implies a stressor that will not cause a fracture in a healthy person under normal circumstances. BMD is a strong predictor of future fractures. However, many fractures occur in persons with BMD values beyond the defined osteoporosis threshold, and BMD measurement only partially identifies the part of the population with increased fracture risk. Also, it is known that risk factors are influencing the bone mass reduction as predictors of future fractures, and their association may lead to an increased fracture risk irrespective of the bone mass and T-score. Aim The 10-year individual risk assessment for osteoporotic fracture and the analysis of impact of individual and multiple osteoporosis risk factors on the degree of osteoporotic fracture risk. Methods The research is a retrospective-prospective study which analyzed 120 patients divided into two groups: 1) asymptomatic patients with known risk factors for osteoporosis in the age group of 40-65 (n=60), 2) asymptomatic patients with known risk factors for osteoporosis in the age group of 65-90 (n=60). FRAX® algorithm was used as a tool for the 10-year hip fracture risk assessment, with prior approval of the Centre for Metabolic Bone Diseases, University of Sheffield from the United Kingdom. Fracture risk assessment was calculated using the online FRAX® calculator. High risk is defined as the hip fracture risk higher than 3% or the risk of a "big" osteoporotic fracture higher than 20%. Results are expressed as mean values with a standard deviation. A comparison between tested patient groups was made applying the student T-test. Results 32% of patients of average age of 65.8±12.6 years are under high hip fracture risk, 28% of patients are under the hip fracture risk higher than 3%, and the risk for 0.03% patients is higher than 20%. Patients with high fracture risk are of advanced age, female, with lower body weight and height values, lower bone mineral density (BMD) and T score values than patients who are not under a high fracture risk. A positive family anamnesis to osteoporosis and fractures, earlier fractures, smoking, rheumatoid arthritis, and use of glucocorticoids are risk factors that are more represented in patients with high fracture risk and osteoporosis. The impact of the majority of individual risk factors for osteoporosis and fracture is moderate, and their joint effect is significant. The contribution of individual risk factors to the overall 10-year fracture risk depends on the type, number and association of risk factors. Conclusion This research is a contribution to the resolution of polemics among authors, i.e. a dilemma whether persons with multiple clinical risk factors for osteoporosis with T score values beyond the defined threshold for osteoporosis are candidates for therapy with bisphosphonates, and a dilemma whether persons without any clinical risk factors for osteoporosis with T score values within the defined osteoporosis threshold require therapy with bisphosphonates, or only monitoring is sufficient.
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Affiliation(s)
- Esad Alibasic
- Department of Family Medicine, Primary Health Care Center Kalesija, Kalesija, Bosnia and Herzegovina
| | - Farid Ljuca
- Department of Physiology, Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina
| | - Selmira Brkic
- Department of Pathophysiology, Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina
| | - Mirsad Fazlic
- Department of Radiotherapy, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland
| | - Damir Husic
- Healthcare Institution "Your Health" Clinic Tuzla, Tuzla, Bosnia and Herzegovina
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12
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Jin H, Shao Z, Wang Q, Miao J, Bai X, Liu Q, Qiu H, Wang C, Zhang Z, Jennifer T, Wang X, Xu J. Sclareol prevents ovariectomy-induced bone loss in vivo and inhibits osteoclastogenesis in vitro via suppressing NF-κB and MAPK/ERK signaling pathways. Food Funct 2020; 10:6556-6567. [PMID: 31549110 DOI: 10.1039/c9fo00206e] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Postmenopausal osteoporosis (PMO) is a progressive disease occurring in elderly postmenopausal women that is characterized by low bone mass and impaired bone quality. Sclareol is a natural product (initially isolated from the leaves and flowers of Salvia Sclarea) that possesses immune-regulation and anti-inflammatory effects, but its role in osteoclastic formation and function as well as the PMO remains unknown. In the current study, we investigated the inhibitory effect of sclareol on osteoclastogenesis and progression of PMO. In vitro, sclareol not only inhibited osteoclast formation but also suppressed osteoclast function. The expression of the receptor activator of NF-κB ligand (RANKL)-induced osteoclast marker gene and protein was also reduced by sclareol treatment. Mechanistically, we found that sclareol inhibits RANKL-induced NF-κB and MAPK/ERK pathway activation. Furthermore, sclareol exerted a protective effect against bone loss in an ovariectomy-induced mouse model. Taken together, our findings suggest that sclareol has potential value as a therapeutic agent for PMO.
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Affiliation(s)
- Haiming Jin
- Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical Universtiy, Wenzhou, China.
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13
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Faber J, Bech A, van Bentum P, Gisolf J, Hassing RJ, de Boer H. Long-Term Impact of Calcium and Vitamin D Supplementation on Bone Density in HIV + Patients with Documented Deficiencies. AIDS Res Hum Retroviruses 2020; 36:58-64. [PMID: 31523978 DOI: 10.1089/aid.2019.0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To assess the efficacy of long-term calcium and vitamin D treatment on bone mineral density (BMD) in HIV+ patients on combined antiretroviral therapy (cART). A retrospective, single-center cohort study. Between March 2010 and July 2012, 268 HIV+ patients were screened for vitamin D and calcium deficiency. Those with proven vitamin D or calcium deficiency received supplementation according to a predefined protocol, and were offered further evaluation of BMD by dual-energy X-ray absorptiometry (DEXA). Calcium and vitamin D status and BMD were assessed at baseline (T0) and approximately one (T1) and 4-6 years (T2) later. Percentual change in BMD of the lumbar spine and hip was compared with reported rates of change in HIV+ patients on cART without standard calcium and vitamin D treatment. The prevalence of vitamin D deficiency and calcium deficiency was 46% and 43%, respectively. Thirteen percent of patients had secondary hyperparathyroidism at baseline. DEXA performed in patients with a deficiency revealed osteopenia in 40% and osteoporosis in 8% of patients. The expected long-term change in lumbar spine and hip BMDs at T2 was -0.7%, -1.5%, and -1.5%, respectively. The measured changes were +2.3%, -0.6%, and -0.6%, respectively. The difference between measured and expected rate of change was significant for the lumbar spine (3.0%, p < .05), but not for the hip. Long-term vitamin D and calcium supplementation improves lumbar spine BMD of HIV+ patients with osteopenia or osteoporosis and with proven calcium and/or vitamin D deficiencies. Screening and treatment are recommended to become part of regular care.
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Affiliation(s)
- Jasmijn Faber
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Anneke Bech
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Petra van Bentum
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Jet Gisolf
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Robert-Jan Hassing
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Hans de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
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14
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Yao S, Lin X, Xu Y, Chen Y, Qiu P, Shao C, Jin B, Mu Z, Sommerdijk NAJM, Tang R. Osteoporotic Bone Recovery by a Highly Bone-Inductive Calcium Phosphate Polymer-Induced Liquid-Precursor. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1900683. [PMID: 31592093 PMCID: PMC6774089 DOI: 10.1002/advs.201900683] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/28/2019] [Indexed: 05/17/2023]
Abstract
Osteoporosis is an incurable chronic disease characterized by a lack of mineral mass in the bones. Here, the full recovery of osteoporotic bone is achieved by using a calcium phosphate polymer-induced liquid-precursor (CaP-PILP). This free-flowing CaP-PILP material displays excellent bone inductivity and is able to readily penetrate into collagen fibrils and form intrafibrillar hydroxyapatite crystals oriented along the c-axis. This ability is attributed to the microstructure of the material, which consists of homogeneously distributed ultrasmall (≈1 nm) amorphous calcium phosphate clusters. In vitro study shows the strong affinity of CaP-PILP to osteoporotic bone, which can be uniformly distributed throughout the bone tissue to significantly increase the bone density. In vivo experiments show that the repaired bones exhibit satisfactory mechanical performance comparable with normal ones, following a promising treatment of osteoporosis by using CaP-PILP. The discovery provides insight into the structure and property of biological nanocluster materials and their potential for hard tissue repair.
