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Wang T, Xiong K, He Y, Feng B, Guo L, Gu J, Zhang M, Wang H, Wu X. Chronic pancreatitis-associated metabolic bone diseases: epidemiology, mechanisms, and clinical advances. Am J Physiol Endocrinol Metab 2024; 326:E856-E868. [PMID: 38656128 DOI: 10.1152/ajpendo.00113.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
Chronic pancreatitis (CP) is a progressive inflammatory disease with an increasing global prevalence. In recent years, a strong association between CP and metabolic bone diseases (MBDs), especially osteoporosis, has been identified, attracting significant attention in the research field. Epidemiological data suggest a rising trend in the incidence of MBDs among CP patients. Notably, recent studies have highlighted a profound interplay between CP and altered nutritional and immune profiles, offering insights into its linkage with MBDs. At the molecular level, CP introduces a series of biochemical disturbances that compromise bone homeostasis. One critical observation is the disrupted metabolism of vitamin D and vitamin K, both essential micronutrients for maintaining bone integrity, in CP patients. In this review, we provide physio-pathological perspectives on the development and mechanisms of CP-related MBDs. We also outline some of the latest therapeutic strategies for treating patients with CP-associated MBDs, including stem cell transplantation, monoclonal antibodies, and probiotic therapy. In summary, CP-associated MBDs represent a rising medical challenge, involving multiple tissues and organs, complex disease mechanisms, and diverse treatment approaches. More in-depth studies are required to understand the complex interplay between CP and MBDs to facilitate the development of more specific and effective therapeutic approaches.
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Affiliation(s)
- Tianlin Wang
- Department of Emergency, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ke Xiong
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanli He
- Department of General Surgery, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Binbin Feng
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - LinBin Guo
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingliang Gu
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengrui Zhang
- Quantitative Sciences Unit, Department of Medicine, Stanford University, Stanford, California, United States
- Division of Immunology and Rheumatology, Stanford University, Stanford, California, United States
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States
| | - Hong Wang
- Department of General Surgery, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaohao Wu
- Division of Immunology and Rheumatology, Stanford University, Stanford, California, United States
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States
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Nasimi N, Jamshidi S, Askari A, Zolfaghari N, Sadeghi E, Nouri M, Bellissimo N, Faghih S. Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis. Br J Nutr 2024; 131:1473-1487. [PMID: 38221822 DOI: 10.1017/s0007114524000060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Vitamin D is a vital indicator of musculoskeletal health, as it plays an important role through the regulation of bone and mineral metabolism. This meta-analysis was performed to investigate the effects of vitamin D supplementation/fortification on bone turnover markers in women. All human randomised clinical trials reported changes in bone resorption markers (serum C-terminal telopeptide of type-I collagen (sCTX) and urinary type I collagen cross-linked N-telopeptide (uNTX)) or bone formation factors (osteocalcin (OC), bone alkaline phosphatase (BALP) and procollagen type-1 intact N-terminal propeptide (P1NP)) following vitamin D administration in women (aged ≥ 18 years) were considered. Mean differences (MD) and their respective 95 % CI were calculated based on fixed or random effects models according to the heterogeneity status. Subgroup analyses, meta-regression models, sensitivity analysis, risk of bias, publication bias and the quality of the included studies were also evaluated. We found that vitamin D supplementation had considerable effect on sCTX (MD: -0·038, n 22) and OC (MD: -0·610, n 24) with high heterogeneity and uNTX (MD: -8·188, n 6) without heterogeneity. Our results showed that age, sample size, dose, duration, baseline vitamin D level, study region and quality of studies might be sources of heterogeneity in this meta-analysis. Subgroup analysis also revealed significant reductions in P1NP level in dose less than 600 μg/d and larger study sample size (>100 participants). Moreover, no significant change was found in BALP level. Vitamin D supplementation/fortification significantly reduced bone resorption markers in women. However, results were inconsistent for bone formation markers.
