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Fitzpatrick D, Laird E, Ward M, Hoey L, Hughes CF, Strain JJ, Cunningham C, Healy M, Molloy AM, McNulty H, Lannon R, McCarroll K. Secondary hyperparathyroidism: Predictors and relationship with vitamin D status, bone turnover markers and bone mineral density. Bone 2024; 184:117108. [PMID: 38642819 DOI: 10.1016/j.bone.2024.117108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Secondary hyperparathyroidism (SHPT) has adverse implications for bone health but is relatively understudied. In this study we examine the prevalence and determinants of SHPT and describe the relationship of SHPT with bone turnover markers and bone mineral density (BMD) in older Irish adults. METHOD Eligible participants (n = 4139) were identified from the Trinity-Ulster-Department of Agriculture (TUDA) study, a cohort of Irish adults aged ≥60 years. Exclusion criteria included an estimated glomerular filtration rate (eGFR) <30 ml/min and serum calcium >2.5 mmol/l to remove hyperparathyroidism due to advanced chronic kidney disease (CKD) and primary hyperparathyroidism respectively. The relationship between SHPT and bone turnover markers and BMD (measured by densitometry) was examined in a subsample (n = 1488). Vitamin D deficiency was defined as 25-hydroxyvitamin D [25 (OH)D] <30 nmol/l. RESULTS Participants had a mean age of 73.6 ± 7.9 years, 65.1 % were female and 19.4 % were found to be vitamin D deficient. The prevalence of SHPT decreased as vitamin D increased, from 30.6 % in those deficient to 9.8 % in those with 25(OH)D ≥ 50 nmol/l and increased with declining kidney function. In non‑calcium supplement users, principal determinants of SHPT were vitamin D deficiency (OR 4.18, CI 3.05-5.73, p < 0.001), eGFR 30-44 ml/min (OR 3.69, CI 2.44-5.57, p < 0.001), loop diuretic use (OR 3.52, CI 2.59-4.79, p < 0.001) and to a lesser extent body mass index (p = 0.001), eGFR 45-59 ml/min (p < 0.001) and 25(OH)D level 30-49 nmol/l (p = 0.002). Similar findings were observed in calcium supplement users, though proton pump inhibitors were also associated with SHPT (OR 1.55, CI 1.08-2.22, p = 0.018) while vitamin D 30-49 nmol/l was not. In participants with SHPT versus those without, bone turnover markers were higher: bone alkaline phosphatase (p = 0.017) and tartrate-resistant acid phosphatase (p = 0.033), whilst there was lower BMD at the neck of femur (0.880 vs. 0.903 g/cm2, p = 0.033) and total hip (0.968 vs. 0.995 g/cm2, P = 0.017). DISCUSSION The results show that up to one in six older Irish adults had SHPT and this was associated with lower BMD and higher concentrations of bone turnover markers. Both vitamin D deficiency and 25(OH)D level 30-49 nmol/l were important predictors of SHPT. Loop diuretics and PPIs may also increase the risk of SHPT, and their use may need to be carefully considered in this population. Further studies examining the potential impact of these factors on bone health in similar populations to our study sample are warranted.
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Affiliation(s)
- Donal Fitzpatrick
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland.
| | - Eamon Laird
- Department of Health & Nutritional Sciences, Atlantic Technological University Sligo, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - J J Strain
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Rosaleen Lannon
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland
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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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Secondulfo C, Visco V, Virtuoso N, Fortunato M, Migliarino S, Rispoli A, La Mura L, Stellato A, Caliendo G, Settembre E, Galluccio F, Hamzeh S, Bilancio G. Vitamin D: A Bridge between Kidney and Heart. Life (Basel) 2024; 14:617. [PMID: 38792638 PMCID: PMC11123235 DOI: 10.3390/life14050617] [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: 04/02/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are highly prevalent conditions, each significantly contributing to the global burden of morbidity and mortality. CVD and CKD share a great number of common risk factors, such as hypertension, diabetes, obesity, and smoking, among others. Their relationship extends beyond these factors, encompassing intricate interplay between the two systems. Within this complex network of pathophysiological processes, vitamin D has emerged as a potential linchpin, exerting influence over diverse physiological pathways implicated in both CKD and CVD. In recent years, scientific exploration has unveiled a close connection between these two prevalent conditions and vitamin D, a crucial hormone traditionally recognized for its role in bone health. This article aims to provide an extensive review of vitamin D's multifaceted and expanding actions concerning its involvement in CKD and CVD.
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Affiliation(s)
- Carmine Secondulfo
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Valeria Visco
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Nicola Virtuoso
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Martino Fortunato
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Serena Migliarino
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Antonella Rispoli
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Lucia La Mura
- Centro Medico Ascione Srl, 80059 Torre del Greco, Italy
| | - Adolfo Stellato
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Giuseppe Caliendo
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Emanuela Settembre
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Fabiana Galluccio
- Department of Medicine and Surgery, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Sarah Hamzeh
- Department of Medicine and Surgery, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Giancarlo Bilancio
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
- Nephrology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
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Ren Y, Feng Y, Qing J, Zhang P, Xiao L, Liang X. The correlation between nuts and algae-less diet and children's blood pressure: from a cross-sectional study in Chongqing. Clin Exp Hypertens 2023; 45:2180024. [PMID: 36823777 DOI: 10.1080/10641963.2023.2180024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Nuts and algae have been shown to improve BP levels, but their effectiveness is controversial. AIMS This study aims to illustrate the effect of dietary pattern with nuts and algae-less on BP levels in children and adolescents from a cross-sectional study. METHODS A total of 5645 children from the Chongqing Children's Health Cohort, aged 9.34 ± 1.74 years with 52.05% males, were analyzed. Stratified analysis was conducted to explore the differences between the two dietary patterns in urban or rural areas, as well as the differences in different gender. Logistic regression was used to analyze the influence factors of increased BP. And a GLM was used to analyze the influence of the two dietary patterns on systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), and mean arterial pressure (MAP, mmHg). RESULTS Children with nuts and algae-less dietary patterns had higher SBP (104.68 ± 10.31 vs 103.81 ± 9.74, P = .006), DBP (64.27 ± 7.53 vs 63.55 ± 7.52, P = .002), and MAP (77.74 ± 7.75 vs 76.97 ± 7.52, P = .001) compared with those children with a balanced diet. After adjusting for covariates, the nuts and algae-less diet was a risk factor for hypertension in children when compared with the balanced diet(OR(95%CI):1.455(1.097,1.930), P = .009). The nuts and algae-less diet has a significant influence on SBP (104.68 ± 10.31 mmHg vs.103.81 ± 9.74 mmHg, P = .006). Stratified analysis by sex showed that nuts and algae-less dietary patterns had a more significant impact on females than males. CONCLUSION Nuts and algae-less dietary pattern correlated with increased BP levels in children, and a greater impact on SBP levels was found in females, suggesting that a balanced diet with appropriate nuts and algae should be proposed for children in China.
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Affiliation(s)
- Yanling Ren
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Ye Feng
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Jun Qing
- Center for Disease Control and Prevention of Jiulongpo District, Chongqing, China
| | - Ping Zhang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Lun Xiao
- Center for Disease Control and Prevention of Jiulongpo District, Chongqing, China
| | - Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
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Tayal R, Yasmin S, Chauhan S, Singh TG, Saini M, Shorog E, Althubyani MM, Alsaadi BH, Aljohani F, Alenazi MA, Abutaily SA, Ansari MY. Are Proton Pump Inhibitors Contributing in Emerging New Hypertensive Population? Pharmaceuticals (Basel) 2023; 16:1387. [PMID: 37895858 PMCID: PMC10609986 DOI: 10.3390/ph16101387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Balancing the therapeutic advantages of a medicine with its possible risks and side effects is an important part of medical practice and drug regulation. When a drug is designed to treat a particular disease or medical condition ends up causing additional risks or side effects that lead to the development of other serious health problems, it can have detrimental consequences for patients. This article explores the correlation between persistent proton pump inhibitor (PPI) use and hypertension, a common cardiovascular ailment. While PPIs are beneficial in treating various gastrointestinal problems, their availability without a prescription has resulted in self-medication and long-term use without medical monitoring. Recent findings have revealed a link between long-term PPI usage and increased cardiovascular risks, particularly hypertension. This study investigates the intricate mechanisms underlying PPI's effects, focusing on potential pathways contributing to hypertension, such as endothelial dysfunction, disruption of nitric oxide bioavailability, vitamin B deficiency, hypocalcemia, and hypomagnesemia. The discussion explains how long-term PPI use can disrupt normal endothelial function, vascular control, and mineral balance, eventually leading to hypertension. The article emphasizes the significance of using PPIs with caution and ongoing research to better understand the implications of these medications on cardiovascular health.
