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Luthfiana F, Sari RA, Sholikhah I, Matsunami K, Sukardiman S, Widyowati R. Effects of <em>eleutherine bulbosa</em> (mill.) urb. bulb extract on mice glucocorticoid-induced osteoporosis models. J Public Health Afr 2023. [PMID: 37492552 PMCID: PMC10365651 DOI: 10.4081/jphia.2023.2507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background: Low bone mass accompanied by microarchitectural alterations in the bone that cause fragility fractures is known as secondary osteoporosis and occurs when there is an underlying condition or medication present. Eleutherine bulbosa bulb extract has been shown to affect bone because of its content, which can help osteoblast differentiation and inhibit osteoclast differentiation.
Objective: This study aimed to assess the effects of 70% ethanol extract of E. bulbosa Bulbs (EBE) from Pasuruan-East Java on blood calcium levels, osteoblast cell count, and bone density of trabecular femur in osteoporosis rats.
Methods: Six groups of 30 female Wistar rats were created. There were no test materials offered to the healthy group; the negative group received 0.5% CMC; the positive group received alendronate 0.9 mg/kg BW; and the dose group received 30, 60, and 120 mg/kg BW. Glucocorticoid (Dexamethasone) 0.1015 mg/kg BW/day induction was given to all groups except the healthy group to create osteoporosis rats for approximately four weeks. Then they were given oral therapy for approximately 28 days. Followed by the determination of blood calcium levels, the number of osteoblast cells, and bone density of the rat femur trabecular.
Results: The result showed that E. bulbosa bulbs extract could raise blood calcium levels and bone density percentage at doses of 60 and 120 mg/kg BW, as well as raise osteoblast cell levels at doses of 120 mg/kg BW.
Conclusions: The findings indicate that E.bulbosa bulb extract is a potential complementary medicine for osteoporosis.
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Shih HY, Lu JH, Xiong AH, Tse JMW, Wong BST. Topical application of the plant extract SDTL-E in ovariectomized rats: A potential new approach for treating osteoporosis. Front Med (Lausanne) 2022; 9:988235. [PMID: 36341259 PMCID: PMC9631791 DOI: 10.3389/fmed.2022.988235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/06/2022] [Indexed: 07/16/2024] Open
Abstract
Current osteoporosis medications have drawbacks of causing side effects and having slow onset, therefore developing osteoporosis drugs with faster onset and less side effects is essential. This study investigated the effects of the natural plant extract, SDTL-E, in ovariectomized (OVX)-induced osteoporosis rats. Rats were randomly assigned to sham operation control group (Control Group); OVX rat model group (Model Group) or OVX rat SDTL-E treatment group (SDTL-E Group). All groups underwent ovariectomy, but the Control Group did not have the ovaries removed. SDTL-E Group was treated with SDTL-E, Model and Control Groups were treated with vegetable oil, treatments were topically applied twice daily for 20 days. Results showed when compared with Model Group, SDTL-E Group significantly restored serum estradiol back to near Control Group level, serum ALP activity, serum and urinary calcium were significantly decreased, bone mechanics indicators increased and trabecular bone numbers slightly increased. These results demonstrated 20 days of SDTL-E topical treatment improved bone strength and trabecular bone structure in OVX-induced osteoporosis rats. The underlying mechanisms include restoring estradiol level, reducing bone turnover, net bone resorption, bone calcium loss, and calcium excretion through kidney. These findings suggest topical application of plant extract is a potential new approach with quick efficacy for treating osteoporosis.