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Affiliation(s)
- Nasrin Nasimi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Aida Askari
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nazanin Zolfaghari
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nick Bellissimo
- Toronto Metropolitan University, School of Nutrition, Toronto, ONM5B-2K3, USA
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Xiong A, Li H, Lin M, Xu F, Xia X, Dai D, Sun R, Ling Y, Qiu L, Wang R, Ding Y, Xie Z. Effects of active vitamin D analogues on muscle strength and falls in elderly people: an updated meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1327623. [PMID: 38362274 PMCID: PMC10867111 DOI: 10.3389/fendo.2024.1327623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024] Open
Abstract
Background Elderly people are at high risk of falls due to decreased muscle strength. So far, there is currently no officially approved medication for treating muscle strength loss. The active vitamin D analogues are promising but inconsistent results have been reported in previous studies. The present study was to meta-analyze the effect of active vitamin D analogues on muscle strength and falls in elderly people. Methods The protocol was registered with PROSPERO (record number: CRD42021266978). We searched two databases including PubMed and Cochrane Library up until August 2023. Risk ratio (RR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI) were used to assess the effects of active vitamin D analogues on muscle strength or falls. Results Regarding the effects of calcitriol (n= 1), alfacalcidol (n= 1) and eldecalcitol (n= 1) on falls, all included randomized controlled trials (RCT) recruited 771 participants. Regarding the effects of the effects of calcitriol (n= 4), alfacalcidol (n= 3) and eldecalcitol (n= 3) on muscle strength, all included RCTs recruited 2431 participants. The results showed that in the pooled analysis of three active vitamin D analogues, active vitamin D analogues reduced the risk of fall by 19%. Due to a lack of sufficient data, no separate subgroup analysis was conducted on the effect of each active vitamin D analogue on falls. In the pooled and separate analysis of active vitamin D analogues, no significant effects were found on global muscle, hand grip, and back extensor strength. However, a significant enhancement of quadriceps strength was observed in the pooled analysis and separate analysis of alfacalcidol and eldecalcitol. The separate subgroup analysis on the impact of calcitriol on the quadriceps strength was not performed due to the lack to sufficient data. The results of pooled and separate subgroup analysis of active vitamin D analogues with or without calcium supplementation showed that calcium supplementation did not affect the effect of vitamin D on muscle strength. Conclusions The use of active vitamin D analogues does not improve global muscle, hand grip, and back extensor strength but improves quadriceps strength and reduces risk of falls in elderly population.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Zhongjian Xie
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Mei Z, Hu H, Zou Y, Li D. The role of vitamin D in menopausal women's health. Front Physiol 2023; 14:1211896. [PMID: 37378077 PMCID: PMC10291614 DOI: 10.3389/fphys.2023.1211896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Vitamin D (VD) is known to play an important role in the maintenance of calcium homeostasis and bone metabolism. In recent years, there has also been a growing interest in Vitamin D for health issues beyond the bones. Menopausal women are at risk of reduced bone density and increased risk of fracture due to a decline in estrogen levels. There is also an increased risk of cardiovascular disease, diabetes and hyperlipidaemia due to impaired lipid metabolism. The menopausal and emotional symptoms due to menopause are also increasingly prominent. This article summarizes the role of Vitamin D in menopausal women's health, including the effects of Vitamin D on skeletal muscle, cardiovascular disease, Genitourinary Syndrome of Menopause (GSM), cancer and emotional symptoms. Vitamin D regulates the growth of vaginal epithelial cells and alleviates genitourinary tract problems in menopausal women. Vitamin D also modulates immune function and influences the production of adipokines. Vitamin D and its metabolites also have an anti-proliferative effect on tumour cells. This narrative review, by summarizing recent work on the role of Vitamin D in menopausal women and in animal models of menopause, aims to provide a basis for further development of the role of Vitamin D in the health of menopausal women.
