1
|
Zhou H, Xu M, Pan Y, Wang S, Xu Z, Liu L, Liu X. The association between several serum micronutrients and benign prostatic hyperplasia: Results from NHANES 2003-2006. Prostate 2024; 84:212-220. [PMID: 37899678 DOI: 10.1002/pros.24641] [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: 06/24/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a common condition that affects the quality of life of older men. Specific micronutrients, including retinol, retinyl esters, carotenoids, vitamin E, and vitamin C, have antioxidant and anti-inflammatory properties. However, the correlation between serum concentrations of these micronutrients and BPH is unclear. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES), which included 2067 representative US men. BPH was assessed using the self-reported questionnaire. This association was explored by adjusting for confounders using multivariate logistic regression. RESULTS After fully adjusting for confounders, for every 0.01 μmol/L increase in serum retinyl esters, the risk of BPH increased by 2% (OR = 1.02; 95% CI: 1.01-1.03; p = 0.006). Based on the Bonferroni-corrected p-value, we found this correlation to be significant. One μmol/L increase in total carotenoids was associated with a 22% increase in BPH risk (OR = 1.22; 95% CI: 1.03-1.46; p = 0.025). By analyzing the correlation between different types of carotenoids and BPH, we also found that β-carotenoids (OR = 1.43; 95% CI: 1.03-1.99; p = 0.036) was also positively correlated with BPH. The subgroup analysis revealed a positive correlation between serum vitamin E (OR = 1.02; 95% CI: 1.00-1.04; p = 0.018) and BPH in men under 60 years of age. Serum retinyl ester (OR = 1.02; 95% CI: 1.01-1.04; p = 0.008) and carotenoid (OR = 1.52; 95% CI: 1.22-1.87; p < 0.001) concentrations were positively correlated with BPH in men over 60 years of age. CONCLUSION Our study suggests that excessive serum retinyl esters, total carotenoids, and especially β-carotenoids are potential risk factors for BPH, and this association should be further investigated.
Collapse
Affiliation(s)
- Hang Zhou
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingming Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhunan Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
2
|
Bohn T, de Lera AR, Landrier JF, Rühl R. Carotenoid metabolites, their tissue and blood concentrations in humans and further bioactivity via retinoid receptor-mediated signalling. Nutr Res Rev 2023; 36:498-511. [PMID: 36380523 DOI: 10.1017/s095442242200021x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many epidemiological studies have emphasised the relation between carotenoid dietary intake and their circulating concentrations and beneficial health effects, such as lower risk of cardiometabolic diseases and cancer. However, there is dispute as to whether the attributed health benefits are due to native carotenoids or whether they are instead induced by their metabolites. Several categories of metabolites have been reported, most notably involving (a) modifications at the cyclohexenyl ring or the polyene chain, such as epoxides and geometric isomers, (b) excentric cleavage metabolites with alcohol-, aldehyde- or carboxylic acid-functional groups or (c) centric cleaved metabolites with additional hydroxyl, aldehyde or carboxyl functionalities, not counting their potential phase-II glucuronidated / sulphated derivatives. Of special interest are the apo-carotenoids, which originate in the intestine and other tissues from carotenoid cleavage by β-carotene oxygenases 1/2 in a symmetrical / non-symmetrical fashion. These are more water soluble and more electrophilic and, therefore, putative candidates for interactions with transcription factors such as NF-kB and Nrf2, as well as ligands for RAR-RXR nuclear receptor interactions. In this review, we discuss in vivo detected apo-carotenoids, their reported tissue concentrations, and potential associated health effects, focusing exclusively on the human situation and based on quantified / semi-quantified carotenoid metabolites proven to be present in humans.