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Affiliation(s)
- Rohit Tayal
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (R.T.); (T.G.S.)
| | - Sabina Yasmin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia;
| | - Samrat Chauhan
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (R.T.); (T.G.S.)
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (R.T.); (T.G.S.)
| | - Monika Saini
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala 133207, Haryana, India;
- Swami Vivekanand College of Pharmacy, Ramnagar, Banur 140601, Punjab, India
| | - Eman Shorog
- Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia;
| | - Maryam M. Althubyani
- Department of Clinical Services, Pharmaceutical Care Services, King Salman Medical City, Ministry of Health MOH, Al Madinah Al Munawwarah 11176, Saudi Arabia; (M.M.A.); (B.H.A.)
| | - Baiaan H. Alsaadi
- Department of Clinical Services, Pharmaceutical Care Services, King Salman Medical City, Ministry of Health MOH, Al Madinah Al Munawwarah 11176, Saudi Arabia; (M.M.A.); (B.H.A.)
| | - Fatimah Aljohani
- Prince Sultan Armed Forces Hospital, Al Madenah Al Monwarah 42375, Saudi Arabia;
| | - Maram A. Alenazi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Ministry of Health (MOH), Hail 55471, Saudi Arabia;
| | - Sarah A. Abutaily
- Ambulatory Care Clinical, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia;
| | - Mohammad Yousuf Ansari
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala 133207, Haryana, India;
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Jensen NS, Wehland M, Wise PM, Grimm D. Latest Knowledge on the Role of Vitamin D in Hypertension. Int J Mol Sci 2023; 24:ijms24054679. [PMID: 36902110 PMCID: PMC10003079 DOI: 10.3390/ijms24054679] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
Hypertension is the third leading cause of the global disease burden, and while populations live longer, adopt more sedentary lifestyles, and become less economically concerned, the prevalence of hypertension is expected to increase. Pathologically elevated blood pressure (BP) is the strongest risk factor for cardiovascular disease (CVD) and related disability, thus making it imperative to treat this disease. Effective standard pharmacological treatments, i.e., diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blocker (ARBs), beta-adrenergic receptor blockers (BARBs), and calcium channel blockers (CCBs), are available. Vitamin D (vitD) is known best for its role in bone and mineral homeostasis. Studies with vitamin D receptor (VDR) knockout mice show an increased renin-angiotensin-aldosterone system (RAAS) activity and increased hypertension, suggesting a key role for vitD as a potential antihypertensive agent. Similar studies in humans displayed ambiguous and mixed results. No direct antihypertensive effect was shown, nor a significant impact on the human RAAS. Interestingly, human studies supplementing vitD with other antihypertensive agents reported more promising results. VitD is considered a safe supplement, proposing its great potential as antihypertensive supplement. The aim of this review is to examine the current knowledge about vitD and its role in the treatment of hypertension.
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Affiliation(s)
- Niklas S. Jensen
- Department of Biomedicine, Aarhus University, Ole Worms Allé 4, 8000 Aarhus, Denmark
| | - Markus Wehland
- Department of Microgravity and Translational Regenerative Medicine, University Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany
- Research Group “Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen” (MARS), Otto von Guericke University, 39106 Magdeburg, Germany
| | - Petra M. Wise
- The Saban Research Institute, Children’s Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
| | - Daniela Grimm
- Department of Biomedicine, Aarhus University, Ole Worms Allé 4, 8000 Aarhus, Denmark
- Department of Microgravity and Translational Regenerative Medicine, University Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany
- Research Group “Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen” (MARS), Otto von Guericke University, 39106 Magdeburg, Germany
- Correspondence: ; Tel.: +45-21379702
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7
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Doshi KB, Moon SH, Whitaker MD, Lockhart TE. Assessment of gait and posture characteristics using a smartphone wearable system for persons with osteoporosis with and without falls. Sci Rep 2023; 13:538. [PMID: 36631544 PMCID: PMC9834330 DOI: 10.1038/s41598-023-27788-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
We used smartphone technology to differentiate the gait characteristics of older adults with osteoporosis with falls from those without falls. We assessed gait mannerism and obtained activities of daily living (ADLs) with wearable sensor systems (smartphones and inertial measurement units [IMUs]) to identify fall-risk characteristics. We recruited 49 persons with osteoporosis: 14 who had a fall within a year before recruitment and 35 without falls. IMU sensor signals were sampled at 50 Hz using a customized smartphone app (Lockhart Monitor) attached at the pelvic region. Longitudinal data was collected using MoveMonitor+ (DynaPort) IMU over three consecutive days. Given the close association between serum calcium, albumin, PTH, Vitamin D, and musculoskeletal health, we compared these markers in individuals with history of falls as compared to nonfallers. For the biochemical parameters fall group had significantly lower calcium (P = 0.01*) and albumin (P = 0.05*) and higher parathyroid hormone levels (P = 0.002**) than nonfall group. In addition, persons with falls had higher sway area (P = 0.031*), lower dynamic stability (P < 0.001***), gait velocity (P = 0.012*), and were less able to perform ADLs (P = 0.002**). Thus, persons with osteoporosis with a history of falls can be differentiated by using dynamic real-time measurements that can be easily captured by a smartphone app, thus avoiding traditional postural sway and gait measures that require individuals to be tested in a laboratory setting.
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Affiliation(s)
- Krupa B. Doshi
- grid.417468.80000 0000 8875 6339Division of Endocrinology, Mayo Clinic, Scottsdale, AZ 85259 USA
| | - Seong Hyun Moon
- grid.215654.10000 0001 2151 2636School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85281 USA
| | - Michael D. Whitaker
- grid.417468.80000 0000 8875 6339Division of Endocrinology, Mayo Clinic, Scottsdale, AZ 85259 USA
| | - Thurmon E. Lockhart
- grid.215654.10000 0001 2151 2636School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85281 USA
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Rana ZH, Bourassa MW, Gomes F, Khadilkar A, Mandlik R, Owino V, Pettifor JM, Roth DE, Shlisky J, Thankachan P, Weaver CM. Calcium status assessment at the population level: Candidate approaches and challenges. Ann N Y Acad Sci 2022; 1517:93-106. [PMID: 36044378 DOI: 10.1111/nyas.14886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Inadequate dietary calcium intake is a global public health problem that disproportionately affects low- and middle-income countries. However, the calcium status of a population is challenging to measure, and there are no standard methods to identify high-risk communities even in settings with an elevated prevalence of a disease caused or exacerbated by low calcium intake (e.g., rickets). The calcium status of a population depends on numerous factors, including intake of calcium-rich foods; the bioavailability of the types of calcium consumed in foods and supplements; and population characteristics, including age, sex, vitamin D status, and genetic attributes that influence calcium retention and absorption. The aim of this narrative review was to assess candidate indicators of population-level calcium status based on a range of biomarkers and measurement methods, including dietary assessment, calcium balance studies, hormonal factors related to calcium, and health outcomes associated with low calcium status. Several promising approaches were identified, but there was insufficient evidence of the suitability of any single indicator to assess population calcium status. Further research is required to develop and validate specific indicators of calcium status that could be derived from the analysis of data or samples that are feasibly collected in population-based surveys.