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Affiliation(s)
- Shasha Yao
- Center for Biomaterials and BiopathwaysDepartment of ChemistryZhejiang UniversityHangzhouZhejiang310027China
| | - Xianfeng Lin
- Department of Orthopaedic SurgerySir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310016China
- Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang ProvinceHangzhouZhejiang310016China
| | - Yifei Xu
- Laboratory of Materials and Interface Chemistry and Center for Multiscale Electron MicroscopyDepartment of Chemical Engineering and ChemistryEindhoven University of Technology, EindhovenPO box 5135600 MBEindhovenThe Netherlands
- Institute for Complex Molecular SystemsEindhoven University of Technology, EindhovenPO box 5135600 MBEindhovenThe Netherlands
| | - Yangwu Chen
- Department of Orthopaedic SurgerySir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310016China
- Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang ProvinceHangzhouZhejiang310016China
- Department of Orthopedic SurgerySecond Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310012China
| | - Pengcheng Qiu
- Department of Orthopaedic SurgerySir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310016China
- Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang ProvinceHangzhouZhejiang310016China
| | - Changyu Shao
- Center for Biomaterials and BiopathwaysDepartment of ChemistryZhejiang UniversityHangzhouZhejiang310027China
| | - Biao Jin
- Center for Biomaterials and BiopathwaysDepartment of ChemistryZhejiang UniversityHangzhouZhejiang310027China
| | - Zhao Mu
- Center for Biomaterials and BiopathwaysDepartment of ChemistryZhejiang UniversityHangzhouZhejiang310027China
| | - Nico A. J. M. Sommerdijk
- Laboratory of Materials and Interface Chemistry and Center for Multiscale Electron MicroscopyDepartment of Chemical Engineering and ChemistryEindhoven University of Technology, EindhovenPO box 5135600 MBEindhovenThe Netherlands
- Institute for Complex Molecular SystemsEindhoven University of Technology, EindhovenPO box 5135600 MBEindhovenThe Netherlands
| | - Ruikang Tang
- Center for Biomaterials and BiopathwaysDepartment of ChemistryZhejiang UniversityHangzhouZhejiang310027China
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15
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De Rui M, Inelmen EM, Pigozzo S, Trevisan C, Manzato E, Sergi G. Dietary strategies for mitigating osteosarcopenia in older adults: a narrative review. Aging Clin Exp Res 2019; 31:897-903. [PMID: 30674008 DOI: 10.1007/s40520-019-01130-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/12/2019] [Indexed: 11/27/2022]
Abstract
The synchronic loss of bone mineral density and decrease in muscle mass, strength, and function defines the scenario of osteosarcopenia, which is associated with an increased risk of falls and fractures in older adults. An important role in preventing muscle and bone loss is played by nutritional factors, in particular the intake of proteins, calcium, magnesium and vitamin D. This review summarizes the available literature concerning the influence of protein intake and supplementation (vitamin D, Ca, Mg, branched-chain amino acids) on the decline of musculoskeletal integrity in healthy older adults. Furthermore, in this paper, we attempted to give some suggestions to build up adequate nutritional and dietary strategies against the age-related loss of muscle and bone mass.
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Affiliation(s)
- Marina De Rui
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy.
| | - Emine Meral Inelmen
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Sabrina Pigozzo
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Caterina Trevisan
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Enzo Manzato
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Giuseppe Sergi
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
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16
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Aoun A, Maalouf J, Fahed M, El Jabbour F. When and How to Diagnose and Treat Vitamin D Deficiency in Adults: A Practical and Clinical Update. J Diet Suppl 2019; 17:336-354. [PMID: 30955384 DOI: 10.1080/19390211.2019.1577935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Vitamin D deficiency is considered a major public health concern. Inadequate sun exposure, limited oral intake, and impaired intestinal absorption are common risk factors for vitamin D deficiency. An increasing amount of research is aimed at answering questions regarding the most convenient test that can assess vitamin D status, the indications for screening, and finally the utility of treatments for vitamin D deficiency. Our review outlines practical strategies to diagnose and treat vitamin D deficiency in adults. This study was undertaken in the PubMed and the Google Scholar databases in April 2018 without limitation as to the publication period. Vitamin D status is determined by measuring the 25-hydroxyvitamin D serum concentration. However, this technique has several limitations. Determining the accurate thresholds for vitamin D deficiency is still a matter of debate. Only individuals at risk for vitamin D deficiency should be screened. The symptoms of vitamin D deficiency are unspecific and very common. Therefore, physicians may easily suspect vitamin D deficiency, measure 25-hydroxyvitamin D levels, and sometimes overprescribe supplementation. Hypovitaminosis D could rarely be treated by increasing consumption of foods naturally containing and fortified with vitamin D. Special attention should be given to vitamin D supplementation to prevent adverse effects. No safe and well-defined threshold of ultraviolet exposure allows adequate vitamin D synthesis without increasing the risk of skin cancer. Unanimous and decisive guidelines are urgently needed to improve knowledge and practices related to vitamin D deficiency.
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Affiliation(s)
- Antoine Aoun
- Notre Dame University-Louaize, Zouk Mosbeh, Lebanon
| | | | - Myriam Fahed
- Notre Dame University-Louaize, Zouk Mosbeh, Lebanon
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17
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Pereda CA, Nishishinya MB, Roldan EJA. 25-Hydroxyvitamin D serum levels in rheumatic female patients in southeast Spain: The paradigm of daily optimal sunshine levels and inadequate vitamin D status. ENDOCRINOL DIAB NUTR 2019; 66:181-187. [PMID: 30541681 DOI: 10.1016/j.endinu.2018.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/19/2018] [Accepted: 08/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Almeria is a region in southeast Spain with optimal sunlight levels, along with low pluvial and pollution rates. If exposure to sunlight is sufficient to maintain adequate levels of vitamin D (25OHD), this population should display high serum levels. OBJECTIVES To describe 25OHD serum status in women from Almeria and evaluate the impact of long sunlight exposure along the seasons on 25OHD. METHODS Cross-sectional study, performed in women consecutively recruited from an outpatient rheumatology clinic. Serum levels of 25OHD were assessed in all patients and evaluated according to age (<48 yrs, 48-53 yrs, 54-60 yrs and >60 yrs), season, and presence or absence of menopause. Clinical and laboratory variables that could affect status of vitamin D were also considered. RESULTS The sample included 319 Caucasian female patients. Mean 25OHD were 30.2ng/ml with 195 (61.1%) exhibiting 25OHD inadequate serum levels. Season had a significant effect on 25OHD levels, with autumn being the season in which 25OHD serum levels remained well above 30ng/ml in all age bands, and winter the season with more levels of insufficiency. Menopause did not modify 25OH serum levels. Women whose age was below 48 and over 60 had inadequate levels of 25OHD during summer. CONCLUSIONS Optimal levels of sunlight could not overcome the problem of inadequate 25OHD serum levels, particularly in elderly and young female population. Vitamin D supplementation may be recommended predominantly in winter and summer in this population.
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Affiliation(s)
| | - María Betina Nishishinya
- Instituto Traumatológico Quirón, Barcelona, Spain; MD Programme in Education and Sport Sciences, Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Barcelona, Spain
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18
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Dixit V, Tripathi RL, Dhanwal DK. All 25-hydroxyvitamin D-deficient Indian postmenopausal women do not have secondary hyperparathyroidism. Arch Osteoporos 2018; 13:62. [PMID: 29806069 DOI: 10.1007/s11657-018-0465-1] [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: 03/27/2017] [Accepted: 07/27/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study shows a high 25-hydroxyvitamin D deficiency among postmenopausal women accompanying secondary hyperparathyroidism. However, a sizable number of subjects did not have secondary hyperparathyroidism despite having low 25-hydroxyvitamin D levels. This condition arises a research question in clinical practice needed to be addressed in the future. PURPOSE The present study was attempted to determine the prevalence of secondary hyperparathyroidism and also to analyze the mean value (cutoff) of 25-hydroxyvitamin D from where the PTH begins to rise in Indian postmenopausal women. METHODS A cross-sectional study including 334 postmenopausal women attending the outpatient department (MOPD) of Lok Nayak Hospital, New Delhi, between July 2008 and June 2010. Institutional ethical approval was obtained for this study. The apparently healthy postmenopausal women and attendees of the patients were included in the study. Post-thyroidectomy, thyroid illness, pregnant women, subjects taking drugs that can affect bone mineral metabolism, such as glucocorticoids, antitubercular therapy, antiepileptic, and 25-hydroxyvitamin D supplement were excluded from the study. BMD parameters such as PTH and 25(OH)D were measured by using commercial kits from DiaSorin, USA, and blood chemistry was evaluated by standard methods from the central facility of the center. Dietary calcium was analyzed by applying a food frequency questionnaire by a trained dietician. RESULTS Mean (SD) age of the subjects was 56.4 ± 7.7 years. The mean BMI was 24.7 ± 5.5 kg/m2. The baseline biochemical investigations such as total bilirubin, liver function test (LFT), kidney function test (KFT), calcium, phosphorous, total protein, and serum albumin were in reference range except alkaline phosphatase (ALP). The mean values of 25(OH)D and PTH were 12.95 ± 8.08 ng/ml and 91.60 ± 75.56 pg/ml respectively. The 24-h dietary calcium intake was 487.06 ± 239.36 mg/24 h. 25-hydroxyvitamin D deficiency was found in 277 subjects (82.93%) and was inversely related to PTH. Forty-three subjects had 25-hydroxyvitamin D levels between 20 and 29 ng/ml (12.87%), and only 14 subjects (4.19%) had optimum 25-hydroxyvitamin D levels. Secondary hyperparathyroidism was found in 235 (70.35%) subjects; however, it was not found in 30%. CONCLUSIONS Majority of postmenopausal women of India had 25-hydroxyvitamin D deficiency with raised PTH levels. The cutoff point of 25-hydroxyvitamin D at which PTH began to rise was found at 25 ng/ml which seems similar to that of the Caucasians.