Collapse
Affiliation(s)
- Torsten Bohn
- Nutrition and Health Research Group, Precision Health Department, Luxembourg Institute of Health, 1 A-B, rue Thomas Edison, L-1445, Strassen, Luxembourg
| | - Angel R de Lera
- Departmento de Química Orgánica, Facultade de Química, CINBIO and IBIV, Universidade de Vigo, 36310 Vigo, Spain
| | | | - Ralph Rühl
- CISCAREX UG, Berlin, Germany
- Paprika Bioanalytics BT, Debrecen, Hungary
| |
Collapse
|
3
|
Bergman P. Can vitamin D protect against covid-19? BMJ : BRITISH MEDICAL JOURNAL 2022. [DOI: 10.1136/bmj.o1822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
4
|
Jîtcă G, Ősz BE, Tero-Vescan A, Miklos AP, Rusz CM, Bătrînu MG, Vari CE. Positive Aspects of Oxidative Stress at Different Levels of the Human Body: A Review. Antioxidants (Basel) 2022; 11:antiox11030572. [PMID: 35326222 PMCID: PMC8944834 DOI: 10.3390/antiox11030572] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023] Open
Abstract
Oxidative stress is the subject of numerous studies, most of them focusing on the negative effects exerted at both molecular and cellular levels, ignoring the possible benefits of free radicals. More and more people admit to having heard of the term "oxidative stress", but few of them understand the meaning of it. We summarized and analyzed the published literature data in order to emphasize the importance and adaptation mechanisms of basal oxidative stress. This review aims to provide an overview of the mechanisms underlying the positive effects of oxidative stress, highlighting these effects, as well as the risks for the population consuming higher doses than the recommended daily intake of antioxidants. The biological dose-response curve in oxidative stress is unpredictable as reactive species are clearly responsible for cellular degradation, whereas antioxidant therapies can alleviate senescence by maintaining redox balance; nevertheless, excessive doses of the latter can modify the redox balance of the cell, leading to a negative outcome. It can be stated that the presence of oxidative status or oxidative stress is a physiological condition with well-defined roles, yet these have been insufficiently researched and explored. The involvement of reactive oxygen species in the pathophysiology of some associated diseases is well-known and the involvement of antioxidant therapies in the processes of senescence, apoptosis, autophagy, and the maintenance of cellular homeostasis cannot be denied. All data in this review support the idea that oxidative stress is an undesirable phenomenon in high and long-term concentrations, but regular exposure is consistent with the hormetic theory.
Collapse
Affiliation(s)
- George Jîtcă
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (G.J.); (C.E.V.)
| | - Bianca E. Ősz
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (G.J.); (C.E.V.)
- Correspondence:
| | - Amelia Tero-Vescan
- Department of Biochemistry, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (A.T.-V.); (A.P.M.)
| | - Amalia Pușcaș Miklos
- Department of Biochemistry, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (A.T.-V.); (A.P.M.)
| | - Carmen-Maria Rusz
- Doctoral School of Medicine and Pharmacy, I.O.S.U.D, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (C.-M.R.); (M.-G.B.)
| | - Mădălina-Georgiana Bătrînu
- Doctoral School of Medicine and Pharmacy, I.O.S.U.D, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (C.-M.R.); (M.-G.B.)
| | - Camil E. Vari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (G.J.); (C.E.V.)
| |
Collapse
|
5
|
Rondanelli M, Faliva MA, Barrile GC, Cavioni A, Mansueto F, Mazzola G, Oberto L, Patelli Z, Pirola M, Tartara A, Riva A, Petrangolini G, Peroni G. Nutrition, Physical Activity, and Dietary Supplementation to Prevent Bone Mineral Density Loss: A Food Pyramid. Nutrients 2021; 14:74. [PMID: 35010952 PMCID: PMC8746518 DOI: 10.3390/nu14010074] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Bone is a nutritionally modulated tissue. Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions; orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day); weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). Finally, three to four times per week of 30-40 min of aerobic and resistance exercises must be performed.
Collapse
Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Milena Anna Faliva
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Gaetan Claude Barrile
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Alessandro Cavioni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Francesca Mansueto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Giuseppe Mazzola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Letizia Oberto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Zaira Patelli
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Martina Pirola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Alice Tartara
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Antonella Riva
- Research and Development Department, Indena SpA, 20139 Milan, Italy; (A.R.); (G.P.)
| | | | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| |
Collapse
|
6
|
Warensjö Lemming E, Byberg L. Is a Healthy Diet Also Suitable for the Prevention of Fragility Fractures? Nutrients 2020; 12:nu12092642. [PMID: 32872582 PMCID: PMC7551566 DOI: 10.3390/nu12092642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/20/2022] Open
Abstract
Osteoporosis and sarcopenia contribute to the risk of fracture in the population. These conditions share common features, and it is known that a healthy diet may have beneficial effects on both, theoretically resulting in fewer fractures. The present narrative review gives an overview of recent epidemiological research related to the association between healthy diets/dietary patterns, bone health and fragility fractures. The review also gives a brief overview on general dietary recommendations and advice as the cornerstone of public health nutrition. Although muscle health and sarcopenia contribute to the risk of fractures, these endpoints were not the focus of this review. Healthy diets are nutrient dense and contain bioactive components that are needed for the constant remodeling of the skeleton and to slow the rate of bone loss and muscle wasting, thus contributing to the prevention of fragility fractures. Compliance with healthy dietary patterns were predominantly found to be inversely associated with bone outcomes, although this was not entirely consistent across all studies. Different a priori diet scores, such as the Mediterranean diet score and the Dietary Inflammatory Index, as well as a posteriori data driven dietary patterns, such as the prudent or healthy dietary pattern, were inversely associated with fragility fractures in different populations. In conclusion, different healthy dietary patterns may contribute to bone health and less fractures. Following current dietary guidelines is thus advisable for the prevention of fragility fractures.