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Affiliation(s)
- Ziaul H Rana
- The New York Academy of Sciences, New York, New York, USA
| | | | - Filomena Gomes
- The New York Academy of Sciences, New York, New York, USA.,NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | | | - Rubina Mandlik
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Victor Owino
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - John M Pettifor
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Daniel E Roth
- The Hospital for Sick Children/University of Toronto, Toronto, Ontario, Canada
| | - Julie Shlisky
- The New York Academy of Sciences, New York, New York, USA
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Bae YJ, Kim MH, Choi MK. Dietary Mineral Intake from Nuts and Its Relationship to Hypertension Among Korean Adults. Biol Trace Elem Res 2022; 200:3519-3528. [PMID: 34661846 DOI: 10.1007/s12011-021-02952-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 12/11/2022]
Abstract
Accumulating evidence shows that nut consumption beneficially affects health outcomes. The purpose of this study was to investigate the association between the intake of nuts, focusing on their mineral contents, and the risk of hypertension in nationally representative samples in Korea. A cross-sectional study was conducted among 12,113 subjects (4762 men and 7351 women) aged 19-64 years using raw data from KNHANES 2016-2019. Daily intake of 20 nuts and 9 minerals from nuts was assessed using the 24-h recall method. The risk of hypertension according to the median mineral intake from nuts and nuts themselves was assessed using logistic regression analysis with adjustment for potential confounders. The average daily nut intake was 4.34 g for females and 3.78 g males. Among nut intake, chestnuts represented the highest value at 0.95 g/day, followed by peanuts (0.72 g/day), almonds (0.62 g/day), sesame seeds (0.62 g/day), perilla seeds (0.33 g/day), and walnuts (0.32 g/day). The daily intake of minerals from nuts was significantly higher in the nut-overmedian (OM) group than in the nut-undermedian (UM) group. Regarding mineral intake from nuts, each mineral-UM group showed higher odds of hypertension than the mineral-OM group in women, but not in men. After adjustment for potential confounders, an inverse association between nut consumption, including minerals obtained from nuts, and hypertension prevalence, especially in women, was observed. Based on our results, it is suggested that incorporation of nuts into a daily diet may yield beneficial effects and lower the risk of hypertension in adult Korean women.
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Affiliation(s)
- Yun-Jung Bae
- Major in Food and Nutrition, Korea National University of Transportation, Jeungpyeong, 27909, South Korea
| | - Mi-Hyun Kim
- Department of Food and Nutrition, Kongju National University, Yesan, 32439, South Korea
| | - Mi-Kyeong Choi
- Department of Food and Nutrition, Kongju National University, Yesan, 32439, South Korea.
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Lemoine S, Figueres L, Bacchetta J, Frey S, Dubourg L. Calcium homeostasis pathologies in hyperparathyroidism: nephrologic and endocrinologic points of view. ANNALES D'ENDOCRINOLOGIE 2022; 83:237-243. [DOI: 10.1016/j.ando.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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11
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Han Y, Han K, Zhang Y, Zeng X. Serum 25-hydroxyvitamin D might be negatively associated with hyperuricemia in U.S. adults: an analysis of the National Health and Nutrition Examination Survey 2007-2014. J Endocrinol Invest 2022; 45:719-729. [PMID: 34435335 PMCID: PMC8918159 DOI: 10.1007/s40618-021-01637-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/11/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE The results of previous studies on the relationship between serum 25-hydroxyvitamin D [25(OH)D] and hyperuricemia are controversial. We hypothesized that serum 25(OH)D concentrations of U.S. adults would negatively correlate with the risk of hyperuricemia. METHOD Data came from the National Health and Nutrition Examination Survey 2007-2014 were used, after excluding those who met at least one of the exclusion criteria, a total of 9096 male individuals and 9500 female individuals aged 18 years or older were included. Binary logistic regression analysis and restricted cubic spline with fully adjusted confounding factors were applied to evaluate the association between serum 25(OH)D and hyperuricemia. We further performed stratified analysis and sensitivity analysis to minimize the influence of gender, metabolic syndrome, obesity and renal dysfunction on the above association. RESULTS We found a negative correlation between serum 25(OH)D and hyperuricemia. In the binary logistic regression analysis, compared with the highest serum 25(OH)D quartile [Q4: 25(OH)D > 77.10 nmol/L] group, the odds ratios (95% confidence intervals) in the lowest quartile [Q1: 25(OH)D ≤ 43.20 nmol/L] was 1.46 (1.22-1.75) in the fully adjusted model. Restricted cubic spline analysis showed L-shaped and non-linear relationships between 25(OH)D and hyperuricemia. In sensitivity analysis, after restricting to participants without significant renal dysfunction and obesity, the above association remained significant. After restricting to participants who were diagnosed as metabolic syndrome, above association remained significant in the fully adjusted model. In stratified analysis by gender, the association remained significant among males and females. CONCLUSIONS Serum 25(OH)D might be inversely associated with hyperuricemia in general U.S. adults. From our study, for people with unexplained hyperuricemia, screening for serum Vitamin D concentration might be necessary.
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Affiliation(s)
- Y Han
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - K Han
- Department of Critical Care Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China
| | - Y Zhang
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| | - X Zeng
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
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12
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Caldas APS, Rocha DMUP, Dionísio AP, Hermsdorff HHM, Bressan J. Brazil and cashew nuts intake improve body composition and endothelial health in women at cardiometabolic risk (Brazilian Nuts Study): a randomized controlled trial. Br J Nutr 2022; 128:1-38. [PMID: 35193718 DOI: 10.1017/s000711452100475x] [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] [Indexed: 01/02/2023]
Abstract
Several mechanisms have been proposed for the beneficial effect of nuts on health. However, Brazil and cashew nuts remain the least studied. We aim to evaluate the effect of these nuts within an energy-restricted diet on body weight, body composition, cardiometabolic markers, and endothelial function in cardiometabolic risk women. Brazilian nuts study is a randomized controlled parallel 8-week dietary intervention trial. Forty women were randomly allocated to 1) Control group: Energy-restricted diet without nuts, n= 19 or, 2) Brazil and cashew nuts group (BN-Group): Energy-restricted diet containing daily 45 g of nuts (15 g of Brazil nuts + 30g of cashew nuts), n= 21. At the beginning and final intervention, anthropometry, body composition, and blood pressure were measured. Fasting blood sampling was obtained to evaluate lipid profile, glucose homeostasis, and endothelial function markers. After 8-week, plasma selenium concentration increased in BN-group (∆ = + 31.5 ± 7.8 μg/L; p= 0.001). Brazil and cashew nuts intake reduced total body fat (-1.3 ± 0.4 %) parallel to improvement of lean mass percentage in BN-group compared to the control. Besides, the soluble adhesion molecule VCAM-1 decreased (24.03 ± 15.7 pg/mL vs. -22.2 ± 10.3 pg/mL; p= 0.019) after Brazil and cashew nuts intake compared to the control. However, lipid and glucose profile markers, apolipoproteins, and blood pressure remained unchanged after the intervention. Thus, the addition of Brazil and cashew nuts to an energy-restricted diet can be a healthy strategy to improve body composition, selenium status, and endothelial inflammation in cardiometabolic risk women.
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Affiliation(s)
- Ana Paula Silva Caldas
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | | | - Ana Paula Dionísio
- Embrapa Agroindústria Tropical, Sara Mesquita Street, 2270, 60511-110, Fortaleza, Ceará, Brazil
| | | | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
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Abstract
Coexisting dysfunction of heart and kidney, the cardiorenal syndrome, is a common condition and is associated with worsening of outcomes and complexities of diagnostic, preventive, and therapeutic approaches. The knowledge of the physiology of heart and kidney and their interaction with each other and with other organ systems has progressed significantly in recent years, resulting in a better understanding of the pathogenesis of cardiorenal syndrome. A robust knowledge of the pathophysiology and of the latest practical advancements about cardiorenal syndrome is necessary for cardiologists, nephrologists, and other practitioners who provide medical care to the patients with heart and kidney diseases.
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Affiliation(s)
- Parta Hatamizadeh
- Department of Medicine, Division of Nephrology, Hypertension & Renal Transplantation, University of Florida, 1600 SW Archer Road, CG-98, PO Box 100224, Gainesville, FL 32610, USA.