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Affiliation(s)
- Vivek Dixit
- Department of Medicine, Division of Endocrinology and Metabolism, Maulana Azad Medical College, New Delhi, India
| | - R L Tripathi
- Department of Biochemistry, University College of Medical Sciences, New Delhi, India
| | - Dinesh Kumar Dhanwal
- Department of Medicine, Division of Endocrinology and Metabolism, Maulana Azad Medical College, New Delhi, India.
- NMC Specialty Hospital, Abu Dhabi, United Arab Emirates.
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19
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He A, Wang W, Prakash NT, Tinkov AA, Skalny AV, Wen Y, Hao J, Guo X, Zhang F. Integrating genome-wide association study summaries and element-gene interaction datasets identified multiple associations between elements and complex diseases. Genet Epidemiol 2017; 42:168-173. [PMID: 29265413 DOI: 10.1002/gepi.22106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 12/17/2022]
Abstract
Chemical elements are closely related to human health. Extensive genomic profile data of complex diseases offer us a good opportunity to systemically investigate the relationships between elements and complex diseases/traits. In this study, we applied gene set enrichment analysis (GSEA) approach to detect the associations between elements and complex diseases/traits though integrating element-gene interaction datasets and genome-wide association study (GWAS) data of complex diseases/traits. To illustrate the performance of GSEA, the element-gene interaction datasets of 24 elements were extracted from the comparative toxicogenomics database (CTD). GWAS summary datasets of 24 complex diseases or traits were downloaded from the dbGaP or GEFOS websites. We observed significant associations between 7 elements and 13 complex diseases or traits (all false discovery rate (FDR) < 0.05), including reported relationships such as aluminum vs. Alzheimer's disease (FDR = 0.042), calcium vs. bone mineral density (FDR = 0.031), magnesium vs. systemic lupus erythematosus (FDR = 0.012) as well as novel associations, such as nickel vs. hypertriglyceridemia (FDR = 0.002) and bipolar disorder (FDR = 0.027). Our study results are consistent with previous biological studies, supporting the good performance of GSEA. Our analyzing results based on GSEA framework provide novel clues for discovering causal relationships between elements and complex diseases.
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Affiliation(s)
- Awen He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Wenyu Wang
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | | | - Alexey A Tinkov
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.,Yaroslavl State University, Yaroslavl, Russia
| | - Anatoly V Skalny
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.,Yaroslavl State University, Yaroslavl, Russia.,Orenburg State University, Orenburg, Russia.,Trace Element Institute for UNESCO, Lyon, France
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Jingcan Hao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
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20
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Lee YK, Chang JS, Min YK, Byun DW, Park Y, Ha YC. Low calcium and vitamin D intake in Korean women over 50 years of age. J Bone Miner Metab 2017; 35:522-528. [PMID: 27683158 DOI: 10.1007/s00774-016-0782-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/29/2016] [Indexed: 12/01/2022]
Abstract
Inadequate calcium and vitamin D intake is a possible risk factor of osteoporosis. Our purposes were to estimate calcium and vitamin D intake in Korean women, and to determine associated risk factors for low calcium and vitamin D intake. This is a multicenter, hospital-based, and cross-sectional study on osteoporosis. In this study, 1516 women of 50 years or older were involved. Dietary calcium and vitamin D intake were evaluated using the self-reporting KCAT questionnaire. Average daily calcium intake was 662.8 ± 473.8 mg, and vitamin D intake 9.5 ± 10.7 μg. In multivariate analysis, older age (OR 1.02, 95 % CI 1.00-1.04, p = 0.001), and rural residence (OR 2.43, 95 % CI 1.34-4.43, p = 0.004) were significant risk factors for lower calcium intake, and older age (OR 1.03, 95 % CI 1.02-1.04, p < 0.001), and rural residence (OR 1.85, 95 % CI 1.10-3.11, p < 0.001) were significant risk factors for lower vitamin D intake. About 70 % of women aged 50 years or older had calcium and vitamin D intake below the recommended dietary intake. Older age and rural residence were significant risk factors for lower calcium and vitamin D intake in Korean women.
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Affiliation(s)
- Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Suk Chang
- Department of Orthopaedic Surgery, Asan Medical Center, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Won Byun
- Department of Endocrinology, Soon Chun Hyang University Hospital, Seoul, Korea
| | - Yongsoon Park
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-ku, Seoul, 156-755, South Korea.
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Curneen JMG, Casey M, Laird E. The relationship between protein quantity, BMD and fractures in older adults. Ir J Med Sci 2017; 187:111-121. [PMID: 28674746 DOI: 10.1007/s11845-017-1642-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/26/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previously, no large-scale literature reviews have focussed on the relationship between dietary protein and its impact on bone mineral density (BMD) and fracture risk-as measures of bone health-in older adults and its potential impact as a primary prevention tool. AIMS The aim of this study was to assess the impact of varying dietary protein levels on bone health. METHODS A literature review of trials concerning older adults' (>50 years of age) and animals' varying protein intake in the diet and its effect on BMD (human and animal) and fracture risk (human only) was carried out. Additionally, a review of dietary assessment tools used in these studies was also analysed. RESULTS Ten out of fourteen trials assessing BMD and dietary protein quantity in humans and 3/4 in animal trials found a positive relationship between these two parameters. Four out of seven trials investigating the relationship between dietary protein quantity and fracture risk displayed a positive, protective effect of dietary protein levels on fracture risk. Sixty-two percent of studies used the Food-Frequency Questionnaire assessment method. DISCUSSION Increased protein intake in the diet is beneficial to bone health and reduces morbidity and mortality. The importance of using dietary protein, along with calcium and vitamin D, as a primary preventative strategy should be stressed, given the health and cost benefits that this would deliver, with a possible need for a higher level of protein in the diet of an elderly person than what is currently recommended.
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Affiliation(s)
- J M G Curneen
- University College Dublin, Belfield, Dublin 4, County Dublin, Ireland.
| | - M Casey
- Department of Geriatric Medicine, St James' Hospital, James' Street, Dublin 8, County Dublin, Ireland.
| | - E Laird
- Trinity College School of Biochemistry and Immunology, St James' Hospital, James' Street, Dublin 8, County Dublin, Ireland
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22
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Hiligsmann M, Burlet N, Fardellone P, Al-Daghri N, Reginster JY. Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France. Osteoporos Int 2017; 28:833-840. [PMID: 27757506 PMCID: PMC5306172 DOI: 10.1007/s00198-016-3786-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/22/2016] [Indexed: 11/24/2022]
Abstract
UNLABELLED The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years. INTRODUCTION This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years. METHODS We estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60-69, 70-79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case. RESULTS The total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years. CONCLUSION Vitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years.
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Affiliation(s)
- M Hiligsmann
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - N Burlet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - P Fardellone
- Department of Rheumatology, Centre Hospitalier Universitaire d'Amiens, INSERM U1088, Amiens, France
| | - N Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - J-Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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Sriring P, Kanjanarach T. Brief communication (Original). Development and validation of a scale for “attitudes towards calcium consumption”. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0806.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Attitude is recognized as a key determinant of health-related behaviors, including calcium intake for prevention of osteoporosis. Most existing instruments that measure attitudes towards calcium consumption are not appropriate for use in the Thai population because they focus on attitudes towards the consumption of dairy products, which are not a common source of calcium for Thais.
Objectives: To develop and validate an instrument for measuring attitudes towards calcium consumption among Thai adults.
Methods: An initial attitudinal scale (25 items) was developed and administered to 250 Thais (age ≥20 years) living in Khon Kaen, the largest province in the northeast Thailand, to assess its dimensions using exploratory factor analysis. Three factors were identified. The scale was reduced to 15 items and administered to 733 subjects to validate the identified factor structure and optimize the length of the scale.
Results: A three-factor model (10 items) was validated and interpreted as (1) a negative effect of calcium consumption on the body (4 items, reliability = 0.90), (2) the health benefits of calcium consumption for the body (3 items, reliability = 0.78), and (3) the need to take calcium on a regular basis (3 items, reliability = 0.86). The model fitted the data well (relative χ2 = 1.43, adjusted goodness-of-fit index = 0.98, confirmatory fit index = 0.997, root mean square error of approximation = 0.024).