Collapse
|
7
|
Harari A, Melnikov N, Kandel Kfir M, Kamari Y, Mahler L, Ben-Amotz A, Harats D, Cohen H, Shaish A. Dietary β-Carotene Rescues Vitamin A Deficiency and Inhibits Atherogenesis in Apolipoprotein E-Deficient Mice. Nutrients 2020; 12:nu12061625. [PMID: 32492795 PMCID: PMC7352614 DOI: 10.3390/nu12061625] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/25/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023] Open
Abstract
Vitamin A deficiency (VAD) is a major health problem, especially in developing countries. In this study, we investigated the effect of VAD from weaning to adulthood in apoE−/− mice. Three-week-old male mice were allocated into four diet groups: I. VAD II. VAD+vitamin A (VA), 1500 IU retinyl-palmitate; III. VAD+β-carotene (BC), 6 g/kg feed, containing 50% all-trans and 50% 9-cis BC. IV. VAD with BC and VA (BC+VA). After 13 weeks, we assessed the size of atherosclerotic plaques and measured VA in tissues and BC in plasma and tissues. VAD resulted in diminished hepatic VA levels and undetectable brain VA levels compared to the other groups. BC completely replenished VA levels in the liver, and BC+VA led to a two-fold elevation of hepatic VA accumulation. In adipose tissue, mice fed BC+VA accumulated only 13% BC compared to mice fed BC alone. Atherosclerotic lesion area of BC group was 73% lower compared to VAD group (p < 0.05). These results suggest that BC can be a sole source for VA and inhibits atherogenesis.
Collapse
Affiliation(s)
- Ayelet Harari
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
- Correspondence:
| | - Nir Melnikov
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
| | - Michal Kandel Kfir
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
| | - Yehuda Kamari
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Lidor Mahler
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
| | - Ami Ben-Amotz
- N.B.T., Nature Beta Technologies LTD, Eilat 8851100, Israel;
| | - Dror Harats
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Hofit Cohen
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Aviv Shaish
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer 5262000, Israel; (N.M.); (M.K.K.); (Y.K.); (L.M.); (D.H.); (H.C.); (A.S.)
- The Department of Life Sciences, MP, Achva Academic College, Shikmim 7980400, Israel
| |
Collapse
|
8
|
Managing acute cancer pain. JAAPA 2020; 33:31-36. [PMID: 32452959 DOI: 10.1097/01.jaa.0000662384.93538.a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cancer-related pain is an ongoing concern for patients and families. Clinicians should include pain management or palliative care specialists who have advanced knowledge in pharmacotherapy and who have the ability to perform interventional procedures to help alleviate patients' pain and reduce opioid use. This article discusses available interventions for patients with cancer pain.
Collapse
|
9
|
Auriti C, Rotunno R, Diociaiuti A, Manzoni SM, Uva A, Bersani I, Santisi A, Dotta A, El Hachem M. Juvenile idiopathic arthritis in infants with Harlequin Ichthyosis: two cases report and literature review. Ital J Pediatr 2020; 46:44. [PMID: 32293521 PMCID: PMC7158043 DOI: 10.1186/s13052-020-0817-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
Background Harlequin Ichthyosis is the most severe variant of congenital autosomal recessive ichthyosis, associated with severe morbidity and potentially lethal in early life. At birth, patients present thick and plaque-like scales all over the body, with consequent cutaneous and extra-cutaneous complications, such as poor thermoregulation, recurrent infections, pain, electrolytes imbalance and joint contractures. Juvenile Idiopathic Arthritis usually manifests before the age of 16 years and persists for more than 6 weeks. The association between these two pathologies has been described in the literature as a very rare event, which creates diagnostic and therapeutic challenge. Case presentation We describe two patients affected by Harlequin Ichthyosis who early developed Juvenile Idiopathic Arthritis. Both patients were treated with retinoids, ibuprofen and long-acting intra-articular glucocorticoids; due to polyarticular involvement, one child was also treated with weekly oral methotrexate. Conclusions The association between Harlequin Ichthyosis and Juvenile Idiopathic Arthritis is rare and the pathophysiological mechanism that binds them is still unknown. Nonetheless caregivers should be aware of the possible occurrence of Juvenile Idiopathic Arthritis at very early ages in children affected by Harlequin Ichthyosis.