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Parathyroid Hormone: A Uremic Toxin. Toxins (Basel) 2020; 12:toxins12030189. [PMID: 32192220 PMCID: PMC7150960 DOI: 10.3390/toxins12030189] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/08/2020] [Accepted: 03/08/2020] [Indexed: 12/27/2022] Open
Abstract
Parathyroid hormone (PTH) has an important role in the maintenance of serum calcium levels. It activates renal 1α-hydroxylase and increases the synthesis of the active form of vitamin D (1,25[OH]2D3). PTH promotes calcium release from the bone and enhances tubular calcium resorption through direct action on these sites. Hallmarks of secondary hyperparathyroidism associated with chronic kidney disease (CKD) include increase in serum fibroblast growth factor 23 (FGF-23), reduction in renal 1,25[OH]2D3 production with a decline in its serum levels, decrease in intestinal calcium absorption, and, at later stages, hyperphosphatemia and high levels of PTH. In this paper, we aim to critically discuss severe CKD-related hyperparathyroidism, in which PTH, through calcium-dependent and -independent mechanisms, leads to harmful effects and manifestations of the uremic syndrome, such as bone loss, skin and soft tissue calcification, cardiomyopathy, immunodeficiency, impairment of erythropoiesis, increase of energy expenditure, and muscle weakness.
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15
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Rural and Urban Population Differences in the Association of Dietary Calcium with Blood Pressure and Hypertension Occurrence: Analysis of Longitudinal Data from the China Health and Nutrition Survey. J 2020. [DOI: 10.3390/j3010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The relationship of dietary calcium intake (DCI) to blood pressure (BP) and hypertension occurrence (HTN) in the general population is controversial. Few studies have reported the impact of DCI on high blood pressure (HBP) and HTN in rural and urban populations (RPs and UPs, respectively). In this study, we assessed how DCI is related to BP and HTN among the RP and the UP. This retrospective study used data from the Chinese Health and Nutrition Survey (CHNS) for 2000–2009. We analyzed 12,052 records from 3013 participants using path analysis and logistic regressions. DCI and HTN were significantly higher in the UP compared to the RP. When UPs and RPs were analyzed together, a 1 unit increase in DCI decreased systolic blood pressure (SBP) by 0.01 (p = 0.002) but had no effect on diastolic blood pressure. Males vs. females from the RP presented significant risk of HTN by the high DCI (OR = 2.3 (1.6–3.6)). DCI and its association with BP varied based on living environment and sex.
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Gabbett MT, Jeavons CJ, Gray PH. Severe hypertension-An infantile feature of Jansen metaphyseal chondrodysplasia? Am J Med Genet A 2020; 182:768-772. [PMID: 31977144 DOI: 10.1002/ajmg.a.61494] [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: 12/10/2019] [Revised: 01/09/2020] [Accepted: 01/12/2020] [Indexed: 11/10/2022]
Abstract
Jansen metaphyseal chondrodysplasia (JMC) is a rare autosomal dominant skeletal dysplasia caused by gain-of-function mutations in the parathyroid hormone receptor 1 gene, PTH1R. We report on a patient presenting in the neonatal period with clinical signs of JMC in addition to severe hypertension. A pathogenic mutation in PTH1R was demonstrated, but investigations for hypertension yielded normal results. Hypertension has not been previously associated with JMC. Given aberration of the parathyroid hormone (PTH)/parathyroid-related protein pathway is the underlying pathogenic mechanism attributed to JMC, and also given evidence that hyperparathyroidism plays an important role in blood pressure homeostasis, we propose that hypertension is a hitherto unrecognized feature of JMC.
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Affiliation(s)
- Michael T Gabbett
- School of Biomedical Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Genetic Health Queensland, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Cassandra J Jeavons
- Genetic Health Queensland, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.,Department of Medical Imaging, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Peter H Gray
- Newborn Services, Mater Health Services, Brisbane, Queensland, Australia.,Mater Medical Research Institute, Brisbane, Queensland, Australia
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Responses of primary osteoblasts and osteoclasts from hemizygous β-globin knockout thalassemic mice with elevated plasma glucose to 1,25-dihydroxyvitamin D 3. Sci Rep 2019; 9:13963. [PMID: 31562377 PMCID: PMC6765013 DOI: 10.1038/s41598-019-50414-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/11/2019] [Indexed: 02/01/2023] Open
Abstract
β-thalassemia is often associated with hyperglycemia, osteoporosis and increased fracture risk. However, the underlying mechanisms of the thalassemia-associated bone loss remain unclear. It might result from abnormal activities of osteoblasts and osteoclasts, and perhaps prolonged exposure to high extracellular glucose. Herein, we determined the rate of duodenal calcium transport in hemizygous β-globin knockout thalassemic (BKO) mice. Their bones were collected for primary osteoblast and osteoclast culture. We found that BKO mice had lower calcium absorption than their wild-type (WT) littermates. Osteoblasts from BKO mice showed aberrant expression of osteoblast-specific genes, e.g., Runx2, alkaline phosphatase and osteocalcin, which could be partially restored by 1,25(OH)2D3 treatment. However, the mRNA expression levels of RANK, calcitonin receptor (Calcr), c-Fos, NFATc1, cathepsin K and DMT1 were similar in both BKO and WT groups. Exposure to high extracellular glucose modestly but significantly affected the expression of osteoclast-specific markers in WT osteoclasts with no significant effect on osteoblast-specific genes in WT osteoblasts. Thus, high glucose alone was unable to convert WT bone cells to BKO-like bone cells. In conclusion, the impaired calcium absorption and mutation-related aberrant bone cell function rather than exposure to high blood glucose were likely to be the principal causes of thalassemic bone loss.
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18
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Villa-Etchegoyen C, Lombarte M, Matamoros N, Belizán JM, Cormick G. Mechanisms Involved in the Relationship between Low Calcium Intake and High Blood Pressure. Nutrients 2019; 11:E1112. [PMID: 31109099 PMCID: PMC6566648 DOI: 10.3390/nu11051112] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/01/2019] [Accepted: 05/16/2019] [Indexed: 01/21/2023] Open
Abstract
There is increasing epidemiologic and animal evidence that a low calcium diet increases blood pressure. The aim of this review is to compile the information on the link between low calcium intake and blood pressure. Calcium intake may regulate blood pressure by modifying intracellular calcium in vascular smooth muscle cells and by varying vascular volume through the renin-angiotensin-aldosterone system. Low calcium intake produces a rise of parathyroid gland activity. The parathyroid hormone increases intracellular calcium in vascular smooth muscles resulting in vasoconstriction. Parathyroidectomized animals did not show an increase in blood pressure when fed a low calcium diet as did sham-operated animals. Low calcium intake also increases the synthesis of calcitriol in a direct manner or mediated by parathyroid hormone (PTH). Calcitriol increases intracellular calcium in vascular smooth muscle cells. Both low calcium intake and PTH may stimulate renin release and consequently angiotensin II and aldosterone synthesis. We are willing with this review to promote discussions and contributions to achieve a better understanding of these mechanisms, and if required, the design of future studies.
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Affiliation(s)
- Cecilia Villa-Etchegoyen
- Laboratory of Cardiovascular Surveillance of Drugs, Department of Toxicology and Pharmacology, School of Medicine, Universidad de Buenos Aires, Ciudad Autonoma de Buenos Aires, Buenos Aires 1121, Argentina.
| | - Mercedes Lombarte
- Bone Biology Laboratory, School of Medicine, Rosario National University, Rosario, Santa Fe 3100, Argentina.
| | - Natalia Matamoros
- Instituto de Desarrollo e Investigaciones Pediátricas "Prof. Dr. Fernando E. Viteri" Hospital de Niños "Sor María Ludovica de La Plata (IDIP), Ministerio de Salud/Comisión de Investigacines Científicas de la Provincia de Buenos Aires, La Plata, Buenos Aires 1900, Argentina.
| | - José M Belizán
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad Autonoma de Buenos Aires, Buenos Aires 1414, Argentina.
| | - Gabriela Cormick
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad Autonoma de Buenos Aires, Buenos Aires 1414, Argentina.
- Departamento de Salud, Universidad Nacional de La Matanza, Florencio Varela, San Justo 1903, Argentina.