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Affiliation(s)
- Zhaojun Mei
- Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Hong Hu
- Department of Gynaecology, Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Yi Zou
- Department of Nephrology, Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Dandan Li
- School of Basic Medical Sciences, University of Chinese Academy of Sciences, Beijing, China
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Are Skeletal Muscle Changes during Prolonged Space Flights Similar to Those Experienced by Frail and Sarcopenic Older Adults? LIFE (BASEL, SWITZERLAND) 2022; 12:life12122139. [PMID: 36556504 PMCID: PMC9781047 DOI: 10.3390/life12122139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Microgravity exposure causes several physiological and psychosocial alterations that challenge astronauts' health during space flight. Notably, many of these changes are mostly related to physical inactivity influencing different functional systems and organ biology, in particular the musculoskeletal system, dramatically resulting in aging-like phenotypes, such as those occurring in older persons on Earth. In this sense, sarcopenia, a syndrome characterized by the loss in muscle mass and strength due to skeletal muscle unloading, is undoubtedly one of the most critical aging-like adverse effects of microgravity and a prevalent problem in the geriatric population, still awaiting effective countermeasures. Therefore, there is an urgent demand to identify clinically relevant biological markers and to underline molecular mechanisms behind these effects that are still poorly understood. From this perspective, a lesson from Geroscience may help tailor interventions to counteract the adverse effects of microgravity. For instance, decades of studies in the field have demonstrated that in the older people, the clinical picture of sarcopenia remarkably overlaps (from a clinical and biological point of view) with that of frailty, primarily when referred to the physical function domain. Based on this premise, here we provide a deeper understanding of the biological mechanisms of sarcopenia and frailty, which in aging are often considered together, and how these converge with those observed in astronauts after space flight.
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Zhang JL, Poon CCW, Wong MS, Li WX, Guo YX, Zhang Y. Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Endocrinol (Lausanne) 2022; 13:863448. [PMID: 35721712 PMCID: PMC9199366 DOI: 10.3389/fendo.2022.863448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/19/2022] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION In postmenopausal women, vitamin D deficiency (as defined by the circulating level of 25(OH)D being below 20 ng/ml (50 nmol/L)) is a regular occurrence. The effect of vitamin D supplementation on the muscle function of postmenopausal women has been controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) examines and summarizes the effects of vitamin D supplementation on the muscular strength and mobility of postmenopausal women. METHODS RCTs that met the inclusion criteria for this study were identified by searching PubMed, EMBASE, and the Cochrane Library. Postmenopausal women who were included in the study were exposed to RCTs assessing the effectiveness of vitamin D supplements. Meta-analysis data were extracted by two independent reviewers and screened for methodological quality. RCTs that did not meet the minimum requirement for assessment were excluded. In the meta-analysis, the effect size (weighted mean differences, WMD) of handgrip strength (HGS) and timed-up and go test (TUG) with a 95% confidence interval (CI) was obtained to compare reported results across the included RCTs. RESULTS A total of 19 trials were included in this systematic review, among which 13 trials were eligible for the meta-analysis. In the 13 included studies, supplementing with vitamin D produced a weighted mean difference of 0.876 kg (95% CI = 0.180 to 1.571, P = 0.014, I2 = 68.5%) for HGS, a measurement of muscle strength. However, an insignificant decrease of 0.044 s was observed after analyzing the TUG (95% CI = -0.979 to 0.892, P = 0.927, I2 = 95%). According to subgroup analysis, vitamin D supplementation increased HGS in patients over the age of 60 (P = 0.001), in those without calcium supplementation (P = 0.032), and in those whose baseline vitamin D level was greater than 75 nmol/L (30 ng/ml) (P = 0.003). CONCLUSIONS Taking into account the studies in this systematic review, vitamin D supplementation improved muscle strength in postmenopausal women. However, an insignificant result was demonstrated in terms of mobility after vitamin D supplementation.