Collapse
Affiliation(s)
- Cinzia Auriti
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy.
| | - Roberta Rotunno
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Diociaiuti
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Andrea Uva
- Rheumatology Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Pediatrics Department, Umberto I Hospital, La Sapienza University, Rome, Italy
| | - Iliana Bersani
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Alessandra Santisi
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Andrea Dotta
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - May El Hachem
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| |
Collapse
|
10
|
Abstract
Drugs may cause bone loss by lowering sex steroid levels (e.g., aromatase inhibitors in breast cancer, GnRH agonists in prostate cancer, or depot medroxyprogestone acetate - DMPA), interfere with vitamin D levels (liver inducing anti-epileptic drugs), or directly by toxic effects on bone cells (chemotherapy, phenytoin, or thiazolidinedions, which diverts mesenchymal stem cells from forming osteoblasts to forming adipocytes). However, besides effects on the mineralized matrix, interactions with collagen and other parts of the unmineralized matrix may decrease bone biomechanical competence in a manner that may not correlate with bone mineral density (BMD) measured by dual energy absorptiometry (DXA).Some drugs and drug classes may decrease BMD like the thiazolidinediones and consequently increase fracture risk. Other drugs such as glucocorticoids may decrease BMD, and thus increase fracture risk. However, glucocorticoids may also interfere with the unmineralized matrix leading to an increase in fracture risk, not mirrored in BMD changes. Some drugs such as selective serotonin reuptake inhibitors (SSRI), paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs) may not per se be associated with bone loss, but fracture risk may be increased, possibly stemming from an increased risk of falls stemming from effects on postural balance mediated by effects on the central nervous system or cardiovascular system.This paper performs a systematic review of drugs inducing bone loss or associated with fracture risk. The chapter is organized by the Anatomical Therapeutic Chemical (ATC) classification.
Collapse
Affiliation(s)
- Peter Vestergaard
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
- Steno Diabetes Center North Jutland, Aalborg, Denmark.
| |
Collapse
|
11
|
Parveen B, Parveen A, Vohora D. Biomarkers of Osteoporosis: An Update. Endocr Metab Immune Disord Drug Targets 2019; 19:895-912. [DOI: 10.2174/1871530319666190204165207] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/16/2018] [Accepted: 01/19/2019] [Indexed: 02/06/2023]
Abstract
Background:
Osteoporosis, characterized by compromised bone quality and strength is
associated with bone fragility and fracture risk. Biomarkers are crucial for the diagnosis or prognosis
of a disease as well as elucidating the mechanism of drug action and improve decision making.
Objective:
An exhaustive description of traditional markers including bone mineral density, vitamin D,
alkaline phosphatase, along with potential markers such as microarchitectural determination, trabecular
bone score, osteocalcin, etc. is provided in the current piece of work. This review provides insight into
novel pathways such as the Wnt signaling pathway, neuro-osseous control, adipogenic hormonal imbalance,
gut-bone axis, genetic markers and the role of inflammation that has been recently implicated
in osteoporosis.
Methods:
We extensively reviewed articles from the following databases: PubMed, Medline and Science
direct. The primary search was conducted using a combination of the following keywords: osteoporosis,
bone, biomarkers, bone turnover markers, diagnosis, density, architecture, genetics, inflammation.
Conclusion:
Early diagnosis and intervention delay the development of disease and improve treatment
outcome. Therefore, probing for novel biomarkers that are able to recognize people at high risk for
developing osteoporosis is an effective way to improve the quality of life of patients and to understand
the pathomechanism of the disease in a better way.