Conclusion: The developed scale is a reliable and useful instrument for measuring attitudes towards calcium consumption. Further research is needed to validate the scale in different populations.
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Affiliation(s)
- Pennapa Sriring
- Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand
- Sirindhorn College of Public Health, Khon Kaen 40000, Thailand
| | - Tipaporn Kanjanarach
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand Thailand
- Center of Research and Development in Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand
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Abstract
PURPOSE Dairy products are rich in nutrients that positively influence bone health and hence fracture risk, and have therefore been recommended and used for fracture prevention. To help decision makers to efficiently allocate scare resources, it is further important to assess the public health and economic impact of any health intervention. In recent years, several studies have been conducted to estimate the public health and/or economic impact of dairy products but no overview is currently available. This article aims therefore to summarize evidence and review articles that estimated the public health and/or economic impact of vitamin D-fortified dairy products for fracture prevention. METHODS A literature review was conducted using PubMed to identify original studies that assessed the public health and/or economic impact of dairy products (or of calcium/vitamin D supplementation) for fracture prevention up to January 15, 2017. RESULTS Seven articles were identified. Different strategies were used by the authors to model the economic/public health impact of dairy products. The four studies assessing the public health impact of dairy products revealed a substantial benefit in terms of fracture prevented, life years, disability-adjusted life years and/or quality-adjusted life years gained. Studies assessing the cost-effectiveness revealed that the use of dairy products is generally cost-effective in the general population aged above 70 years, and from the age of 60 years in populations at high risk of fractures. CONCLUSION This systematic review suggests that the use of dairy products could substantially reduce the burden of osteoporotic fractures and seem to be an economically beneficial strategy.
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Yoon DS, Lee YK, Ha YC, Kim HY. Inadequate Dietary Calcium and Vitamin D Intake in Patients with Osteoporotic Fracture. J Bone Metab 2016; 23:55-61. [PMID: 27294077 PMCID: PMC4900961 DOI: 10.11005/jbm.2016.23.2.55] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background Inadequate calcium and vitamin D intake is a possible risk factor of osteoporosis. Our purposes were to estimate calcium and vitamin D intake in women with osteoporotic fractures, to determine associated factors for low calcium and vitamin D intake, and to evaluate the effects of calcium and vitamin D intake on bone mineral density (BMD). Methods This is a multicenter, hospital-based, and cross-sectional study involving 277 women with osteoporotic fractures. Dietary calcium and vitamin D intake were evaluated using the Korean Calcium Assessment Tool (KCAT) self-reported questionnaire. BMD was measured by dual energy X-ray absorptiometry (DXA) in the lumbar spine and femoral neck. Results Average daily calcium and vitamin D intake was 503.7±274.7 mg and 7.5±12.6 µg, respectively. Patients with low calcium intake had less family history of osteoporosis and were older. There was a negative correlation between age and calcium intake (r=-0.14; P=0.019). In multivariate analysis, calcium intake showed a positive correlation with BMD of femoral neck (β=0.0005, P=0.021). Conclusions About 80% of patients with osteoporotic fracture had calcium and vitamin D intake below the recommended dietary intake. Low calcium intake was associated with no family history of osteoporosis and older age. Dietary calcium intake showed positive effect on BMD.
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Affiliation(s)
- Dong Sik Yoon
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ha-Young Kim
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
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26
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Bruns J, Werner M, Soyka M. Is vitamin D insufficiency or deficiency related to the development of osteochondritis dissecans? Knee Surg Sports Traumatol Arthrosc 2016; 24:1575-9. [PMID: 25371231 DOI: 10.1007/s00167-014-3413-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 10/27/2014] [Indexed: 01/21/2023]
Abstract
PURPOSE The aetiology of osteochondritis dissecans is still unclear. The aim of this prospective pilot study was to analyse whether vitamin D insufficiency, or deficiency, might be a contributing etiological factor in the development of an OCD lesion. METHODS The serum level of vitamin D3 in 23 consecutive patients (12 male and 11 female) suffering from a stage III, or stages III and IV, OCD lesion (mostly stage III) admitted for surgery was measured. RESULTS The patients' mean age was 31.3 years and most of them already exhibited closed epiphyseal plates. In the majority of patients (18/23), a distinct vitamin D3 deficiency was found, two patients were vitamin D3-insufficient and, in three patients, the vitamin D3 level reached the lowest normal value. CONCLUSION These first data show that a vitamin D3 deficiency rather than an insufficiency may be involved in the development of OCD lesions. Probably, with a vitamin D3 substitution, the development of an advanced OCD stage could be avoided. Further analyses, including morphological analyses regarding a possible osteomalacia, and examination of the PTH and other determinants of the bone metabolism, should be undertaken to either confirm or refute these data. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Juergen Bruns
- Department of Orthopaedic Surgery, Agaplesion Diakonieklinikum, Hohe Weide 17, 20259, Hamburg, Germany.
| | - Mathias Werner
- Department of Pathology, HELIOS Klinikum Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany
| | - Matthias Soyka
- "Activion"Medizinisches Versorgungszentrum, Alte Holstenstrasse 2, 21031, Hamburg, Germany
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Abbassy MA, Watari I, Bakry AS, Ono T, Hassan AH. Calcitonin and vitamin D3 have high therapeutic potential for improving diabetic mandibular growth. Int J Oral Sci 2016; 8:39-44. [PMID: 27025264 PMCID: PMC4822182 DOI: 10.1038/ijos.2015.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 11/25/2022] Open
Abstract
The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent (calcitonin) and an anabolic agent (vitamin D3) on treating the detrimental effects of Type 1 diabetes mellitus (DM) on mandibular bone formation and growth. Forty 3-week-old male Wistar rats were divided into four groups: the control group (normal rats), the control C+D group (normal rats injected with calcitonin and vitamin D3), the diabetic C+D group (diabetic rats injected with calcitonin and vitamin D3) and the diabetic group (uncontrolled diabetic rats). An experimental DM condition was induced in the male Wistar rats in the diabetic and diabetic C+D groups using a single dose of 60 mg·kg−1 body weight of streptozotocin. Calcitonin and vitamin D3 were simultaneously injected in the rats of the control C+D and diabetic C+D groups. All rats were killed after 4 weeks, and the right mandibles were evaluated by micro-computed tomography and histomorphometric analysis. Diabetic rats showed a significant deterioration in bone quality and bone formation (diabetic group). By contrast, with the injection of calcitonin and vitamin D3, both bone parameters and bone formation significantly improved (diabetic C+D group) (P < 0.05). These findings suggest that these two hormones might potentially improve various bone properties.
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Affiliation(s)
- Mona A Abbassy
- Orthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orofacial Development and Function, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,Alexandria University, Alexandria, Egypt
| | - Ippei Watari
- Department of Orofacial Development and Function, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ahmed S Bakry
- Conservative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical & Dental University, Tokyo, Japan.,Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Takashi Ono
- Department of Orofacial Development and Function, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ali H Hassan
- Orthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Blair MW, Wu X, Bhandari D, Astudillo C. Genetic Dissection of ICP-Detected Nutrient Accumulation in the Whole Seed of Common Bean (Phaseolus vulgaris L.). FRONTIERS IN PLANT SCIENCE 2016; 7:219. [PMID: 27014282 PMCID: PMC4782139 DOI: 10.3389/fpls.2016.00219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 02/08/2016] [Indexed: 05/19/2023]
Abstract
Nutrient transport to grain legume seeds is not well studied and can benefit from modern methods of elemental analysis including spectroscopic techniques. Some cations such as potassium (K) and magnesium (Mg) are needed for plant physiological purposes. Meanwhile, some minerals such as copper (Cu), iron (Fe), molybdenum (Mo), and zinc (Zn) are important micronutrients. Phosphorus (P) is rich in legumes, while sulfur (S) concentration is related to essential amino acids. In this research, the goal was to analyze a genetic mapping population of common bean (Phaseolus vulgaris L.) with inductively coupled plasma (ICP) spectrophotometry to determine concentrations of and to discover quantitative trait loci (QTL) for 15 elements in ground flour of whole seeds. The population was grown in randomized complete block design experiments that had been used before to analyze Fe and Zn. A total of 21 QTL were identified for nine additional elements, of which four QTL were found for Cu followed by three each for Mg, Mn, and P. Fewer QTL were found for K, Na and S. Boron (B) and calcium (Ca) had only one QTL each. The utility of the QTL for breeding adaptation to element deficient soils and association with previously discovered nutritional loci are discussed.