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Affiliation(s)
- Jia-Li Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Christina Chui-Wa Poon
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Man-Sau Wong
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Wen-Xiong Li
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi-Xun Guo
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Yan Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- *Correspondence: Yan Zhang,
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Interaction of serum calcium and folic acid treatment on first stroke in hypertensive males. Clin Nutr 2021; 40:2381-2388. [DOI: 10.1016/j.clnu.2020.10.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022]
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Bollen SE, Atherton PJ. Myogenic, genomic and non-genomic influences of the vitamin D axis in skeletal muscle. Cell Biochem Funct 2020; 39:48-59. [PMID: 33037688 DOI: 10.1002/cbf.3595] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 12/14/2022]
Abstract
Despite vitamin D-deficiency clinically presenting with myopathy, muscle weakness and atrophy, the mechanisms by which vitamin D exerts its homeostatic effects upon skeletal muscle remain to be fully established. Recent studies have shown that the receptor by which 1α,25-dihydroxyvitamin D3 (1,25[OH]2 D3 ) exerts its biological actions (ie, the vitamin D receptor, VDR) elicits both genomic and non-genomic effects upon skeletal muscle. The controversy surrounding skeletal muscle VDR mRNA/protein expression in post-natal muscle has been allayed by myriad recent studies, while dynamic expression of VDR throughout myogenesis, and association of higher VDR levels during muscle regeneration/immature muscle cells, suggests a role in myogenesis and perhaps an enrichment of VDR in satellite cells. Accordingly, in vitro studies have demonstrated 1,25(OH)2 D3 is anti-proliferative in myoblasts, yet pro-differentiation in latter stages of myogenesis. These effects involve modulation of gene expression (VDR as a transcriptional co-activator controls ~3% of the genome) and post-genomic intracellular signalling for example, via c-Src and alterations to intramuscular calcium homeostasis and proteostasis. The aim of this review is to consider the biomolecular role for the vitamin D/VDR axis in myogenesis, while also exploring global evidence for genomic and non-genomic mechanisms of action for 1,25(OH)2 D3 /VDR.
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Affiliation(s)
- Shelby E Bollen
- 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, Derby, 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, Derby, UK
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Wang Q, Ma A, Schouten EG, Kok FJ. A double burden of tuberculosis and diabetes mellitus and the possible role of vitamin D deficiency. Clin Nutr 2020; 40:350-357. [PMID: 32948348 DOI: 10.1016/j.clnu.2020.08.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 08/07/2020] [Accepted: 08/30/2020] [Indexed: 01/19/2023]
Abstract
Tuberculosis remains a major global health challenge, particularly in low-to-middle income countries such as China. At the same time, the country is facing a rapidly increasing diabetes incidence over the last 10 years. Diabetes aggravates the tuberculosis epidemic which poses a serious challenge in public health. In recent years, the high prevalence of vitamin D deficiency represents a global health problem, which is also associated with the risk of diabetes, and tuberculosis. Therefore, this review aims to provide an overall and updated understanding of the epidemiology of co-occurrence of tuberculosis and diabetes in China, and to elucidate the possible role of vitamin D deficiency. In conclusion, significant aggravation of the tuberculosis epidemic due to diabetes may exist in China for a relatively long period of time to come. Further, the double burden and its implications to public health in this country may be significantly influenced by the high prevalence of vitamin D deficiency. Bidirectional screening for tuberculosis and diabetes is recommended, and extra vitamin D may benefit especially in a situation of a heavy tuberculosis burden combined with prevalent vitamin D deficiency. Longitudinal studies to verify the role of vitamin D deficiency in the double burden, and trials on the effect of vitamin D supplementation are needed in the future.
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Affiliation(s)
- Qiuzhen Wang
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China.