Collapse
Affiliation(s)
- Bushra Parveen
- Department of Pharmacology, Pharmaceutical Medicine, School of Pharmaceutical Education and Research, Jamia Hamdard, New-Delhi-10062, India
| | - Abida Parveen
- Department of Clinical Research, School of Interdisciplinary Sciences, Jamia Hamdard, New-Delhi-10062, India
| | - Divya Vohora
- Department of Pharmacology, Pharmaceutical Medicine, School of Pharmaceutical Education and Research, Jamia Hamdard, New-Delhi-10062, India
| |
Collapse
|
12
|
Sitek JC, Merckoll E, Tølløfsrud PA. Osteopenia and Multiple Fractures in an Infant With Harlequin Ichthyosis. JAMA Dermatol 2019; 154:847-849. [PMID: 29710282 DOI: 10.1001/jamadermatol.2018.0308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jan Cezary Sitek
- Department of Dermatology, Oslo University Hospital, Oslo, Norway.,Center for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - Else Merckoll
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | | |
Collapse
|
13
|
Mancini R, Hooker M, Williams T. Treating Tretinoin Ostealgia With Pamidronate. J Oncol Pract 2018; 14:273-275. [DOI: 10.1200/jop.2017.027888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
14
|
Holvik K, Ahmed LA, Forsmo S, Gjesdal CG, Grimnes G, Samuelsen SO, Schei B, Blomhoff R, Tell GS, Meyer HE. No increase in risk of hip fracture at high serum retinol concentrations in community-dwelling older Norwegians: the Norwegian Epidemiologic Osteoporosis Studies. Am J Clin Nutr 2015; 102:1289-96. [PMID: 26377161 DOI: 10.3945/ajcn.115.110528] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 08/19/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Norway has the highest hip fracture rates worldwide and a relatively high vitamin A intake. Increased fracture risk at high intakes and serum concentrations of retinol (s-retinol) have been observed in epidemiologic studies. OBJECTIVE We aimed to study the association between s-retinol and hip fracture and whether high s-retinol may counteract a preventive effect of vitamin D. DESIGN We conducted the largest prospective analysis of serum retinol and hip fracture to date in 21,774 men and women aged 65-79 y (mean age: 72 y) who attended 4 community-based health studies during 1994-2001. Incident hip fractures occurring up to 10.7 y after baseline were retrieved from electronic hospital discharge registers. Retinol determined by high-pressure liquid chromatography with ultraviolet detection in stored serum was available in 1154 incident hip fracture cases with valid body mass index (BMI) data and in a subcohort defined as a sex-stratified random sample (n = 1418). Cox proportional hazards regression weighted according to the stratified case-cohort design was performed. RESULTS There was a modest increased risk of hip fracture in the lowest compared with the middle quintile of s-retinol (HR: 1.41; 95% CI: 1.09, 1.82) adjusted for sex and study center. The association was attenuated after adjustment for BMI and serum concentrations of α-tocopherol (HR: 1.16; 95% CI: 0.88, 1.51). We found no increased risk in the upper compared with the middle quintile. No significant interaction between serum concentrations of 25-hydroxyvitamin D and s-retinol on hip fracture was observed (P = 0.68). CONCLUSIONS We found no evidence of an adverse effect of high serum retinol on hip fracture or any interaction between retinol and 25-hydroxyvitamin D. If anything, there tended to be an increased risk at low retinol concentrations, which was attenuated after control for confounders. We propose that cod liver oil, a commonly used food supplement in Norway, should not be discouraged as a natural source of vitamin D for fracture prevention.
Collapse
Affiliation(s)
- Kristin Holvik
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Global Public Health and Primary Care and
| | - Luai A Ahmed
- Department of Health and Care Sciences, Faculty of Health Sciences, and Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Siri Forsmo
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Clara G Gjesdal
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Guri Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Sven Ove Samuelsen
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Mathematics
| | - Berit Schei
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynecology, St. Olav's Hospital, Trondheim, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, and
| | - Grethe S Tell
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Global Public Health and Primary Care and
| | - Haakon E Meyer
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway; and
| |
Collapse
|
15
|
Hypercalcaemia secondary to hypervitaminosis a in a patient with chronic renal failure. W INDIAN MED J 2014; 63:105-8. [PMID: 25303202 DOI: 10.7727/wimj.2011.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 12/19/2011] [Indexed: 11/18/2022]
Abstract
Vitamin A toxicity is a well-described medical condition with a multitude of potential presenting signs and symptoms. It can be divided into acute and chronic toxicity. Serum vitamin A concentrations are raised in chronic renal failure even with ingestion of less than the usual toxic doses. Hypercalcaemia can occasionally be associated with high levels of vitamin A but it is rare. In this report, we describe a 67- year old female patient with chronic kidney disease who was taking vitamin A supplements for approximately 10 years. The patient had worsening of her chronic kidney disease over the last years and developed chronic hypercalcaemia. Her vitamin A level was elevated with a daily intake of 7000 IU. The vitamin A supplement was stopped. A few months later, vitamin A level diminished substantially and serum calcium levels returned to normal.