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Affiliation(s)
- Hui-Yuan Shih
- Hong Kong Small Biomolecules Laboratory, Hong Kong, Hong Kong SAR, China
| | - Jun-Hua Lu
- Department of Pharmacology, Jinan University College of Pharmacy, Guangzhou, China
| | - Ai-Hua Xiong
- Laboratory Technical Teaching Centre, Jinan University College of Pharmacy, Guangzhou, Hong Kong SAR, China
| | | | - Ben Siu-Tak Wong
- SDTL Reborntech Company Limited, Hong Kong, Hong Kong SAR, China
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The potential of salivary biomarkers of nutritional status and dietary intake: A Systematic Review. J Dent 2021; 115:103840. [PMID: 34624418 DOI: 10.1016/j.jdent.2021.103840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To explore whether nutritional salivary biomarkers could be used to aid nutritional status assessment and/or support traditional dietary assessment methods for patients. DATA AND SOURCES Searches were performed using four electronic databases; MEDLINE, EMBASE, Scopus and Web of Science. Trial registers (i.e. Cochrane), grey literature and reference lists were searched. STUDY SELECTION Studies which measured nutritional salivary biomarkers related to nutritional status and/or dietary intake outcome were included. No restrictions on participants' age, study design, publication date, setting or health status. Animal studies, non-English language studies, commentaries, and conference abstracts were excluded. RESULTS Study titles and abstracts were screened (n = 7982), full-texts assessed (n = 176) and 85 studies were included in a narrative synthesis. The most promising salivary biomarkers for nutritional status included: glucose, where saliva and serum levels were positively correlated in those with type 2 diabetes (T2D), higher salivary calcium levels in post-menopausal women in general and specifically those with lower bone mineral density (BMD), and salivary vitamin D to assess vitamin D status in healthy volunteers. Higher salivary total antioxidant capacity (TAC), nitrate/nitrite and fluoride were observed with increased antioxidant, nitrate/nitrite and fluoride dietary intake, respectively. A meta-analysis found significantly higher mean salivary glucose (n = 12) in T2D compared with healthy controls, but there was substantial heterogeneity (I2=94%) and evidence of publication bias. CONCLUSIONS The most promising salivary biomarkers identified in this systematic review were, glucose, vitamin D, calcium, TAC, nitrate/nitrite and fluoride. However, this was based on a small number of studies of varying quality, with many lacking a salivary assay performance assessment. CLINICAL SIGNIFICANCE At present, nutritional salivary biomarkers cannot be used alone to assess nutritional status or dietary intake. Further research into the most promising nutritional salivary biomarkers is required.
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Urine and Serum Electrolytes and Biochemical Values Associated with Osteoporosis in Premenopausal and Postmenopausal Women: A Longitudinal and Cross-Sectional Study Using Korean Genome and Epidemiology Study (KoGES) Cohort. J Clin Med 2021; 10:jcm10102155. [PMID: 34067578 PMCID: PMC8156403 DOI: 10.3390/jcm10102155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is a major public health concern, especially in women. This study aims to identify early biomarkers from biochemical measurements of serum and urine for recognizing the development of osteoporosis and osteopenia in premenopausal and postmenopausal women. From the Korean Genome and Epidemiology Study (KoGES) cohort, longitudinal study participants with normal bone density were enrolled and assessed for the association of baseline clinical and biochemical factors with osteoporosis development over 4 years. In addition, a cross-sectional study between normal bone density and osteopenia/osteoporosis was conducted to validate the risk factors found in the longitudinal cohort. Of the 5272 female participants in the KoGES cohort, 813 women (501 premenopausal and 312 menopausal) who had normal bone density at baseline were included in the longitudinal study. During the 4 years of follow-up, 64 patients developed osteoporosis and 354 developed osteopenia. In a multivariate logistic regression analysis, serum calcium and urine uric acid levels were significantly associated with elevated osteoporosis risk in premenopausal and postmenopausal women, respectively (risk of osteoporosis by serum calcium levels in premenopausal women: 4.03 (1.09–14.93), p = 0.037; risk of osteoporosis by urine uric acid levels in postmenopausal women: 24.08 (1.79–323.69), p = 0.016). For the cross-sectional study, serum and urine parameters were compared between women with osteopenia or osteoporosis at baseline and those with normal bone density. Urine uric acid levels were found to be significantly higher in both premenopausal and postmenopausal women with bone loss than in women with normal bone density (p < 0.001 and p = 0.004, respectively). Uric acid level in urine may be an early marker for the development of osteoporosis in women, especially after menopause.