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19
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Underbjerg L, Sikjaer T, Rejnmark L. Cardiovascular findings in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism: A cohort study. Clin Endocrinol (Oxf) 2019; 90:592-600. [PMID: 30589959 DOI: 10.1111/cen.13927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE As only sparse data are available on indices of cardiovascular health among patients with nonsurgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP), we aimed to compare the cardiovascular profile between these groups of patients. METHODS A total of 56 patients with Ns-HypoPT and 30 with PHP were included and underwent a clinical examination including blood sampling and measurements of arterial stiffness, pulse wave velocity (PWV) and blood pressure (BP). Arterial stiffness and PWV were measured using AtCor SphygmoCor-XCEL (Atcor Medical Pty Ltd, Sydney, NSW, Australia). RESULTS Patients with Ns-HypoPT had an average age of 47 ± 17 years (68% females) and PHP patients 36 ± 13 years (80% females). Over 70% in both groups were genetically screened. Groups did not differ in terms of a history of cardiovascular disease, smoking status, use of calcium and vitamin D supplements or treatment with cholesterol-lowering or antihypertensive drugs. Compared with Ns-HypoPT, PHP patients had significantly lower levels of high-density lipoproteins (HDL) cholesterol and average glucose from HbA1c (Pboth = 0.01). PWV was significantly higher among patients with Ns-HypoPT (Pcrude = 0.02), even after adjustment for mean arterial pressure, body mass index, age and gender (Padjusted < 0.01). Heart rate was significantly higher in Ns-HypoPT compared with PHP (P = 0.03). Office BP and 24-hour ambulatory BP did not differ between groups (P > 0.05). CONCLUSION Patients with Ns-HypoPT have compared with PHP a higher arterial stiffness and heart rate. This has been associated with an increased risk of cardiovascular disease. Our data suggest that resistance to PTH is present in the cardiovascular system in PHP.
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Affiliation(s)
- Line Underbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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20
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Asghari G, Mirmiran P, Yuzbashian E, Dehghan P, Mahdavi M, Tohidi M, Wagner CL, Neyestani TR, Hosseinpanah F, Azizi F. Association of circulating 25-hydroxyvitamin D and parathyroid hormone with carotid intima media thickness in children and adolescents with excess weight. J Steroid Biochem Mol Biol 2019; 188:117-123. [PMID: 30605777 DOI: 10.1016/j.jsbmb.2018.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/10/2018] [Accepted: 12/31/2018] [Indexed: 02/06/2023]
Abstract
Evidence on the association of vitamin D and parathyroid hormone (PTH) with cardiovascular risk factors in the young is limited. We therefore assessed the relationships of circulating vitamin D and PTH concentrations and subclinical atherosclerosis in overweight or obese children and adolescents. This was a cross-sectional study, investigated the association of 25-hydroxyvitamin D (25(OH)D), intact PTH (iPTH), and iPTH/25(OH)D ratio with carotid intima-media thickness (cIMT) in 368 Iranian children and adolescents with a body mass index (BMI) ≥1 z-score based on WHO criteria. Ultrasound measurement of cIMT was performed. Multivariable linear and logistic regressions were used to test associations between 25(OH)D, iPTH, and iPTH/25(OH)D ratio using one-ln-unit increment with cIMT. Median (25-75 interquartile range) 25(OH)D and iPTH concentrations were 11.8 (8.2-18.6) ng/ml and 38.2 (25.0-61.4) pg/ml, respectively. Among boys, each one-ln-unit increase of iPTH and iPTH/25(OH)D ratio was significantly associated with 0.194 mm and 0.147 mm increase, respectively, in cIMT, after adjustment for confounders. A similar pattern of association was observed between iPTH (β = 0.143, p = 0.037) and iPTH/25(OH)D ratio (β=0.172, p = 0.007) with cIMT among obese participants. Furthermore, among obese participants in the fully adjusted model, each one-ln-unit increase of iPTH and 25(OH)D/iPTH ratio was significantly associated with 53% and 39% increased odds of having high cIMT, respectively. Girls and those who were overweight did not show any significant association of 25(OH)D, iPTH, and iPTH/25(OH)D ratio with cIMT. High iPTH and iPTH/25(OH)D ratio were associated with increased cIMT in boys and those who are obese.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooneh Dehghan
- Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Carol L Wagner
- Department of Pediatrics, Division of Neonatology, Shawn Jenkins Children's Hospital, Charleston, SC, USA
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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A randomised controlled trial comparing the efficacy of micellised and fat-soluble vitamin D3 supplementation in healthy adults. Br J Nutr 2019; 121:859-865. [PMID: 30898175 DOI: 10.1017/s0007114518003215] [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] [Indexed: 01/01/2023]
Abstract
Nanoemulsion formulation of vitamin D3 have been shown to have better bioavailability than the coarse emulsion preparation in vitro and in vivo animal studies. In the absence of randomised trial in humans, comparing the efficacy of nanotechnology-based miscellised vitamin D3 over conventional vitamin D3, we undertook this study. A total of 180 healthy adults were randomised to receive either micellised (DePura, group A) or conventional vitamin D3 (Calcirol, group B) at a monthly dose of 60 000 IU (1500μg) for 6 months. The outcome parameters were serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), Ca, phosphate, alkaline phosphatase and urinary Ca:creatinine ratio. A total of eighty-nine subjects in group A and seventy-seven in group B completed the trial. Subjects in both the groups had a significant increase in their serum 25(OH)D levels following supplementation (group A: 21·5 (sd 10·9) to 76·7 (sd 18·8) nmol/l (P<0·001); group B: 22·8 (sd 10·4) to 57·8 (sd 16·0) nmol/l (P<0·001)). Participants in micellised group had an additional increase of 20·2 (95 % CI 14·0, 26·4) nmol/l in serum 25(OH)D levels (P<0·001). The difference between the groups was 17·5 (95 % CI 11·8, 23·1) nmol/l, which remained statistically significant (P<0·001) even after adjustment for age and sex. Significant decline in mean serum PTH was observed in both the groups. No hypercalcaemia or hypercalciuria was noted. Although supplementation with both the preparations resulted in a significant rise in serum 25(OH)D levels, micellised vitamin D3 appeared to be more efficacious in achieving higher levels of serum 25(OH)D.
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McKeating DR, Fisher JJ, Perkins AV. Elemental Metabolomics and Pregnancy Outcomes. Nutrients 2019; 11:E73. [PMID: 30609706 PMCID: PMC6356574 DOI: 10.3390/nu11010073] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/26/2018] [Accepted: 01/01/2019] [Indexed: 01/22/2023] Open
Abstract
Trace elements are important for human health and development. The body requires specific micronutrients to function, with aberrant changes associated with a variety of negative health outcomes. Despite this evidence, the status and function of micronutrients during pregnancy are relatively unknown and more information is required to ensure that women receive optimal intakes for foetal development. Changes in trace element status have been associated with pregnancy complications such as gestational diabetes mellitus (GDM), pre-eclampsia (PE), intrauterine growth restriction (IUGR), and preterm birth. Measuring micronutrients with methodologies such as elemental metabolomics, which involves the simultaneous quantification and characterisation of multiple elements, could provide insight into gestational disorders. Identifying unique and subtle micronutrient changes may highlight associated proteins that are affected underpinning the pathophysiology of these complications, leading to new means of disease diagnosis. This review will provide a comprehensive summary of micronutrient status during pregnancy, and their associations with gestational disorders. Furthermore, it will also comment on the potential use of elemental metabolomics as a technique for disease characterisation and prediction.
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Affiliation(s)
- Daniel R McKeating
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Southport 9726, Queensland, Australia.
| | - Joshua J Fisher
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Southport 9726, Queensland, Australia.
| | - Anthony V Perkins
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Southport 9726, Queensland, Australia.
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Hemmingway A, O'Callaghan KM, Hennessy Á, Hull GLJ, Cashman KD, Kiely ME. Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude. Nutrients 2018; 10:E916. [PMID: 30018262 PMCID: PMC6073976 DOI: 10.3390/nu10070916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 01/02/2023] Open
Abstract
Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks' gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = -0.311, p < 0.001), but not with calcium intake or serum calcium (r = -0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800⁻1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.