Collapse
|
16
|
Broulík PD, Raška I, Brouliková K. Prolonged overdose of all-trans retinoic acid enhances bone sensitivity in castrated mice. Nutrition 2013; 29:1166-9. [PMID: 23830742 DOI: 10.1016/j.nut.2013.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 03/07/2013] [Accepted: 03/08/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Intake of multivitamin preparations is very common in developed countries. However, excessive intake of vitamin A was associated with increased bone fragility. The aim of this study was to determine if chronic administration of the active metabolite of vitamin A all-trans-retinoic acid (ATRA) in slight excess is associated with changes of bone turnover and density in intact and castrated mice. METHOD Three mo old male mice (C57B1/6) intact and castrated were injected intraperitonealy with 10 mg/kg/d of the ATRA or vehicle (control) once daily for 3 wk. The bone density, ash weights, calcium, and phosphorus content of the femur were measured. Plasma tartrate-resistant acid phosphatase (Tr-ACP) and serum bone alkaline phosphatase (B-ALP) were determined. RESULTS ATRA decreased bone density in both groups; however, this effect was more pronounced in castrated animals (1.487 ± 0.04 to 1,360 ± 0.05 g/cm(3)) than in intact mice (1.570 ± 0.03 to 1.510 ± 0.03 g/cm(3)). Bone density correlated with decreased B-ALP and increased Tr-ACP in ATRA-treated mice. ATRA treatment led to significantly lower thickness of cortical bone both in the intact and castrated animals. CONCLUSION Our results indicate that repeated administration of ATRA in slight excess leads to significant bone loss both in intact and castrated mice. This effect was more pronounced in testosterone-deficient animals. Testosterone deficiency as occurs following castration may sensitize the bone to resorption mediated by ATRA. Therefore, chronic vitamin A administration may be a risk factor for osteoporosis, especially in older and testosterone-depleted subjects.
Collapse
Affiliation(s)
- Peter Dan Broulík
- Third Internal Clinic, 1st Faculty of Medicine and Military Hospital, Charles University, Prague, Czech Republic.
| | | | | |
Collapse
|
17
|
Abstract
STUDY DESIGN Cross-sectional cohort study of elderly people. OBJECTIVE The relationships of osteophyte formation on plain lumbar radiographs with serum levels of antioxidants (carotenoids, vitamin A, vitamin E) and other factors were investigated to examine whether antioxidants are involved in lumbar spine degeneration. SUMMARY OF BACKGROUND DATA Antioxidants have inhibitory effects on the onset of many diseases. However, the association of lumbar osteophyte formation with antioxidant levels in the general population has not been investigated. METHODS The subjects were 286 people (103 men and 183 women; mean age = 68 years) who underwent resident health screening. Osteophyte formation on lumbar lateral radiographs (Nathan classification), lumbar lordosis angles, sacral inclination angles, serum levels of antioxidants, triglyceride levels, body mass index, osteoporosis, back muscle strength, history of alcohol intake, and smoking history were studied in these subjects. RESULTS Lumbar osteophyte formation was detected in 48 subjects (17%). Osteophyte formation was significantly more common in elderly persons, men, and subjects with a history of alcohol intake; and had a significant correlation with sacral inclination angle. The levels of α-tocopherol, β-tocopherol, zeaxanthin/lutein, cryptoxanthin, lycopene, α-carotene, and β-carotene were significantly lower in subjects with osteophytes. Logistic regression analysis adjusted for all factors showed that a higher age (odds ratio [OR] = 1.1, 95% confidence interval [CI] = 1.02-1.16; P = 0.02) and a low β-carotene level (OR = 6.7, 95% CI = 1.39-32.6; P = 0.02) were risk factors for osteophyte formation. CONCLUSION The serum levels of carotenoids and vitamin E were significantly lower in subjects with lumbar osteophyte formation, and a low β-carotene level was the strongest risk factor for lumbar osteophytes. This is the first evidence of an association between carotenoids and lumbar osteophyte formation. This finding suggests that appropriate dietary intake of antioxidants is important for inhibition of lumbar spine degeneration in a rapidly aging society.