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Qu Z, Yang F, Yan Y, Hong J, Wang W, Li S, Jiang G, Yan S. Relationship between Serum Nutritional Factors and Bone Mineral Density: A Mendelian Randomization Study. J Clin Endocrinol Metab 2021; 106:e2434-e2443. [PMID: 33581692 DOI: 10.1210/clinem/dgab085] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Multiple risk factors have been implicated in the development of osteoporosis. This study examined potential associations between serum nutritional factors and bone mineral density (BMD). METHODS Six nutritional factors were selected as exposures. Outcomes included total body BMD (n = 66 945); BMD at the forearm (FA), femoral neck (FN) and lumbar spine (LS) (n = 8143, n = 32 735, and n = 28 498, respectively); estimated heel BMD (HL eBMD) (n = 394 929); and HL eBMD stratified by sex (n = 206 496). A 2-sample Mendelian randomization approach was adopted to estimate the association between serum nutritional factors and BMD. The threshold for adjusted P value was 1.39 × 10-3. RESULTS Serum calcium levels were inversely associated with LS BMD (effect = -0.55; 95% CI, -0.86 to -0.24; P = 0.001), whereas serum selenium levels were positively correlated with HL eBMD (effect = 0.22; 95% CI, 0.10 to 0.33; P = 1.70 × 10-4). Regarding nominal significance, there was a positive association between serum selenium levels and FA BMD. Nominally significant results were also obtained for serum retinol as well as vitamin E levels and HL eBMD. Moreover, sex-specific effects of serum retinol and vitamin E levels on BMD were observed in men. CONCLUSION Serum calcium and selenium levels influence BMD at specific skeletal sites. This implies that these nutritional factors play crucial roles in bone metabolism.
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Affiliation(s)
- Zihao Qu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Fangkun Yang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yishang Yan
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jianqiao Hong
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Sihao Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Guangyao Jiang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Shigui Yan
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
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Min C, Yoo DM, Wee JH, Lee HJ, Choi HG. High-Intensity Physical Activity with High Serum Vitamin D Levels is Associated with a Low Prevalence of Osteopenia and Osteoporosis: A Population-Based Study. Osteoporos Int 2021; 32:883-891. [PMID: 33230576 DOI: 10.1007/s00198-020-05746-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
UNLABELLED We found that combination of high-intensity PA and high 25(OH)D levels was associated with low prevalence of osteoporosis/osteopenia. In addition, the prevalence of osteoporosis was lower in the low PA with high 25(OH)D levels than in the moderate or high PA with low 25(OH)D levels. INTRODUCTION The aim of this study was to explore the association of physical activity (PA) and serum 25-hydroxyvitamin D (25[OH]D) levels with osteopenia/osteoporosis. METHODS The Korean National Health and Nutrition Examination Survey data from 2008 to 2011 were used in this study. Data from 6868 individuals were selected. Each individual's level of PA was classified as 'low', 'moderate', or 'high'. Serum 25(OH)D levels were classified as 'low' or 'high'. Accordingly, the combined PA and 25(OH)D groups were divided into 6 groups. Bone mineral density (BMD) was classified as 'normal (T score ≥ - 1.0)', 'osteopenia (- 2.5 < T score < - 1.0)' or 'osteoporosis (T score ≤ - 2.5)'. Crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression models. RESULTS The AORs (95% CIs) for osteopenia were 0.64 (0.50-0.83) in the high PA with high 25(OH)D group and 0.69 (0.53-0.88) in the moderate PA with high 25(OH)D group. The AORs (95% CIs) for osteoporosis were increased in the groups in ascending order as follows: high PA with high 25(OH)D (0.40 [0.28-0.57]) < moderate PA with high 25(OH)D (0.47 [0.33-0.66]) < low PA with high 25(OH)D (0.59 [0.42-0.83]) < high PA with low 25(OH)D (0.70 [0.49-1.00]) < moderate PA with low 25(OH)D (0.76 [0.53-1.07]) < low PA with low 25(OH)D. This result was consistent in males but not evident in females. CONCLUSION We suggest that the combination of high-intensity PA and high 25(OH)D levels is positively associated with high BMD.