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Affiliation(s)
- Matthew Wohlgemuth Blair
- Department of Agricultural and Environmental Sciences, Tennessee State University, NashvilleTN, USA
- *Correspondence: Matthew Wohlgemuth Blair,
| | - Xingbo Wu
- Department of Agricultural and Environmental Sciences, Tennessee State University, NashvilleTN, USA
| | - Devendra Bhandari
- Department of Agricultural and Environmental Sciences, Tennessee State University, NashvilleTN, USA
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[Evaluation of adherence to treatment with calcium and vitamin D in the elderly in a basic health area]. ACTA ACUST UNITED AC 2015; 31:10-7. [PMID: 26476876 DOI: 10.1016/j.cali.2015.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE The vitamin D deficiency is high in the elderly population. Calcium and vitamin D supplements is a frequently used measure in individuals at risk for falls and/or fractures. However, this practice has achieved a low level of compliance. The aim is to assess the adherence to treatment with calcium and vitamin D in elders with hypovitaminosis D in an urban area of Madrid. PATIENTS AND METHODS Intervention study performed on 438 individuals ≥65years from the 'Peñagrande Cohort' with hypovitaminosis D that were treated with calcium and vitamin D. Adherence at 3 and 12 months was assessed using the Morisky-Green and counting of prescriptions written. RESULTS A total of 413 of the 438 individuals with hypovitaminosis D were analysed (18 patients were not treated because of contraindications, and 7 were considered lost). At 3 and 12 months, 63.9% and 47.2%, respectively, were adherents. After a brief educational intervention, 19.3% of individuals without adherence at 3 months became good compliers when measured at one year. Comorbidity was associated with lower rates of adherence to treatment after one year (46.3% versus 35.2%, P=.027). The main cause of non-adherence to calcium was digestive intolerance, and due to oversights for vitamin D. Concordance between adherence assessed by the Morisky test and counting of prescriptions written was high (Kappa index=69.8%). CONCLUSIONS Non-adherence to chronic treatment with calcium and vitamin D is a relevant problem in elderly. It is important to assess adherence and implement health education strategies in clinical practice.
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Abimanyi-Ochom J, Watts JJ, Borgström F, Nicholson GC, Shore-Lorenti C, Stuart AL, Zhang Y, Iuliano S, Seeman E, Prince R, March L, Cross M, Winzenberg T, Laslett LL, Duque G, Ebeling PR, Sanders KM. Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS). Osteoporos Int 2015; 26:1781-90. [PMID: 25792491 PMCID: PMC4468793 DOI: 10.1007/s00198-015-3088-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/23/2015] [Indexed: 11/28/2022]
Abstract
UNLABELLED We investigated change in health-related quality of life due to fracture in Australian adults aged over 50 years. Fractures reduce quality of life with the loss sustained at least over 12 months. At a population level, the loss was equivalent to 65 days in full health per fracture. PURPOSE We aimed to quantify the change in health-related quality of life (HRQoL) that occurred as a consequence of a fracture using the EQ-5D-3 L questionnaire. METHODS Adults aged ≥50 years with a low to moderate energy fracture were recruited from eight study centres across Australia. This prospective study included an 18-month follow-up of participants recruited within 2 weeks of a fracture (hip, wrist, humerus, vertebral and ankle). Information collected at baseline and 4, 12 and 18 months included characteristics of participants such as income level, education and prior fracture status. At 12 months post-fracture, the cumulative loss of quality of life was estimated using multivariate regression analysis to identify the predictors of HRQoL loss. RESULTS Mean HRQoL for all participants before fracture was 0.86, with wrist fracture having the highest pre-fracture HRQoL (0.90), while vertebral fracture had the lowest (0.80). HRQoL declined to 0.42 in the immediate post-fracture period. Only participants with a wrist, humerus or ankle fracture returned to their pre-fracture HRQoL after 18 months. An increased loss of HRQoL over 12 months was associated with HRQoL prior to the fracture, hospitalisation, education and fracture site. The multiple regression explained 30 % of the variation in the cumulative HRQoL loss at 12 months post-fracture for all fractures. CONCLUSION Low to moderate energy fractures reduce HRQoL, and this loss is sustained for at least 12 months or, in the case of hip and spine fractures, at least 18 months. At a population level, this represents an average loss of 65 days in full health per fragility fracture. This significant burden reinforces the need for cost-effective fracture prevention strategies.
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Affiliation(s)
- J Abimanyi-Ochom
- Deakin Health Economics, Population Health Strategic Research Centre, Deakin University, Burwood, VIC, Australia.
| | - J J Watts
- Deakin Health Economics, Population Health Strategic Research Centre, Deakin University, Burwood, VIC, Australia
| | - F Borgström
- LIME/MMC, Karolinska Institutet, Solna, Sweden
| | - G C Nicholson
- Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia
- Rural Clinical School, The University of Queensland, Toowoomba, QLD, Australia
| | - C Shore-Lorenti
- Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia
| | - A L Stuart
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Y Zhang
- Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - S Iuliano
- Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - E Seeman
- Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - R Prince
- Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - L March
- Institute of Bone and Joint Research, University of Sydney-Royal North Shore Hospital, Sydney, NSW, Australia
| | - M Cross
- Institute of Bone and Joint Research, University of Sydney-Royal North Shore Hospital, Sydney, NSW, Australia
| | - T Winzenberg
- Menzies Research Institute Tasmania, University of Tasmania, Tasmania, TAS, Australia
| | - L L Laslett
- Menzies Research Institute Tasmania, University of Tasmania, Tasmania, TAS, Australia
| | - G Duque
- Ageing Bone Research Program, Sydney Medical School, Nepean Hospital, University of Sydney, Sydney, NSW, Australia
| | - P R Ebeling
- Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - K M Sanders
- Australian Institute of Musculoskeletal Science, Department of Medicine, The University of Melbourne-Western Health, Melbourne, VIC, Australia
- Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia
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31
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Hiligsmann M, Ben Sedrine W, Bruyère O, Evers SM, Rabenda V, Reginster JY. Cost-effectiveness of vitamin D and calcium supplementation in the treatment of elderly women and men with osteoporosis. Eur J Public Health 2014; 25:20-5. [PMID: 25096255 DOI: 10.1093/eurpub/cku119] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The supplementation with vitamin D and calcium has been recommended for elderly, specifically those with increased risk of fractures older than 65 years. This study aims to assess the cost-effectiveness of vitamin D and calcium supplementation in elderly women and men with osteoporosis and therefore to assess if this recommendation is justified in terms of cost-effectiveness. METHODS A validated model for economic evaluations in osteoporosis was used to estimate the cost per quality-adjusted life-year (QALY) gained of vitamin D/calcium supplementation compared with no treatment. The model was populated with cost and epidemiological data from a Belgian health-care perspective. Analyses were conducted in women and men with a diagnosis of osteoporosis (i.e. bone mineral density T-score ≤-2.5). A literature search was conducted to describe the efficacy of vitamin D and calcium in terms of fracture risk reduction. RESULTS The cost per QALY gained of vitamin D/calcium supplementation was estimated at €40 578 and €23 477 in women and men aged 60 years, respectively. These values decreased to €7912 and €10 250 at the age of 70 years and vitamin D and calcium supplementation was cost-saving at the age of 80 years, meaning that treatment cost was less than the costs of treating osteoporotic fractures of the no-treatment group. CONCLUSION This study suggests that vitamin D and calcium supplementation is cost-effective for women and men with osteoporosis aged over 60 years. From an economic perspective, vitamin D and calcium should therefore be administrated in these populations including those also taking other osteoporotic treatments.
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Affiliation(s)
- Mickaël Hiligsmann
- 1 Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, The Netherlands
| | - Wafa Ben Sedrine
- 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Silvia M Evers
- 1 Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, The Netherlands
| | - Véronique Rabenda
- 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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Oh EG, Yoo JY, Lee JE, Hyun SS, Ko IS, Chu SH. Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial. Res Nurs Health 2014; 37:292-301. [PMID: 24976566 DOI: 10.1002/nur.21608] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 11/09/2022]
Abstract
In this randomized controlled trial, we examined the effects of a 3-month therapeutic lifestyle modification (TLM) intervention on knowledge, self-efficacy, and health behaviors related to bone health in postmenopausal women in rural Korea. Forty-one women ages 45 or older were randomly assigned to either the intervention (n = 21) or control (n = 20) group. The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium-vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis.