Collapse
|
18
|
Balkan W, Rodríguez-Gonzalez M, Pang M, Fernandez I, Troen BR. Retinoic acid inhibits NFATc1 expression and osteoclast differentiation. J Bone Miner Metab 2011; 29:652-61. [PMID: 21384111 DOI: 10.1007/s00774-011-0261-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
Abstract
Ingestion of excess vitamin A appears to correlate with an increased fracture risk, an outcome that is likely mediated by retinoic acids (RAs); these are vitamin A metabolites that have dramatic effects on skeletal development. We studied the impacts of RA and isoform-specific RA receptor (RAR) agonists (α, β, and γ) on osteoclast formation (osteoclastogenesis) in two model systems: RAW264.7 cells and murine bone marrow-derived monocytes. The pan-RAR agonists, all-trans and 9-cis RA, inhibited receptor activator of nuclear factor kappa B ligand (RANKL)-mediated osteoclast differentiation in a concentration-dependent manner. Isoform-specific RAR agonists (α, β, and γ) also inhibited osteoclastogenesis, with the RARα agonist producing the most consistent reductions in both osteoclast number and size and total area covered. Inhibition of osteoclastogenesis correlated with reductions in expression, DNA binding, and nuclear abundance of nuclear factor of activated T cells c1 (NFATc1), a transcription factor critical for osteoclastogenesis. The upregulation of three NFATc1-responsive genes, cathepsin K, dendritic cell-specific transmembrane protein and osteoclast-associated receptor were similarly reduced following RA or RAR agonist exposure. These results suggest that RA blocks in vitro RANKL-mediated osteoclastogenesis by decreasing NFATc1 function.
Collapse
Affiliation(s)
- Wayne Balkan
- Geriatric Research, Education, and Clinical Center and Research Service, Bruce W. Carter Veterans Affairs Healthcare System, Miami, FL 33125, USA.
| | | | | | | | | |
Collapse
|
19
|
|
20
|
Abstract
Background Recently, the laparoscopic sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched. Methods From January 2005 to October 2008, 60 patients underwent LSG. All patients were instructed to take daily vitamin supplements. Patients were tested for micronutrient deficiencies 6 and 12 months after surgery. Results Anemia was diagnosed in 14 (26%) patients. Iron, folic acid, and vitamin B12 deficiency was found in 23 (43%), eight (15%), and five (9%) patients, respectively. Vitamin D and albumin deficiency was diagnosed in 21 (39%) and eight (15%) patients. Hypervitaminosis A, B1, and B6 were diagnosed in 26 (48%), 17 (31%), and 13 (30%) patients, respectively. Conclusions Due to inadequate intake and uptake of micronutrients, patients who underwent LSG are at serious risk for developing micronutrient deficiencies. Moreover, some vitamins seem to increase to chronic elevated levels with possible complications in the long-term. Multivitamins and calcium tablets should be regarded only as a minimum and supplements especially for iron, vitamin B12, vitamin D, and calcium should be added to this regimen based on regular blood testing.
Collapse
|
21
|
Wei MY, Garland CF, Gorham ED, Mohr SB, Giovannucci E. Vitamin D and prevention of colorectal adenoma: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2009; 17:2958-69. [PMID: 18990737 DOI: 10.1158/1055-9965.epi-08-0402] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Vitamin D status is associated inversely with risk of colorectal cancer, but the association with adenoma risk is less clear. This meta-analysis examined the overall relationship between circulating (plasma or serum) 25-hydroxyvitamin D [25(OH)D], vitamin D intake (dietary, supplemental, or total), and colorectal adenoma incidence in published studies. METHODS A meta-analysis composed of 17 epidemiologic studies [1 cross-sectional, 9 case-control, and 7 cohort or nested case-control studies; 7 on 25(OH)D and 12 on vitamin D intake] published before December 2007 was done to examine the association between circulating 25(OH)D, vitamin D intake, and colorectal adenomas. Summary Peto odds ratios (OR) were computed for overall and stratified analyses. RESULTS Circulating 25(OH)D was inversely associated with risk of colorectal adenomas: the OR was 0.70 [95% confidence interval (95% CI), 0.56-0.87] for high versus low circulating 25(OH)D. The highest quintile of vitamin D intake was associated with an 11% marginally decreased risk of colorectal adenomas compared with low vitamin D intake (OR, 0.89; 95% CI, 0.78-1.02). For recurrent adenomas, there was a decreased risk of 12% (95% CI, 0.72-1.07) among individuals with high versus low vitamin D intake. The inverse associations appeared stronger for advanced adenoma [OR, 0.64; 95% CI, 0.45-0.90 for serum 25(OH)D and OR, 0.77; 95% CI, 0.63-0.95 for vitamin D intake], but the number of studies was small. CONCLUSIONS Both circulating 25(OH)D and vitamin D intake were inversely associated with colorectal adenoma incidence and recurrent adenomas. These results further support a role of vitamin D in prevention of colorectal adenoma incidence and recurrence.