| | - Aiguo Ma
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Evert G Schouten
- Division of Nutrition and Health, Wageningen University&Research, Wageningen, the Netherlands
| | - Frans J Kok
- Division of Nutrition and Health, Wageningen University&Research, Wageningen, the Netherlands
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Sharifan P, Khoshakhlagh M, Khorasanchi Z, Darroudi S, Rezaie M, Safarian M, Vatanparast H, Afshari A, Ferns G, Ghazizadeh H, Ghayour Mobarhan M. Efficacy of low-fat milk and yogurt fortified with encapsulated vitamin D 3 on improvement in symptoms of insomnia and quality of life: Evidence from the SUVINA trial. Food Sci Nutr 2020; 8:4484-4490. [PMID: 32884728 PMCID: PMC7455959 DOI: 10.1002/fsn3.1750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Sleep disorders are a common condition globally. Vitamin D receptors are present on cells in several regions of the brain. It is possible that vitamin D status may affect brain function, including sleep patterns. We aimed to evaluate the 1,500 IU of Nano-encapsulated vitamin D fortified in dairy products on the symptoms of insomnia and associated improvement of quality of life. METHODS A case series was undertaken as part of the Survey of ultraviolent intake by nutritional approach project. Subjects enrolled among adults with abdominal obesity. Twenty-nine subjects with insomnia were selected according to the results of Insomnia Severity Index questionnaire and quality of life using a Short Form Health Survey (SF-36) questionnaire. Subjects were allocated to four groups: low-fat milk fortified by 1,500 IU vitamin D3 (n = 8), simple milk (n = 8), low-fat yogurt fortified by 1,500 IU vitamin D3 (n = 7), and simple yogurt (n = 6) and were treated for 10 weeks. RESULTS The insomnia score improved after the intervention in the group receiving vitamin D fortified milk compared to group receiving unfortified milk (p < .001). There were no significant differences between the two groups taking yogurt (fortified vs. unfortified). Comparison of quality of life scores between baseline and after intervention indicated significant improvements in both fortified and simple milk groups (p = .002 and p = .03, respectively); but no differences were found in the groups taking yogurt. CONCLUSION Fortified low-fat milk containing 1,500 IU vitamin D3 can improve insomnia symptoms and subsequently quality of life.Trial registration number: IRCT20101130005280N27, www.IRCT.ir.
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Affiliation(s)
- Payam Sharifan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mahdieh Khoshakhlagh
- Department of Medical BiochemistryFaculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zahra Khorasanchi
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Susan Darroudi
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mitra Rezaie
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohammad Safarian
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Hassan Vatanparast
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSKCanada
| | - Asma Afshari
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Gordon Ferns
- Brighton and Sussex Medical SchoolDivision of Medical EducationBrightonUK
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Majid Ghayour Mobarhan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
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Doruk Analan P, Kaya E. The Effect of Serum 25(OH)D3 Level on Breast Cancer-Related Lymphedema. Lymphat Res Biol 2020; 18:22-26. [DOI: 10.1089/lrb.2018.0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Pınar Doruk Analan
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Emine Kaya
- Department of Physical Medicine and Rehabilitation, Adana City Training and Research Hospital, Adana, Turkey
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Hillstrom HJ, Soeters R, Miranda M, Backus SI, Hafer J, Gibbons M, Thaqi I, Lenhoff M, Hannan MT, Endo Y, Sculco T, Lane J. Effect of increased serum 25(OH)D and calcium on structure and function of post-menopausal women: a pilot study. Arch Osteoporos 2020; 15:154. [PMID: 33009959 PMCID: PMC7532965 DOI: 10.1007/s11657-020-00814-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/01/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED The purpose was to determine if increasing serum 25(OH)D and calcium in postmenopausal women increased skeletal muscle size, strength, balance, and functional task performance while decreasing muscle fatigue. PCSA of the vastus lateralis increased and ascent of stairs time decreased after 6 months of increased serum 25(OH)D. PURPOSE The Institute of Medicine recommends ≥ 20 ng/ml of serum 25-hydroxyvitamin D [25(OH)D] for bone and overall health. Serum 25(OH)D levels have been associated with physical performance, postural sway, and falls. The purpose of this study was to determine if increasing postmenopausal women's serum 25(OH)D levels from 20-30 ng/ml to 40-50 ng/ml improved skeletal muscle size, strength, balance, and functional performance while decreasing skeletal muscle fatigue. METHODS Twenty-six post-menopausal women (60-85 years old) with baseline serum 25(OH)D levels between 20 and 30 ng/ml were recruited. Oral over-the-counter (OTC) vitamin D3 and calcium citrate were prescribed to increase subjects' serum 25(OH)D to levels between 40 and 50 ng/ml, serum calcium levels above 9.2 mg/dl, and PTH levels below 60 pg/ml, which were confirmed at 6 and 12 weeks. Outcome measures assessed at baseline and 6 months included muscle physiological cross-sectional area (PCSA), muscle strength, postural balance, time to perform functional tasks, and muscle fatigue. Repeated measures comparisons between baseline and follow-up were performed. RESULTS Nineteen subjects completed the study. One individual could not afford the time commitment for the repeated measures. Three individuals did not take their vitamin D as recommended. Two subjects were lost to follow-up (lack of interest), and one did not achieve targeted serum 25(OH)D. Vastus lateralis PCSA increased (p = 0.007) and ascent of stair time decreased (p = 0.042) after 6 months of increasing serum 25(OH)D levels from 20-30 ng/ml to 40-50 ng/ml. Isometric strength was unchanged. Anterior-posterior center of pressure (COP) excursion and COP path length decreased (p < 0.1) albeit non-significantly, suggesting balance may improve from increased serum 25(OH)D and calcium citrate levels. CONCLUSIONS Several measures of muscle structure and function were sensitive to elevated serum 25(OH)D and calcium levels indicating that further investigation of this phenomenon in post-menopausal women is warranted.