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Affiliation(s)
- C Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - D M Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| | - J H Wee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - H-J Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - H G Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
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Pan K, Tu R, Yao X, Zhu Z. Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents. Adv Rheumatol 2021; 61:16. [PMID: 33691805 DOI: 10.1186/s42358-021-00174-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/02/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUNDS It is important to improve our understanding of the roles of calcium and vitamin D in bone health for preventing osteoporosis. We aimed at exploring the associations between serum calcium, vitamin D level, and bone mineral density (BMD) in adolescents included in the National Health and Nutrition Examination Survey (NHANES) 2001-2006. METHODS Weighted multivariate linear regression models were used to estimate the associations of serum calcium, 25(OH)D level with total BMD. Smooth curve fitting was used to explore the potential non-linear relationship. RESULTS A total of 5990 individuals aged between 12 and 19 years were included in this study. The fully-adjusted model showed serum calcium positively correlated with total BMD. However, an inverted U-shaped relationship was found when we performed the smooth curve fitting method, and the inflection point was calculated at 9.6 mg/dL using the two-piecewise linear regression model. In contrast, there was a positive correlation between serum 25(OH)D and total BMD after adjusting for potential confounders. CONCLUSIONS The present study revealed a positive correlation between serum 25(OH)D level and total BMD, and an inverted U-shaped relationship between serum calcium and total BMD.
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Affiliation(s)
- Kaiyu Pan
- Department of Paediatrics, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China
| | - Rongliang Tu
- Department of Paediatrics, Zhejiang Xiaoshan Hospital, Hangzhou, 311200, Zhejiang, China
| | - Xiaocong Yao
- Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China
| | - Zhongxin Zhu
- Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China. .,Clinical Research Center, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, 311200, Zhejiang, China.
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Dalemo S, Boström KB, Hjerpe P. Plasma albumin and calcium concentrations, and long-term mortality in primary health care patients in Sweden. Scand J Prim Health Care 2020; 38:430-438. [PMID: 33226880 PMCID: PMC7783069 DOI: 10.1080/02813432.2020.1843809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Low plasma (p)-albumin and p-calcium concentrations are associated with increased mortality in hospitalised patients. There are few studies addressing this in primary care. Low p-calcium has been associated with mortality, but it is not known whether this applies to p-albumin. Could p-albumin and p-calcium be used as markers of an increased risk of mortality? PURPOSE To study p-albumin and p-calcium at baseline and their association with mortality after 10-14 years. DESIGN Prospective cohort study using data from a large primary health care area and the National Swedish Cause of Death Register. SETTING Primary health care in Skaraborg, Sweden. SUBJECTS 43,052 patients (39.1% men), ≥18 years, 60.7 ± 18.4 years with p-albumin and p-calcium concentrations registered in 2001-2005. MAIN OUTCOME MEASURES P-albumin and p-calcium concentrations at baseline and their association with mortality after a mean follow-up period of 10.3 ± 4.0 years. RESULTS Low p-albumin was associated with total mortality compared with normal p-albumin, greatest at lower ages (18-47 years). The hazard ratios for women and men were 3.12 (95% CI 1.27-7.70) and 4.09 (95% CI 1.50-11.14), respectively. The increased mortality was seen in both cardiovascular and malignant diseases in both women and men. In contrast, low p-calcium was not associated with increased mortality, 1.00 (95% CI 0.96-1.05). Elevated p-calcium was associated with increased mortality, 1.17 (95% CI 1.13-1.22). CONCLUSIONS Low p-albumin could be a marker of an increased risk of mortality, especially in patients of younger ages. This finding should prompt diagnostic measures in order to identify underlying causes. KEY POINTS Low p-albumin and calcium concentrations have been associated with increased mortality in hospitalised patients, but this is unexplored in primary care patients. A low p-albumin concentration at baseline was a risk marker for mortality; highest in the younger age groups. Increased mortality in both cardiovascular and malignant diseases was seen in both men and women with low compared with normal p-albumin concentrations. Elevated but not low p-calcium concentrations were associated with increased mortality after 10-14 years of follow-up.