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Affiliation(s)
- Andrea Hemmingway
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - Karen M O'Callaghan
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - Áine Hennessy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - George L J Hull
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- Department of Medicine, University College Cork, T12 Y337 Cork, Ireland.
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
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Sukumar D, Becker KB, Cheung M, Diamond S, Duszak R, Aljahdali A, Volpe SL, Nasser JA. Can bone-regulating hormones and nutrients help characterize the metabolically healthy obese phenotype. Nutr Health 2018; 24:153-162. [PMID: 29950143 DOI: 10.1177/0260106018777336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Bone-regulating hormones and nutrients play an important role in influencing metabolic health. AIM: The aim of this study was to determine whether bone-regulating hormones and nutrients, such as parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), and magnesium (Mg) could be used to characterize the metabolically healthy obese (MHO) phenotype. METHODS: This study included 27 overweight or obese participants (14 men/13 women) classified as MHO ( n = 14) or metabolically unhealthy obese (MUO) ( n = 13) based on the presence or absence of metabolic abnormalities, determined by percentage body fat, percentage trunk fat, and waist circumference. Biochemical (serum concentrations of hormones and cytokines such as PTH, 25OHD, ionized Mg (iMg), cytokines, lipids, glycemic indices), physiological (percentage body fat, percentage trunk fat, blood pressure (BP)), and dietary intake (Mg intake, calcium intake) measurements were obtained. RESULTS: Serum PTH concentrations were significantly lower ( p = 0.005) in the MHO group (39.68 ± 11.06 pg/mL) compared with the MUO group (63.78 ± 25.82 pg/mL). Serum iMg concentrations were higher ( p = 0.052) in the MHO group (0.565 ± 0.41 mmol/L) than in the MUO group (0.528 ± 0.050 mmol/L). Serum concentrations of osteocalcin were also higher (10.37 ± 3.70 ng/mL) in the MHO compared with the MUO (6.51 ± 4.14 ng/mL) group ( p = 0.017). The MHO group had significantly lower serum insulin concentrations ( p = 0.006) and diastolic BP ( p = 0.035). Concentrations of serum 25OHD, total triglycerides, C-reactive protein and systolic BP did not differ between groups. CONCLUSIONS: These findings suggest that bone-regulating hormones and nutrients, especially serum PTH, osteocalcin concentrations, and dietary Mg intakes, can help to characterize the MHO phenotype.
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Affiliation(s)
- Deeptha Sukumar
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Kendra B Becker
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - May Cheung
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Samantha Diamond
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Rittane Duszak
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Abeer Aljahdali
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Stella L Volpe
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Jennifer A Nasser
- 1 Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, USA
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Joukar S, Ebrahimi S, Khazaei M, Bashiri A, Shakibi MR, Naderi V, Shahouzehi B, Alasvand M. Co-administration of walnut (Juglans regia) prevents systemic hypertension induced by long-term use of dexamethasone: a promising strategy for steroid consumers. PHARMACEUTICAL BIOLOGY 2017; 55:184-189. [PMID: 27653214 PMCID: PMC7011871 DOI: 10.1080/13880209.2016.1233570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 04/12/2016] [Accepted: 09/04/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT The long-term consumption of glucocorticoids (GCs) may induce serious adverse effects such as hypertension. There is sufficient evidence related to the benefit of walnuts on the cardiovascular system. OBJECTIVE This study assesses the effect of methanol extract of walnut [Juglans regia L. (Juglandaceae)] on dexamethasone-induced hypertension and the possible mechanisms in Wistar rats. MATERIAL AND METHODS Animals were randomized into control, kernel extract (100 and 200 mg/kg/d, orally), dexamethasone (0.03 mg/kg/d, subcutaneously), dexamethasone + kernel (100 and 200 mg/kg/d, separately), and dexamethasone + captopril (25 mg/kg/d, orally) groups. Animals were treated with water, kernel extract or captopril by gavage 4 d before and during 11 d of saline or dexamethasone treatment. On the 16th day, blood pressure (BP) was recorded and blood samples were collected to measure nitric oxide (NO). Animal hearts were frozen for measurement of malondialdehyde (MDA) and glutathione peroxidase (GPX). RESULTS Dexamethasone increased the diastolic BP and MDA/GPX ratio in comparison with control group (128 ± 7 vs. 105 ± 3 mmHg, p < 0.05 and 0.2 ± 0.046 vs. 0.08 ± 0.02, p < 0.05). Combination of dexamethasone and walnut (200 mg/kg) prevented the dexamethasone-induced diastolic hypertension (109 ± 3 vs. 128 ± 7 mmHg; p < 0.05), increased the GPX level (14.8 ± 1.46 vs. 5.1 ± 0.64 unit/mg, p < 0.05), reduced the MDA/GPX ratio (0.16 ± 0.015 vs. 0.2 ± 0.046) and improved serum NO level. CONCLUSION Similar to captopril, walnut extract normalized dexamethasone-induced hypertension. A part of this beneficial effect apparently involves maintaining balance of the redox system and NO production.
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Affiliation(s)
- Siyavash Joukar
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
- Department of Physiology and Pharmacology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sahar Ebrahimi
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Khazaei
- Neurogenic Inflammation Research Center and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Bashiri
- Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mohammad Reza Shakibi
- Department of Internal Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Vida Naderi
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Beydolah Shahouzehi
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Alasvand
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Vishnu A, Ahuja V. Vitamin D and Blood Pressure Among U.S. Adults: A Cross-sectional Examination by Race/Ethnicity and Gender. Am J Prev Med 2017; 53:670-679. [PMID: 28928036 DOI: 10.1016/j.amepre.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 06/14/2017] [Accepted: 07/10/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The cross-sectional association of serum vitamin D levels with blood pressure and hypertension status among a representative sample of U.S. adults was examined. METHODS Participants of the National Health and Nutrition Examination Survey from 2001 to 2010 were included in these analyses. Harmonizing of the vitamin D levels from 2001 to 2006 with vitamin D measurement from 2007 to 2010 was done using regression equations released by the Centers for Disease Control and Prevention. Use of vitamin D supplements was assessed for all participants. Statistical analyses included examination of linear association of vitamin D levels with blood pressure and non-linear cubic splines with hypertension in overall population, by gender, and by race/ethnicity. RESULTS With every 10 nmol/L higher vitamin D, systolic blood pressure decreased by 0.19 mmHg in this population (p<0.01). In fully adjusted stratified analyses, this association was present among females (-0.25 mmHg, p<0.01) and non-Hispanic whites (0.22 mmHg, p<0.01). After race/ethnic and gender stratification, this association was observed among non-Hispanic white females (0.26 mmHg, p=0.01), non-Hispanic black females (0.65 mmHg, p=0.02), and marginally significant among Hispanic males (0.33 mmHg, p=0.07). Non-parametric assessment with cubic splines show that vitamin D has an inverse association with odds of hypertension up to 100 nmol/L with no apparent benefit at higher levels in overall population, and even lower threshold levels of vitamin D in non-Hispanic blacks (50 nmol/L) and Hispanic Americans (70 nmol/L). CONCLUSIONS Significant race/ethnic and gender differences exist in the association of vitamin D and systolic blood pressure. Odds for hypertension are reduced significantly at higher vitamin D levels, but this benefit plateaus at very high vitamin D levels.
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Affiliation(s)
- Abhishek Vishnu
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Vasudha Ahuja
- Department of Community Medicine, Andaman and Nicobar Institute of Medical Sciences, Andaman and Nicobar Islands, India
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Parathyroid hormone and the risk of incident hypertension: the Atherosclerosis Risk in Communities study. J Hypertens 2016; 34:196-203. [PMID: 26867053 DOI: 10.1097/hjh.0000000000000794] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent evidence suggests that parathyroid hormone (PTH) has effects on vascular smooth muscle cells, the rennin-angiotensin system and kidney function, but less is known about its role in the development of hypertension. The distribution of serum PTH also varies by race. METHODS AND RESULTS Therefore, we examined the relation between PTH and incident hypertension and tested for interaction by race among 7504 Atherosclerosis Risk in Communities participants (1264 black, 6240 white, median age 56 years) without initial hypertension in 1990-1992. During a median follow-up of 6 years, 1487 white and 509 black participants developed hypertension. In the overall study population, PTH was not associated with incident hypertension after adjustment for demographics and behavioral risk factors [hazard ratio highest vs. lowest quintiles, 95% confidence interval: 1.11 (0.96-1.28); P for linear trend 0.02]. Although the interaction was not statistically significant (P = 0.60), there was some evidence that the PTH-hypertension association differed by race. Among blacks, PTH was positively associated with incident hypertension, independent of demographics, and behavioral risk factors (P for linear trend 0.003). Among whites, PTH was not associated with hypertension risk. Results were similar when comparing participants with elevated versus nonelevated PTH (≥65 vs. <65 pg/ml): hazard ratio in blacks: 1.24 (1.02-1.54); hazard ratio in whites: 0.95 (0.78-1.16). CONCLUSIONS In this large community-based cohort, PTH levels, overall, were not independently associated with the risk of hypertension. However, we found some evidence that PTH may be associated with hypertension in blacks. Future research should continue to explore potential race differences in the PTH-hypertension association.