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Affiliation(s)
- H. J. Hillstrom
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - R. Soeters
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - M. Miranda
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - S. I. Backus
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - J. Hafer
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA ,Biomechanics Lab, Department of Kinesiology, University of Massachusetts, Totman rm.110, 30 Eastman Lane, Amherst, MA USA
| | - M. Gibbons
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - I. Thaqi
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - M. Lenhoff
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - M. T. Hannan
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, 1200 Centre Street, Boston, MA USA
| | - Y. Endo
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - T. Sculco
- Leon Root Motion Analysis Laboratory (LRMALab), Hospital for Special Surgery (HSS), 535 East 70th Street, New York, NY USA
| | - J. Lane
- Metabolic Bone Disease Service, HSS, 535 East 70th Street, New York, NY USA
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13
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Abshirini M, Mozaffari H, Kord‐Varkaneh H, Omidian M, Kruger M. The effects of vitamin D supplementation on muscle strength and mobility in postmenopausal women: a systematic review and meta‐analysis of randomised controlled trials. J Hum Nutr Diet 2019; 33:207-221. [DOI: 10.1111/jhn.12717] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 12/18/2022]
Affiliation(s)
- M. Abshirini
- School of Health Sciences College of Health Massey University Palmerston North New Zealand
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran Iran
| | - H. Mozaffari
- Faculty of Land and Food Systems University of British ColumbiaVancouver Canada
| | - H. Kord‐Varkaneh
- Nutrition and Food technology Shahid Beheshti University of Medical SciencesTehran Iran
| | - M. Omidian
- Department of Cellular, Molecular Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran
| | - M.C Kruger
- School of Health Sciences College of Health Massey University Palmerston North New Zealand
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14
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Tabrizi R, Hallajzadeh J, Mirhosseini N, Lankarani KB, Maharlouei N, Akbari M, Asemi Z. The effects of vitamin D supplementation on muscle function among postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. EXCLI JOURNAL 2019; 18:591-603. [PMID: 31611742 PMCID: PMC6785780 DOI: 10.17179/excli2019-1386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/23/2019] [Indexed: 02/05/2023]
Abstract
The loss of muscle mass and its strength is one of the most critical changes in aging which is associated with an increased risk of falls, osteoporotic fractures and mobility disability. Vitamin D, with its extra-skeletal benefits, might improve muscle function in elderly. The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize available relevant data and determine the effect of vitamin D supplementation on muscle function among postmenopausal women. We reached databases including; Cochrane library, Embase, PubMed, and Web of Science database until the end of May 2018 to identify relevant published RCTs. Heterogeneity among included studies was assessed using Q-test and I2 statistics. Random-effect model was applied to pool data and weighted mean difference (WMD) was calculated representing summary effect size. Outcomes of interest included the effects of vitamin D supplementation on hand grip strength (HGS), back muscle strength (BMS), and Timed Up and Go (TUG). Twelve RCTs out of 1739 potential reports were included in our meta-analysis. The pooled findings showed that vitamin D supplementation had no significant effect on HGS (WMD -0.03 kilogram (Kg); 95 % CI, -0.26, 0.20; P=0.78), BMS (WMD 7.21 newton (N); 95 % CI, -5.98, 20.40; P=0.28), and TUG (WMD 0.01 second (S); 95 % CI, -0.17, 0.18; P=0.93) in postmenopausal women. Overall, the current meta-analysis showed that taking vitamin D supplementation by postmenopausal women did not affect markers of muscle function. Further studies are required to confirm the effect of vitamin D supplementation on markers of muscle function.