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Affiliation(s)
- Eui Geum Oh
- Professor, Nursing Policy and Research Institute, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
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Sowa I, Wójciak-Kosior M, Strzemski M, Dresler S, Szwerc W, Blicharski T, Szymczak G, Kocjan R. Biofortification of soy (Glycine max (L.) Merr.) with strontium ions. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:5248-52. [PMID: 24835388 DOI: 10.1021/jf501257r] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Soy (Glycine max (L.) Merr.) is an annual plant cultivated worldwide mostly for food. Moreover, due to its pharmacological properties it is widely used in pharmacy for alleviating the symptoms of osteoporosis. The aim of the present study was to investigate the biofortification of soy treated with various concentrations of strontium. Soy was found to have a strong capacity to absorb Sr(2+) (bioconcentration factor higher than 1). A positive linear correlation (R(2) > 0.98) between the amount of strontium in the growth medium and its content in the plant was also observed. Moreover, at a concentration of 1.5 mM, strontium appeared to be nontoxic and even stimulated plant growth by approximately 19.4% and 22.6% of fresh weight for shoots and roots, respectively. Our research may be useful to obtain vegetable products or herbal preparations containing both phytoestrogens and strontium to prevent postmenopausal osteoporosis.
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Affiliation(s)
- Ireneusz Sowa
- Department of Analytical Chemistry, Medical University of Lublin , Chodźki 4a, 20-093 Lublin, Poland
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Bruyère O, Slomian J, Beaudart C, Buckinx F, Cavalier E, Gillain S, Petermans J, Reginster JY. Prevalence of vitamin D inadequacy in European women aged over 80 years. Arch Gerontol Geriatr 2014; 59:78-82. [PMID: 24784761 DOI: 10.1016/j.archger.2014.03.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/28/2014] [Accepted: 03/29/2014] [Indexed: 11/28/2022]
Abstract
Inadequate vitamin D status is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate vitamin D status in European women aged over 80 years. Assessments of serum 25-hydroxyvitamin D levels (25(OH)D) were performed on 8532 European women with osteoporosis or osteopenia of which 1984 were aged over 80 years. European countries included in the study were: France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed: <75 nmol/L (30 ng/ml) and <50 nmol/L (20 ng/ml). Mean (SD) age of the patients was 83.4 (2.9) years, body mass index was 25.0 (4.0) kg/m(2) and level of 25(OH)D was 53.3 (26.7) nmol/L (21.4 [10.7] ng/ml). There was a highly significant difference of 25(OH)D level across European countries (p<0.0001). In these women aged over 80 years, the prevalence of 25(OH)D inadequacy was 80.9% and 44.5% when considering cut-offs of 75 and 50 nmol/L, respectively. In the 397 (20.0%) patients taking supplemental vitamin D with or without supplemental calcium, the mean serum 25(OH)D level was significantly higher than in the other patients (65.2 (29.2) nmol/L vs. 50.3 (25.2) nmol/L; P<0.001). This study indicates a high prevalence of vitamin D (25(OH)D) inadequacy in old European women. The prevalence could be even higher in some particular countries.
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Affiliation(s)
- Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium.
| | - Justine Slomian
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium
| | - Fanny Buckinx
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Bât B35, 4000 Liège, Belgium
| | - Sophie Gillain
- Geriatric Department, CHU Sart-Tilman, Bât B35, 4000 Liège, Belgium
| | - Jean Petermans
- Geriatric Department, CHU Sart-Tilman, Bât B35, 4000 Liège, Belgium
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium
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Rizzoli R, Dawson-Hughes B, Kaufman JM, Fardellone P, Brandi ML, Vellas B, Collette J, Reginster JY. Correction of vitamin D insufficiency with combined strontium ranelate and vitamin D3 in osteoporotic patients. Eur J Endocrinol 2014; 170:441-50. [PMID: 24322182 DOI: 10.1530/eje-13-0775] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aims to investigate the efficacy and safety of oral fixed-dose combination of strontium ranelate 2 g/vitamin D₃ 1000 IU daily vs strontium ranelate 2 g daily for correcting vitamin D insufficiency in osteoporosis. DESIGN A 6-month international, randomized, double-blind, parallel-group, phase 3 study. METHODS A total of 518 men and postmenopausal women aged ≥50 years with primary osteoporosis (T-score ≤-2.5 s.d.) and serum 25-hydroxyvitamin D (25(OH)D) >22.5 nmol/l were included. Patients were allocated to strontium ranelate 2 g/vitamin D₃ 1000 IU daily (n=413) or strontium ranelate 2 g daily (n=105). The participants received calcium 1 g daily. The primary endpoint was serum 25(OH)D at last post-baseline evaluation during 3 months. RESULTS Both groups were comparable at baseline. Mean baseline of 25(OH)D was 44.1 ± 14.6 nmol/l. After 3 months, the percentage of patients with 25(OH)D ≥50 nmol/l was higher with strontium ranelate/vitamin D₃ vs strontium ranelate (84 vs 44%, P<0.001; adjusted between-group odds ratio=6.7; 95% CI, 4.2-10.9). The efficacy of the fixed-dose combination on 25(OH)D was maintained at 6 months (86 vs 40%, P<0.001). Mean 25(OH)D was 65.1 and 49.5 nmol/l, respectively, after 3 months and 66.9 and 45.4 nmol/l after 6 months. Physical performance improved in both groups. Falls were 17 and 20% in the strontium ranelate/vitamin D₃ and strontium ranelate groups respectively. Parathyroid hormone levels were inversely correlated with 25(OH)D. No clinically relevant differences in safety were observed. CONCLUSIONS This study confirms the efficacy and safety of fixed-dose combination of strontium ranelate 2 g/vitamin D₃ 1000 IU for correction of vitamin D insufficiency in osteoporotic patients.
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Affiliation(s)
- R Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Faculty of Medicine, Geneva University Hospitals, CH-1211 Geneva 14, Switzerland
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de Villiers TJ, Pines A, Panay N, Gambacciani M, Archer DF, Baber RJ, Davis SR, Gompel AA, Henderson VW, Langer R, Lobo RA, Plu-Bureau G, Sturdee DW. Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric 2014; 16:316-37. [PMID: 23672656 DOI: 10.3109/13697137.2013.795683] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- T J de Villiers
- MediClinic Panorama and Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa
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Rizzoli R, Abraham C, Brandi ML. Nutrition and bone health: turning knowledge and beliefs into healthy behaviour. Curr Med Res Opin 2014; 30:131-41. [PMID: 24059908 DOI: 10.1185/03007995.2013.847410] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Primary osteoporosis prevention requires healthy behaviours, such as regular physical exercise and adequate dietary intakes of calcium, vitamin D and protein. Calcium and vitamin D can decrease postmenopausal bone loss and prevent fracture risk. However, there is still a high prevalence of calcium and vitamin D insufficiency in women aged 50+ years. Dietary sources of these nutrients are the preferred choice, and dairy products represent a valuable dietary source of calcium due to the high content, high absorptive rate and relatively low cost. Furthermore, dairy products also contain other key nutrients including vitamin D, phosphorus and protein that contribute to bone health. Studies of women's beliefs and behaviours with respect to osteoporosis highlight poor knowledge of the importance of dietary nutrient intakes and low concern regarding bone health. Osteoporosis educational programmes exist to help women change behaviours relevant to bone health. Such programmes can have positive influences on women's knowledge, attitudes, perceived norms, motivation and behaviours. Increased awareness of the consequences of low calcium and vitamin D intakes may promote women's attitudes towards dietary sources, in particular dairy products, and lead to better adherence to health recommendations. Increasing dietary nutrient intakes through educational initiatives should be further developed to aid the prevention of osteoporosis and the efficacy of osteoporosis management.
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Affiliation(s)
- R Rizzoli
- Geneva University Hospitals and Faculty of Medicine , Geneva , Switzerland
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Park Y, Kim SH, Lim YT, Ha YC, Chang JS, Kim IS, Min YK, Chung HY. Validation of a new food frequency questionnaire for assessment of calcium and vitamin d intake in korean women. J Bone Metab 2013; 20:67-74. [PMID: 24524060 PMCID: PMC3910312 DOI: 10.11005/jbm.2013.20.2.67] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 12/22/2022] Open
Abstract
Background Validated simple calcium questionnaires are available to assess the intake of calcium and vitamin D in western countries, but they are not appropriate for Koreans since dairy products are not the major source of calcium and vitamin D in Korea. Thus, the objective of the present study was to develop and validate a simple and easy food frequency questionnaire (FFQ) of calcium and vitamin D for Korean. Methods Two hundred and fifty-six women were asked to complete the validated FFQ used by the Korean National Health and Nutrition Examination Survey (KNHANES) and a newly developed FFQ, the Korean Calcium Assessment Tool (KCAT), which contain the 7 food groups with 24 categories of 45 food items that are consumed frequently by Koreans. Results Calcium intake was not significantly different between the two methods; Pearson's correlation coefficient of 0.98 indicated a positive correlation, and Cohen's kappa coefficient of 0.78 indicated the subjects were correctly classified. Bland-Altman plot also showed that the mean differences of the calcium intake as assessed by the two methods were in high agreement. However, the vitamin D intake assessed by KCAT was significantly higher than that assessed by the FFQ used in KNHANES. The vitamin D intakes as assessed by the two methods were positively correlated but the two methods were in moderate agreement. Conclusions The results suggested that the newly developed KCAT was a valid tool for assessing the calcium intake in Korean women, but it might overestimate the vitamin D intake.