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Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study. ACTA ACUST UNITED AC 2016; 11:69-74. [PMID: 15167209 DOI: 10.1097/01.hjr.0000114706.27531.01] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary hyperparathyroidism (PHPT) is associated with hypertension, coronary atherosclerosis and other cardiovascular diseases. We aimed to evaluate serum parathyroid hormone (PTH) levels as an independent risk factor for coronary heart disease (CHD) in subjects with serum calcium within the reference range. DESIGN Population-based cross-sectional study. METHODS The Tromsø Study was attended by 27159 subjects aged 25-79 years. Serum PTH was measured in 3570 subjects. They all completed a questionnaire on medical history, including questions on angina pectoris and myocardial infarction along with a food-frequency questionnaire. A total of 1459 men and 1753 women with serum calcium 2.20-2.60 mmol/l, serum creatinine<121 micromol/l and who did not use diuretics were included in the present study. Linear regression was used to reveal associations between PTH, age, body mass index, serum calcium, calcium intake, cholesterol, blood pressure, glycosylated haemoglobin (HbA1c) and smoking status. A logistic regression model was used to find the independent predictors of CHD. RESULTS When stratified for age the rate of CHD was higher in the subjects with serum PTH > 6.8 pmol/l than in those with normal or low serum PTH levels [relative risk 1.67, 95% confidence interval (CI) 1.26-2.23 in men and 1.78, 95% CI 1.22-2.57 in women]. The highest PTH quartile (> 3.50 pmol/l in men and > 3.30 pmol/l in women) predicted CHD, with odds ratios of 1.70 (95% CI 1.08-2.70) for men and 1.73 (95% CI 1.04-2.88) for women, versus the lowest PTH quartile (< 1.90 pmol/l for men and <1.80 pmol/l for women). CONCLUSIONS Serum PTH predicts CHD in subjects with calcium levels within the reference range. This may indicate a role for PTH in the development of CHD.
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Affiliation(s)
- Elena Kamycheva
- Department of Internal Medicine, University Hospital of North, Norway.
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Domiciano DS, Machado LG, Lopes JB, Figueiredo CP, Caparbo VF, Oliveira RM, Scazufca M, McClung MR, Pereira RM. Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study. J Bone Miner Res 2016; 31:1146-57. [PMID: 26814375 DOI: 10.1002/jbmr.2795] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 01/20/2016] [Accepted: 01/25/2016] [Indexed: 11/09/2022]
Abstract
Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 ± 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p = 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p = 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p = 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p < 0.001), low physical activity score (HR 1.78; 95% CI, 1.14 to 2.79; p = 0.011), prior cardiovascular event (HR 1.76; 95% CI, 1.18 to 2.63; p = 0.006), total hip BMD (HR 1.41; 95% CI, 1.15 to 1.72; p = 0.001, per each 1 SD decrease), and intact PTH (iPTH) (HR 1.06; 95% CI, 1.04 to 1.08; p < 0.001, per each 10 pg/mL increase) were independently associated with all-cause mortality. The subjects in the highest quartile of PTH (>49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p = 0.007) compared with the subjects in the lowest quartile (<26 pg/mL). Low BMD and higher PTH were significantly associated with mortality in community-dwelling older adults. These findings support the notion that careful screening of these bone parameters might lead to better management of older patients and improve outcomes in this population. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Diogo S Domiciano
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luana G Machado
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jaqueline B Lopes
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Camille P Figueiredo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Valéria F Caparbo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Márcia Scazufca
- Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Rosa Mr Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Vaidya A, Curhan GC, Paik JM, Kronenberg H, Taylor EN. Hypertension, Antihypertensive Medications, and Risk of Incident Primary Hyperparathyroidism. J Clin Endocrinol Metab 2015; 100:2396-404. [PMID: 25885946 PMCID: PMC4454810 DOI: 10.1210/jc.2015-1619] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT Hypertension is associated with higher PTH levels, and specific antihypertensive medications may modulate PTH. Whether hypertension or the use of specific antihypertensive medications influences the risk of developing incident primary hyperparathyroidism (P-HPTH) is not known. OBJECTIVE The purpose of this study was to investigate whether a history of hypertension and the use of specific antihypertensive medications determine the risk for developing P-HPTH in a large prospective study. DESIGN/PARTICIPANTS A longitudinal prospective cohort of female nurses in the Nurses' Health Study I (n = 75 600), who did not have P-HPTH at baseline and completed a questionnaire assessment of lifetime history of P-HPTH were followed from 1986 to 2008. Most participants were white and postmenopausal. SETTING The study was a nationwide cohort study. MAIN OUTCOME MEASURE Incident P-HPTH was assessed initially via questionnaire and then was confirmed by medical record review. Cox proportional hazards models were used to adjust for potential confounders. RESULTS We documented 347 incident cases of P-HPTH during 1 719 416 person-years of follow-up. The age-adjusted relative risk (RR) for incident P-HPTH associated with hypertension was 1.80 (95% confidence interval [CI], 1.43-2.26), and the multivariate-adjusted RR was 1.45 (95% CI, 1.10-1.91). Among participants with a history of hypertension, the use of furosemide, when compared with the use of other antihypertensive medications, was associated with increased risk for developing P-HPTH; age-adjusted RR for incident P-HPTH was 1.79 (95% CI, 1.15-2.79) and multivariate-adjusted RR was 1.71 (95% CI, 1.08-2.71). CONCLUSIONS In a large longitudinal prospective cohort study of mostly older white women, a history of hypertension and use of furosemide were associated with a significantly higher risk of developing P-HPTH.