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Affiliation(s)
- Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Clinical Neurology Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Jamal Hallajzadeh
- Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maraghe University of Medical Science, Maraghe, Iran
| | | | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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15
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Matthews J, Torres SJ, Milte CM, Hopkins I, Kukuljan S, Nowson CA, Daly RM. Effects of a multicomponent exercise program combined with calcium-vitamin D 3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial. Eur J Nutr 2019; 59:1081-1091. [PMID: 30993400 DOI: 10.1007/s00394-019-01969-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Osteoporosis is associated with both lower health-related quality of life and depression in older people. We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin D3 fortified milk on health-related quality of life (HR-QoL) and depression in older men. METHODS In this 12-month, factorial design randomized controlled trial, 180 healthy community-dwelling men aged 50-79 years with normal to below average bone mineral density were allocated into one of four groups: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of high-intensity resistance training with weight-bearing exercise (3 days per week; 60-75 min per session). Men assigned to fortified milk consumed 400 ml/day of low-fat milk containing 1000 mg/day calcium and 800IU/day vitamin D3. Questionnaires were used to assess HR-QoL (SF-36) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) at baseline, and 6 and 12 months. A linear mixed model analysis was used to test whether there was a synergistic interaction between exercise and calcium-vitamin D3. If no significant interactions were detected, the main effects of exercise and fortified milk were examined. RESULTS Mean adherence to the exercise program and fortified milk was 67% (95% CI 61, 73%) and 90% (95% CI 86, 93%), respectively. There were no exercise-by-fortified milk interactions nor main effects of exercise or calcium-vitamin D for any of the HR-QoL measures or depressive symptoms. CONCLUSION In healthy community-dwelling older men, exercise training and/or calcium-vitamin D fortified milk did not improve HR-QoL or depressive symptoms.
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Affiliation(s)
- Joshua Matthews
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Indee Hopkins
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Sonja Kukuljan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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16
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Gu J, Wang C, Zhang H, Yue H, Hu W, He J, Fu W, Zhang Z. No association between the vitamin D pathway gene polymorphisms and bone biomarkers response to calcium and low dose calcitriol supplementation in postmenopausal Chinese women: a one-year prospective study. Biomarkers 2018; 23:664-669. [PMID: 29732934 DOI: 10.1080/1354750x.2018.1474259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The aim of the study was to explore the association between the vitamin D pathway gene variations and the bone biomarkers response to calcium and low dose calcitriol supplementation in postmenopausal Chinese women. METHODS A total of 110 healthy postmenopausal Chinese women (61.51 ± 6.93 years) were enrolled. The participants were supplemented with calcium (600 mg/d) and calcitriol (0.25 μg/d), for 1 year. Four biomarkers, serum levels of beta C-terminal cross-linked telopeptides of type I collagen (β-CTX), amino-terminal propeptide of type I collagen (P1NP), parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] were measured at baseline and 12-month follow-up. Multivariate regression models were established to explore the statistical association between the change rate of the four biomarkers and 15 key genes within the vitamin D metabolic pathway. RESULTS This exclusion process left 98 participants for analysis. Serum levels of P1NP, β-CTX and PTH were significantly decreased at the 12-month follow-up (all p < 0.05). Serum 25(OH)D level had no significant change (p > 0.05). No association was found between the vitamin D pathway gene polymorphisms and bone biomarkers response to calcium and low dose calcitriol supplementation. CONCLUSIONS Genetic background of postmenopausal Chinese women might not influence supplemental response of the biomarkers to calcium and low dose calcitriol.