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Affiliation(s)
- Yongsoon Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Sang-Hee Kim
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Yong-Taek Lim
- Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Suk Chang
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - I-Seok Kim
- Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, Korea
| | - Yong-Ki Min
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho-Yeon Chung
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee Hospital at Gangdong, Seoul, Korea
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Rajatanavin R, Chailurkit L, Saetung S, Thakkinstian A, Nimitphong H. The efficacy of calcium supplementation alone in elderly Thai women over a 2-year period: a randomized controlled trial. Osteoporos Int 2013; 24:2871-7. [PMID: 23681085 DOI: 10.1007/s00198-013-2387-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 03/18/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Supplementation with elemental calcium 500 mg/day alone for 2 years is able to decrease bone turnover and is effective in retarding bone loss at lumbar spine and slowing bone loss at femoral neck in elderly Thai women who had low dietary calcium intake. INTRODUCTION Most elderly Thais have a total dietary calcium intake of less than the recommended amount. The aim of the study was to investigate the effect of calcium supplementation on bone mineral density and biochemical indices of bone remodeling in Thai postmenopausal women. METHODS Four hundred and four healthy postmenopausal women 60 years old or older without osteoporosis were recruited and conducted in a randomized, double-blinded, placebo-controlled trial. They were randomly given elementary calcium 500 mg/day or placebo for 2 years. Dietary calcium intake was calculated from the nutrient compositional analysis of the 3-day food records. Serum 25 hydroxyvitamin D was measured by radioimmunoassay and bone turnover markers were determined by electrochemiluminescence immunoassay. RESULTS The age of the subjects was 65.8 ± 4.4 years. All baseline characteristics of the subjects in the calcium-supplemented group and the placebo group were not statistically different. At the end of the study, significant decreases in serum C-terminal telopeptide of type I collagen and serum total procollagen type I amino terminal propeptide in the calcium-supplemented group were observed, while there was no change in the placebo group. In addition, plasma parathyroid hormone decreased, although not significantly, only in the calcium-supplemented group. Percent changes from baseline of lumbar spine (L2-L4) bone mineral density increased 2.76% in the calcium-supplemented group and 0.87% in the placebo group, whereas the percent changes from baseline of femoral neck decreased 0.21% in the calcium-supplemented group and 0.90% in the placebo group. CONCLUSIONS Calcium supplementation is necessary for the decrease of bone turnover and prevention of bone loss in Thai elderly women.
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Affiliation(s)
- R Rajatanavin
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Rama 6 Rd., Rajthevi, Bangkok, 10400, Thailand,
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Risk of Hip Fracture in Community-dwelling and Institutionalized Osteoporotic Patients: A 3-year Study. INT J GERONTOL 2013. [DOI: 10.1016/j.ijge.2012.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 2013; 29:305-13. [PMID: 23320612 DOI: 10.1185/03007995.2013.766162] [Citation(s) in RCA: 229] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Vitamin D insufficiency has deleterious consequences on health outcomes. In elderly or postmenopausal women, it may exacerbate osteoporosis. SCOPE There is currently no clear consensus on definitions of vitamin D insufficiency or minimal targets for vitamin D concentrations and proposed targets vary with the population. In view of the potential confusion for practitioners on when to treat and what to achieve, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) convened a meeting to provide recommendations for clinical practice, to ensure the optimal management of elderly and postmenopausal women with regard to vitamin D supplementation. FINDINGS Vitamin D has both skeletal and extra-skeletal benefits. Patients with serum 25-hydroxyvitamin D (25-(OH)D) levels <50 nmol/L have increased bone turnover, bone loss, and possibly mineralization defects compared with patients with levels >50 nmol/L. Similar relationships have been reported for frailty, nonvertebral and hip fracture, and all-cause mortality, with poorer outcomes at <50 nmol/L. CONCLUSION The ESCEO recommends that 50 nmol/L (i.e. 20 ng/mL) should be the minimal serum 25-(OH)D concentration at the population level and in patients with osteoporosis to ensure optimal bone health. Below this threshold, supplementation is recommended at 800 to 1000 IU/day. Vitamin D supplementation is safe up to 10,000 IU/day (upper limit of safety) resulting in an upper limit of adequacy of 125 nmol/L 25-(OH)D. Daily consumption of calcium- and vitamin-D-fortified food products (e.g. yoghurt or milk) can help improve vitamin D intake. Above the threshold of 50 nmol/L, there is no clear evidence for additional benefits of supplementation. On the other hand, in fragile elderly subjects who are at elevated risk for falls and fracture, the ESCEO recommends a minimal serum 25-(OH)D level of 75 nmol/L (i.e. 30 ng/mL), for the greatest impact on fracture.
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Affiliation(s)
- R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Yu G, Wang L, Li Y, Ma Z, Li Y. Identification of drug candidate for osteoporosis by computational bioinformatics analysis of gene expression profile. Eur J Med Res 2013; 18:5. [PMID: 23448234 PMCID: PMC3599344 DOI: 10.1186/2047-783x-18-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Accepted: 01/31/2013] [Indexed: 11/12/2022] Open
Abstract
Background Osteoporosis is a condition of bones that leads to an increased susceptibility to fracture and consequent painful morbidity. It has become a major issue of life quality worldwide. However, until now, the molecular mechanism of this disease is far from being clear. Methods In this study, we obtained the gene expression profile of osteoporosis and controls from Gene Expression Omnibus and identified differentially expressed genes (DEGs) using classical t-test method. Then, functional enrichment analyses were performed to identify the dysregulated Gene Ontology categories and dysfunctional pathways in osteoporosis patients compared to controls. Besides, the connectivity map was used to identify compounds that induced inverse gene changes to osteoporosis. Results A total of 5581 DEGs were identified. We found these DEGs were enriched in 9 pathways by pathway enrichment analysis, including focal adhesion and MAPK signaling pathway. Besides, sanguinarine was identified as a potential therapeutic drug candidate capable of targeting osteoporosis. Conclusion Although candidate agents identified by our approach may be premature for clinical trials, it is clearly a direction that warrants additional consideration.
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Affiliation(s)
- Guiyong Yu
- Department of Orthopedic, The people's Hospital of Hengshui, No,180 Renmin Street, 053000, Hebei Province, Hengshui, China.
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Reymondier A, Caillet P, Abbas-Chorfa F, Ambrosi V, Jaglal SB, Chapurlat R, Schott AM. MENOPOST--calcium and vitamin D supplementation in postmenopausal osteoporosis treatment: a descriptive cohort study. Osteoporos Int 2013; 24:559-66. [PMID: 22588183 DOI: 10.1007/s00198-012-1999-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 04/04/2012] [Indexed: 10/28/2022]
Abstract
SUMMARY Adequate vitamin D/calcium supplementation during osteoporosis (OP) treatments seems insufficient. This cohort study within a national claims database evaluated calcium/vitamin D co-prescription in postmenopausal women initiating an OP treatment. A high co-prescription rate was observed with three quarters of women supplemented with calcium and/or vitamin D in agreement with current recommendations. INTRODUCTION Adequate calcium/vitamin D supplementation should be taken in combination with antiresorptive drugs in OP treatment. Despite guidelines, supplementation appears to be insufficient. The objective of this study was to describe and estimate co-prescription rates of calcium/vitamin D among postmenopausal women initiating an OP treatment. METHODS All women over 50 years with a first claim for a bisphosphonates, raloxifene, or strontium prescription filled between May and August 2010 were included in a retrospective cohort study. Data source was the health insurance claims database of the Rhône-Alpes area. RESULTS Among 4,415 women, 77.0 % had co-prescription of calcium or vitamin D with initial OP treatment, of which 2,150 (49.7 %) had both calcium and vitamin D. The proportion of women with calcium and/or vitamin D (81.7 %) was significantly higher when OP treatment was a bisphosphonate compared to strontium (70.9 %) or raloxifene (67.0 %) (p < 0.05). Among women prescribed both calcium and vitamin D, 7.6 % received a bisphosphonate and vitamin D ± calcium fixed-combination pack. General practitioners prescribed two thirds of initial supplementation treatment (66.9 %). Patients were twice as likely to be prescribed supplementation when the prescriber was a rheumatologist (OR = 2; 95 % CI = 1.57-2.54). CONCLUSION Three quarters of women initiating OP treatment were supplemented with calcium and/or vitamin D in agreement with current recommendations. This represents a high co-prescription rate.