Collapse
Affiliation(s)
- Melissa Y Wei
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
| | | | | | | | | |
Collapse
|
22
|
|
23
|
Graham-Maar RC, Schall JI, Stettler N, Zemel BS, Stallings VA. Elevated vitamin A intake and serum retinol in preadolescent children with cystic fibrosis. Am J Clin Nutr 2006; 84:174-82. [PMID: 16825693 DOI: 10.1093/ajcn/84.1.174] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Persons with cystic fibrosis (CF) and pancreatic insufficiency (PI) are at risk of vitamin A deficiency because of steatorrhea, despite pancreatic enzyme replacement. Long-standing vitamin A supplementation may increase the risk of vitamin A toxicity. OBJECTIVE The aim was to describe the vitamin A intake and serum retinol concentrations of preadolescent children with CF, PI, and mild-to-moderate pulmonary disease, who were cared for under current practice recommendations. DESIGN This cross-sectional study evaluated children aged 8.0-11.9 y with CF and PI from 13 US CF centers. Dietary and supplemental vitamin A intakes were compared with the Dietary Reference Intakes (DRIs) for healthy children, CF recommendations, and data from the National Health and Nutrition Examination Survey (NHANES), 1999-2000. Serum retinol concentrations were compared with NHANES data. RESULTS The 73 subjects with CF had a dietary vitamin A intake of 816 +/- 336 microg retinol activity equivalents (165 +/- 69% of the recommended dietary allowance), which was similar to the NHANES value. The supplement intake provided 2234 +/- 1574 microg retinol activity equivalents/d and exceeded recommendations in 21% of the subjects with CF. Total preformed retinol intake exceeded the DRI tolerable upper intake level in 78% of the subjects with CF. The serum retinol concentration was 52 +/- 13 microg/dL (range: 26-98 microg/dL), which was significantly higher than the NHANES value (37 +/- 10 microg/dL; range: 17-63 microg/dL; P < 0.001). CONCLUSION Although supplementation helps to prevent vitamin A deficiency in children with CF and PI, their high vitamin A intakes and serum retinol concentrations suggest that usual care may result in excessive vitamin A intake and possible toxicity that would increase the risk of CF-associated liver and bone complications.
Collapse
Affiliation(s)
- Rose C Graham-Maar
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA.
| | | | | | | | | |
Collapse
|
24
|
White SC, Atchison KA, Gornbein JA, Nattiv A, Paganini-Hill A, Service SK. Risk factors for fractures in older men and women: The Leisure World Cohort Study. ACTA ACUST UNITED AC 2006; 3:110-23. [PMID: 16860270 DOI: 10.1016/s1550-8579(06)80200-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2006] [Indexed: 01/24/2023]
Abstract
BACKGROUND Osteoporosis results in >1.5 million fractures in the United States each year, leading to substantial health care costs and loss of quality of life. One major gap in our knowledge is how to effectively identify individuals at risk of developing a fracture. OBJECTIVE We examined a population-based cohort for risk factors for fractures of the hip, wrist, and spine in men and women. METHODS The Leisure World Cohort Study was established between 1981 and 1985 when residents of a southern California retirement community completed a postal health survey. Multiple lifestyle, medical, attitudinal, and anthropomorphic factors were self-reported. Fractures were identified from 4 follow-up surveys, hospital discharge records, and death certificates. Fracture rates were determined separately for men and women. Cox proportional hazards regression was used to identify predictors of fracture. RESULTS Incident fractures of the hip (n = 1,227), wrist (n = 445), and spine (n = 729) incurred over the course of 2 decades were identified in the 13,978 residents surveyed. Mean (SD) age at entry was 74.9 (7.2) years for men and 73.7 (7.4) years for women. The most important risk factors for fracture were the same in men and women: age increased risk of hip and spine fractures (hazard ratio [HR] = 2.3-3.2 per 10 years) and history of fracture increased fracture risk at all 3 sites (HR = 1.4-3.2). In both men and women, glaucoma was a significant risk factor for hip fracture (HR = 1.9 and 1.3, respectively), and smoking was a risk factor for hip and spine fractures. Men and women with a positive mental attitude had fewer hip and spine fractures (HR = 0.7-0.9). High body mass index was protective at all 3 fracture sites in women (HR = 0.7-0.8), but those who used vitamin A supplements had increased rates of hip and wrist fracture (HR = 1.1 per 10,000 IU per day). CONCLUSIONS Attitude, lifestyle choices, and the presence of medical conditions may influence the rate of osteoporotic fracture in older women and men and may help identify individuals at high risk.
Collapse
Affiliation(s)
- Stuart C White
- Section of Oral and Maxillo facial Radiology, UCLA School of Dentistry, Los Angeles, California 90095-1668, USA.
| | | | | | | | | | | |
Collapse
|