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Affiliation(s)
- Jiemei Gu
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Chun Wang
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Hao Zhang
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Hua Yue
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Weiwei Hu
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Jinwei He
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Wenzhen Fu
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Zhenlin Zhang
- a Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases , Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
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17
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Bentes CM, Resende M, Miranda H, Netto CC, Marinheiro LPF. Can Vitamin D supplementation alone effective to increase a physical fitness levels in post-menopausal women with metabolic disorders? Brief Review. Diabetes Metab Syndr 2018; 12:65-68. [PMID: 28855070 DOI: 10.1016/j.dsx.2017.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND During the climacteric period, occur an aging process of the skin, and promote several decreases in the ability of vitamin D synthesis in an organism and lower levels of Vitamin D may contribute to the appearance of conditions such as osteomalacia, osteoporosis, falls and fractures. AIM The present brief review focuses on the influence of Vitamin D supplementation alone on physical fitness (strength, endurance, and balance) in postmenopausal with diseases or not. METHODS Search in Medline and PubMed relevant articles with Vitamin D supplementation alone on physical fitness (strength, endurance, and balance) in postmenopausal with diseases or not, were included only 5 clinical. CONCLUSIONS In conclusion, the effectiveness depends on the amount was prescribed for supplementation and the patient's characteristics. Doses less than 1000 IU/d did not show significant changes in physical fitness on post-menopausal women with metabolic diseases or not.
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Affiliation(s)
- Claudio M Bentes
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil; Federal University of Rio de Janeiro, Physical Education, Graduate Program, Rio de Janeiro, RJ, Brazil.
| | - Monique Resende
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil
| | - Humberto Miranda
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil; Federal University of Rio de Janeiro, Physical Education, Graduate Program, Rio de Janeiro, RJ, Brazil
| | - Claudia C Netto
- Department of Biochemistry, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Lizanka P F Marinheiro
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil
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18
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Ling Y, Lin H, Aleteng Q, Ma H, Pan B, Gao J, Gao X. Cdx-2 polymorphism in Vitamin D Receptor gene was associated with serum 25-hydroxyvitamin D levels, bone mineral density and fracture in middle-aged and elderly Chinese women. Mol Cell Endocrinol 2016; 427:155-61. [PMID: 26970179 DOI: 10.1016/j.mce.2016.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/29/2016] [Accepted: 03/09/2016] [Indexed: 01/23/2023]
Abstract
The aim of the current study was to examine the relationship between Cdx-2 polymorphism in the promoter region of the VDR gene and serum 25-hydroxyvitamin D (25(OH)D) levels, bone mineral density (BMD) and fracture in Chinese population. This was a cross-sectional study, which included 738 individuals (428 women and 310 men) aged 45 years or older. In women, the association of Cdx-2 polymorphism with serum 25(OH)D levels was significant adjusting for age, BMI, estimated glomerular filtration rate, menopausal status and season of blood collection (P = 0.002). Cdx-2 polymorphism was associated with lumbar spine BMD adjusted for age, BMI, menopausal status and serum 25(OH)D in women (P = 0.005). But it was not associated with femoral neck BMD or total hip BMD in women. In women, Cdx-2 polymorphism was also associated with fracture adjusted for age, BMI, menopausal status, serum 25(OH)D and total hip BMD (P = 0.03). Carriers of AA and AG genotypes was associated with a higher odds of fracture compared with the carriers of GG genotype (OR = 2.14, 95% CI 1.04-4.42 and OR = 1.90, 95% CI 1.03-3.51). In men, Cdx-2 polymorphism was not associated with serum 25(OH)D levels, BMD or fracture. Our results indicate that the association of Cdx-2 polymorphism in the VDR gene with serum 25(OH)D levels, BMD and fracture may have sex differences. Cdx-2 polymorphism in the VDR gene may affect the serum 25(OH)D concentrations and the risk of osteoporosis and fracture in middle-aged and elderly Chinese women.
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Affiliation(s)
- Yan Ling
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University and Institute of Chronic Metabolic Diseases of Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University and Institute of Chronic Metabolic Diseases of Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Qiqige Aleteng
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University and Institute of Chronic Metabolic Diseases of Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Baishen Pan
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University and Institute of Chronic Metabolic Diseases of Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Jian Gao
- Department of Clinical Nutrition, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University and Institute of Chronic Metabolic Diseases of Fudan University, No. 180 Fenglin Road, 200032 Shanghai, China.
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