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Affiliation(s)
- A Reymondier
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Epidémiologie, Lyon, F69003, France
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Abstract
Nutrition, in sufficient amount and substance, is crucial for healthy growth and development of the skeleton and surrounding tissues, especially in physically active populations. Inadequate nutrition has been linked to maladies such as the female athlete triad, as well as poor training or competitive performance and increased risk of injury. Dietary choices favoring items high in quality protein of animal or plant origin, polyunsaturated fatty acids, fruits and vegetables high in potassium and fiber, and dairy products or other beverages fortified with calcium and vitamin D are essential to athletes to ensure adequate vitamin and mineral availability to the skeleton, which in turn can affect peak physical performance.
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Affiliation(s)
- Caeley Lorincz
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Abstract
OBJECTIVE Evaluate the role of calcium on bone health. METHODS Review of literatures on calcium and bone development during childhood and bone health in adulthood and older age. RESULTS Calcium intake influences skeletal calcium retention during growth and thus affects peak bone mass achieved in early adulthood. Increased calcium intake is associated with increased bone mineral accretion rate up to a threshold level in all ethnic groups. The minimum intake to achieve maximal retention is 1140 mg/day for white boys and 1300 mg/day for white girls. Calcium also plays a role in preventing bone loss and osteoporotic fractures in later life. Meta-analyses report that calcium supplementation reduce bone loss by 0.5-1.2% and the risk of fracture of all types by at least 10% in older people. Low calcium intake is a widespread problem across countries and age groups. CONCLUSION Adequate calcium intake throughout lifetime is important for bone health and the prevention of osteoporosis and related fractures.
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Cooper C, Reginster JY, Cortet B, Diaz-Curiel M, Lorenc RS, Kanis JA, Rizzoli R. Long-term treatment of osteoporosis in postmenopausal women: a review from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF). Curr Med Res Opin 2012; 28:475-91. [PMID: 22356102 DOI: 10.1185/03007995.2012.663750] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Postmenopausal osteoporosis is a chronic disease requiring treatment that balances long-term fracture efficacy against risk. METHODS We reviewed the efficacy and safety of calcium and vitamin D, the selective estrogen receptor modulators (SERMs), the bisphosphonates, denosumab, and strontium ranelate in studies of 3 years or longer. RESULTS Six trials lasted for 5 years, and seven went beyond that. The evidence beyond 5 years is generally weak, mainly due to methodological issues (open-label design, small samples, or absence of placebo control). Although calcium and vitamin D appear to be beneficial, the data are insufficient to evaluate benefits and risk beyond 3 years. The fracture efficacy of SERMs beyond 5 years is not known, though increases in bone mineral density (BMD) appear to be maintained. The SERMs have good long-term safety, including protective effects against breast cancer. The bisphosphonates have established fracture efficacy to 3 years, and 4 or 5 years with alendronate and risedronate. The evidence beyond 5 years indicates sustained increases in BMD. The safety of the bisphosphonates does not appear to be modified with time, with the possible exceptions of atypical subtrochanteric fracture and other events of unknown frequency. Denosumab has been tested up to 5 years, with continued increased in BMD and no reported safety issues. There is evidence for fracture efficacy of strontium ranelate, and sustained increases in BMD over 10 years. Strontium ranelate has good long-term safety. CONCLUSION Robust long-term studies are relatively rare for the osteoporosis treatments, and generally show maintenance of BMD and, for some agents, an additional reduction in fracture incidence.
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Affiliation(s)
- C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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Body JJ, Bergmann P, Boonen S, Boutsen Y, Bruyere O, Devogelaer JP, Goemaere S, Hollevoet N, Kaufman JM, Milisen K, Rozenberg S, Reginster JY. Non-pharmacological management of osteoporosis: a consensus of the Belgian Bone Club. Osteoporos Int 2011; 22:2769-88. [PMID: 21360219 PMCID: PMC3186889 DOI: 10.1007/s00198-011-1545-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 01/05/2011] [Indexed: 02/07/2023]
Abstract
This consensus article reviews the various aspects of the non-pharmacological management of osteoporosis, including the effects of nutriments, physical exercise, lifestyle, fall prevention, and hip protectors. Vertebroplasty is also briefly reviewed. Non-pharmacological management of osteoporosis is a broad concept. It must be viewed as an essential part of the prevention of fractures from childhood through adulthood and the old age. The topic also includes surgical procedures for the treatment of peripheral and vertebral fractures and the post-fracture rehabilitation. The present document is the result of a consensus, based on a systematic review and a critical appraisal of the literature. Diets deficient in calcium, proteins or vitamin D impair skeletal integrity. The effect of other nutriments is less clear, although an excessive consumption of sodium, caffeine, or fibres exerts negative effects on calcium balance. The deleterious effects of tobacco, excessive alcohol consumption and a low BMI are well accepted. Physical activity is of primary importance to reach optimal peak bone mass but, if numerous studies have shown the beneficial effects of various types of exercise on bone mass, fracture data as an endpoint are scanty. Fall prevention strategies are especially efficient in the community setting, but less evidence is available about their effectiveness in preventing fall-related injuries and fractures. The efficacy of hip protectors remains controversial. This is also true for vertebroplasty and kyphoplasty. Several randomized controlled studies had reported a short-term advantage of vertebroplasty over medical treatment for pain relief, but these findings have been questioned by recent sham-controlled randomized clinical studies.
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Affiliation(s)
- J.-J. Body
- Internal Medicine, Institut Jules Bordet, Brussels, Belgium
| | | | - S. Boonen
- Internal Medicine, UZ Leuven, Leuven, Belgium
| | - Y. Boutsen
- Department of Rheumatology, Mont-Godinne University Hospital-Université Catholique de Louvain, Leuven, Belgium
| | - O. Bruyere
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - J.-P. Devogelaer
- Department of Rheumatology, Mont-Godinne University Hospital-Université Catholique de Louvain, Leuven, Belgium
| | - S. Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases (9K12 IE), Ghent University Hospital, Ghent, Belgium
| | | | - J.-M. Kaufman
- Unit for Osteoprosis and Metabolic Bone Disease, Ghent University Hospital, Ghent, Belgium
| | | | - S. Rozenberg
- Department of Gynaecology-Obstetrics, Free University of Brussels, Brussels, Belgium
| | - J.-Y. Reginster
- Bone and Cartilage Metabolism Research Unit, CHU Centre-Ville, Policliniques L. BRULL, Quai Godefroid Kurth 45 (9ème étage), 4020 Liege, Belgium
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Abstract
BACKGROUND Vitamin D is critical for musculoskeletal health and has been implicated in the risk of extraskeletal diseases, including cancer, cardiovascular diseases, and autoimmune diseases, as well as overall mortality. Although numerous studies deal and have dealt with vitamin D deficiency and its consequences, experts cannot agree on the right 25-hydroxyvitamin D levels. This survey aims to shed light on the ongoing vitamin D controversy from different angles. QUESTIONS/PURPOSES We discuss the minimum threshold for the 25-hydroxyvitamin D level to guarantee optimal health, why vitamin is D critical to musculoskeletal and extraskeletal functions, and new evidence for the success of prevention measures such as food fortification. METHODS We searched PubMed, Google Scholar, and reference lists of articles using several keywords. The most recent search was in February 2011. RESULTS While the use of parathyroid hormone as a surrogate measure did not lead to a consensus concerning the required 25-hydroxyvitamin D serum level, the combined analysis of bone mineralization and vitamin D status has established minimum levels of more than 75 nmol/L (30 ng/mL) to guarantee at least skeletal health. An effective measure to approach this status is food fortification, which has been demonstrated by countries such as Canada, the United States, and Finland. CONCLUSIONS Given the health economic implications of failure to maintain a balanced vitamin D status, action is recommended to integrate current scientific knowledge on vitamin D into physicians' treatment of patients and governmental policies on food fortification.
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Sturdee DW, Pines A, Archer DF, Baber RJ, Barlow D, Birkhäuser MH, Brincat M, Cardozo L, de Villiers TJ, Gambacciani M, Gompel AA, Henderson VW, Kluft C, Lobo RA, MacLennan AH, Marsden J, Nappi RE, Panay N, Pickar JH, Robinson D, Simon J, Sitruk-Ware RL, Stevenson JC. Updated IMS recommendations on postmenopausal hormone therapy and preventive strategies for midlife health. Climacteric 2011; 14:302-20. [PMID: 21563996 DOI: 10.3109/13697137.2011.570590] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- D W Sturdee
- International Menopause Society, Wray, Lancaster, UK
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