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Affiliation(s)
- Sofia Dalemo
- Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan R&D Centre, Skaraborg Primary Care, Skövde, Sweden
- CONTACT Sofia Dalemo Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Bengtsson Boström
- Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan R&D Centre, Skaraborg Primary Care, Skövde, Sweden
| | - Per Hjerpe
- Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan R&D Centre, Skaraborg Primary Care, Skövde, Sweden
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Li GHY, Robinson-Cohen C, Sahni S, Au PCM, Tan KCB, Kung AWC, Cheung CL. Association of Genetic Variants Related to Serum Calcium Levels with Reduced Bone Mineral Density. J Clin Endocrinol Metab 2020; 105:5606940. [PMID: 31650181 PMCID: PMC7453037 DOI: 10.1210/clinem/dgz088] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT The role of serum calcium in bone metabolism is unknown, even though calcium/vitamin D supplementations have been widely used and are expected to improve bone health. We aim to determine the independent role of serum calcium in bone mineral density (BMD). DESIGN AND SETTING Two epidemiological analyses with 5478 and 5556 participants from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2006 and the Hong Kong Osteoporosis Study (HKOS) to evaluate the cross-sectional association of serum calcium with BMD. Two-sample Mendelian randomization (MR) studies using genetic variations as instrumental variables to infer causality. Summary statistics of genome-wide association study of serum calcium (N = 39 400) and lifelong whole-body BMD (N = 66 628) were used. MAIN OUTCOME MEASURE BMD measured by dual-energy X-ray absorptiometry. RESULTS In NHANES 2003-6 and HKOS, each standard deviation (SD) increase in serum calcium was significantly associated with 0.036-0.092 SD decrease in BMD at various sites (all P < .05). In multivariable inverse-variance weighted MR analysis, genetic predisposition to higher serum calcium level was inversely associated with whole-body BMD after adjustment for serum parathyroid hormone, vitamin D, and phosphate (-0.431 SD per SD increase in serum calcium; 95% CI: -0.773 to -0.089, P = .014). Similar estimates were obtained in sensitivity analyses. CONCLUSIONS Our study reveals that genetic predisposition to higher serum calcium level per se may have a negative impact on bone metabolism. Whether increased serum calcium caused by calcium/vitamin D supplementations would have the same negative effect on bone remains unknown, which warrants further investigation. In addition to other adverse clinical outcomes, careful use of high-dose supplementations is required.
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Affiliation(s)
- Gloria Hoi-Yee Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Cassianne Robinson-Cohen
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shivani Sahni
- Marcus Institute, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts
| | - Philip Chun-Ming Au
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Kathryn Choon-Beng Tan
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Annie Wai-Chee Kung
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Correspondence and Reprint Requests: Ching-Lung Cheung, Assistant Professor, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China. E-mail:
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Liu M, Yao X, Zhu Z. Associations between serum calcium, 25(OH)D level and bone mineral density in older adults. J Orthop Surg Res 2019; 14:458. [PMID: 31864386 PMCID: PMC6925486 DOI: 10.1186/s13018-019-1517-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/11/2019] [Indexed: 01/21/2023] Open
Abstract
Background Calcium and vitamin D play important roles in bone health as essential nutrients. We explored whether serum calcium, 25(OH)D were associated with bone mineral density (BMD) in older adults. Methods This cross-sectional study was conducted on a sample of 4595 participants (2281 men and 2314 women) aged ≥ 50 years (from 50 to 85 years, 60.1 ± 8.7 years for men and 62.0 ± 9.7 years for women) from the National Health and Nutrition Examination Survey (NHANES) 2001–2006. The independent variables were serum calcium and 25(OH)D. The dependent variable was lumbar BMD. The other variables were considered potential effect modifiers. We performed weighted multivariate linear regression models and smooth curve fittings to evaluate the associations between them. Subgroup analyses were also performed. Results We observed a negative association between serum calcium and lumbar BMD in the fully adjusted model. In the subgroup analyses, this association was no longer significant among males and other race/ethnicity. On the other hand, there was a positive association between serum 25(OH)D and lumbar BMD in the fully adjusted model. In the subgroup analyses, this association did not differ in different age groups, between men and women. However, the association between serum 25(OH)D and lumbar BMD followed a U-shaped curve in Mexican Americans. Conclusions This cross-sectional study indicated that serum calcium negatively correlated with lumbar BMD, and serum 25(OH)D positively correlated with lumbar BMD in older adults. However, the association between serum calcium and lumbar BMD in males followed a U-shaped curve.
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Affiliation(s)
- Minbo Liu
- Department of Orthopaedics, The First People's Hospital of Xiaoshan District, Hangzhou, 311200, Zhejiang, People's Republic of China
| | - Xiaocong Yao
- Department of Orthopaedics, The First People's Hospital of Xiaoshan District, Hangzhou, 311200, Zhejiang, People's Republic of China
| | - Zhongxin Zhu
- Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, People's Republic of China. .,Institute of Orthopaedics and Traumatology of Zhejiang Province, No. 548, Binwen Road, Hangzhou, 310053, Zhejiang, People's Republic of China.
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