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Affiliation(s)
- Anand Vaidya
- Division of Endocrinology, Diabetes, and Hypertension (A.V.), Division of Renal Medicine (G.C.C., J.M.P.), Channing Division of Network Medicine (G.C.C., J.M.P., E.N.T.), Brigham and Women's Hospital (A.V., G.C.C., J.M.P., E.N.T.), and Endocrine Unit (H.K.), Massachusetts General Hospital, Harvard Medical School (A.V., G.C.C., J.M.P., H.K.), Boston, Massachusetts 02115; and Division of Nephrology and Transplantation (E.N.T.), Maine Medical Center, Portland, Maine 04102
| | - Gary C Curhan
- Division of Endocrinology, Diabetes, and Hypertension (A.V.), Division of Renal Medicine (G.C.C., J.M.P.), Channing Division of Network Medicine (G.C.C., J.M.P., E.N.T.), Brigham and Women's Hospital (A.V., G.C.C., J.M.P., E.N.T.), and Endocrine Unit (H.K.), Massachusetts General Hospital, Harvard Medical School (A.V., G.C.C., J.M.P., H.K.), Boston, Massachusetts 02115; and Division of Nephrology and Transplantation (E.N.T.), Maine Medical Center, Portland, Maine 04102
| | - Julie M Paik
- Division of Endocrinology, Diabetes, and Hypertension (A.V.), Division of Renal Medicine (G.C.C., J.M.P.), Channing Division of Network Medicine (G.C.C., J.M.P., E.N.T.), Brigham and Women's Hospital (A.V., G.C.C., J.M.P., E.N.T.), and Endocrine Unit (H.K.), Massachusetts General Hospital, Harvard Medical School (A.V., G.C.C., J.M.P., H.K.), Boston, Massachusetts 02115; and Division of Nephrology and Transplantation (E.N.T.), Maine Medical Center, Portland, Maine 04102
| | - Henry Kronenberg
- Division of Endocrinology, Diabetes, and Hypertension (A.V.), Division of Renal Medicine (G.C.C., J.M.P.), Channing Division of Network Medicine (G.C.C., J.M.P., E.N.T.), Brigham and Women's Hospital (A.V., G.C.C., J.M.P., E.N.T.), and Endocrine Unit (H.K.), Massachusetts General Hospital, Harvard Medical School (A.V., G.C.C., J.M.P., H.K.), Boston, Massachusetts 02115; and Division of Nephrology and Transplantation (E.N.T.), Maine Medical Center, Portland, Maine 04102
| | - Eric N Taylor
- Division of Endocrinology, Diabetes, and Hypertension (A.V.), Division of Renal Medicine (G.C.C., J.M.P.), Channing Division of Network Medicine (G.C.C., J.M.P., E.N.T.), Brigham and Women's Hospital (A.V., G.C.C., J.M.P., E.N.T.), and Endocrine Unit (H.K.), Massachusetts General Hospital, Harvard Medical School (A.V., G.C.C., J.M.P., H.K.), Boston, Massachusetts 02115; and Division of Nephrology and Transplantation (E.N.T.), Maine Medical Center, Portland, Maine 04102
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van Ballegooijen AJ, Kestenbaum B, Sachs MC, de Boer IH, Siscovick DS, Hoofnagle AN, Ix JH, Visser M, Brouwer IA. Association of 25-hydroxyvitamin D and parathyroid hormone with incident hypertension: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 2014; 63:1214-1222. [PMID: 24480627 DOI: 10.1016/j.jacc.2014.01.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 12/28/2013] [Accepted: 01/06/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVES This study investigated whether lower 25-hydroxyvitamin D and higher parathyroid hormone concentrations are associated with incident hypertension. BACKGROUND Disturbances in vitamin D metabolism are plausibly related to hypertension. METHODS MESA (Multi-Ethnic Study of Atherosclerosis) is a community-based, prospective cohort with baseline measurements obtained between 2000 and 2002. We studied 3,002 men and women free of prevalent cardiovascular disease and hypertension, age 45 to 84 years at baseline. Serum 25-hydroxyvitamin D and intact parathyroid hormone were measured from previously frozen baseline samples using liquid chromatography-mass spectroscopy and a 2-site immunoassay, respectively. We used a complementary log-log model with interval censoring to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for 25-hydroxyvitamin D and parathyroid hormone concentrations with incident hypertension through 2010. RESULTS During a median follow-up of 9.0 years, 41% of the cohort (n = 1,229) developed hypertension. Mean serum 25-hydroxyvitamin D was 26.3 ± 11.2 ng/ml and mean parathyroid hormone was 41.2 ± 17.3 pg/ml. Compared with 25-hydroxyvitamin D ≥30 ng/ml, 25-hydroxyvitamin D <20 ng/ml was associated with a greater hypertension risk (HR: 1.28 [95% CI: 1.09 to 1.50]), although the association was attenuated and not statistically significant after adjusting for potential confounders (HR: 1.13 [95% CI: 0.96 to 1.33]). Compared with parathyroid hormone <33 pg/ml, parathyroid hormone ≥65 pg/ml was associated with a significantly greater risk of hypertension (HR: 1.27 [95% CI: 1.01 to 1.59]) after adjusting for potential confounders. CONCLUSIONS Lower 25-hydroxyvitamin D concentrations were not associated with a greater risk of incident hypertension. Higher serum parathyroid hormone concentrations showed a significant, but statistically marginal, relationship to the development of hypertension. These findings will require further confirmation. (Multi-Ethnic Study of Atherosclerosis; NCT00005487).
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Affiliation(s)
- Adriana J van Ballegooijen
- Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands.
| | - Bryan Kestenbaum
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington
| | - Michael C Sachs
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington
| | - Ian H de Boer
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington
| | - David S Siscovick
- Departments of Medicine and Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington
| | - Joachim H Ix
- Department of Medicine, University of California San Diego, and the Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Marjolein Visser
- Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands
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Liang W, Lee AH, Binns CW. Tea drinking, diet and ischemic stroke prevention in China: a future perspective. Expert Rev Cardiovasc Ther 2014; 7:1447-54. [DOI: 10.1586/erc.09.113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Kim H, Chung YE, Jung SC, Im H, Yang SY, Kim DY, Jeong E, Kim B, Park SK. Independent associations of circulating 25-hydroxyvitamin D and parathyroid hormone concentrations with blood pressure among Koreans: The Korea National Health and Nutrition Examination Survey (KNHANES), 2009-2010. Calcif Tissue Int 2013; 93:549-55. [PMID: 24114552 DOI: 10.1007/s00223-013-9789-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/19/2013] [Indexed: 10/26/2022]
Abstract
Although lower vitamin D and higher parathyroid hormone (PTH) concentrations have been associated with hypertension, their independent contribution to blood pressure (BP) is unclear. The independent associations of serum 25-hydroxyvitamin D (25[OH]D) and PTH levels with BP were therefore investigated. This is a population-based cross-sectional study from the Korea National Health and Nutrition Examination Surveys, which includes a total of 4,513 participants (2,019 men and 2,494 women) aged ≥ 50 years. 25(OH)D and PTH were measured by radioimmunoassays, and BP was determined with a sphygmomanometer. Hypertensive subjects had significantly lower 25(OH)D (p = 0.023) and significantly higher PTH (p < 0.001) concentrations than normotensives. In subjects not taking antihypertensive medications, 25(OH)D showed reverse correlations with systolic and diastolic BP, both in men (p = 0.038-0.061 and p = 0.011-0.038, respectively) and in women (p = 0.006-0.018 and p = 0.001-0.011, respectively), while serum PTH concentrations showed positive correlations with systolic and diastolic BP in men (p = 0.001-0.014 and p < 0.001, respectively) and women (p < 0.001-0.008 and p = 0.001-0.040, respectively). When 25(OH)D and PTH were included in the same model, both remained independently associated with BP in men and women. In conclusion, both lower 25(OH)D and higher PTH may be independent factors for the development of hypertension.
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Affiliation(s)
- Hyeonmok Kim
- Department of Internal Medicine, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-Gil, Gangdong-gu, Seoul, Korea
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Yazdekhasti N, Mohammadifard N, Sarrafzadegan N, Mozaffarian D, Nazem M, Taheri M. The relationship between nut consumption and blood pressure in an Iranian adult population: Isfahan Healthy Heart Program. Nutr Metab Cardiovasc Dis 2013; 23:929-936. [PMID: 24099725 DOI: 10.1016/j.numecd.2013.04.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 04/16/2013] [Accepted: 04/23/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Few studies outside of Western countries have evaluated the relationship between consumption of nuts and blood pressure (BP). This study aimed to investigate the relationship between nut consumption and blood pressure in an Iranian adult population. METHODS AND RESULTS We performed a cross-sectional investigation among 9660 randomly selected Iranian adults, sampled to represent three large Iranian regions, using data collected in the Isfahan Healthy Heart Program in 2007. The frequency of nut consumption was assessed by a food frequency questionnaire. Systolic and diastolic BPs (SBP and DBP) were measured in duplicate by trained personnel using a standard protocol. Multiple linear and logistic regressions were applied to assess the relationship between nut intake and BP levels and the presence of hypertension as SBP ≥ 140 mmHg, and/or a DBP ≥ 90 mmHg and/or current use of at least one type of anti-hypertensive medication. Those with nut consumption ≥4 times/week showed less mean of BPs and hypertension prevalence, compared to those who consumed nuts <1 times/week (p < 0.001). Compared to no consumption, consuming nuts ≥4 times/week was associated with a 34% lower prevalence of hypertension (multivariate odds ratio (OR) = 0.66; confidence interval (CI) = 0.51-0.87; p for trend = 0.009). CONCLUSIONS More frequent nut consumption is associated with lower BP and lower risk of hypertension among Iranian adults.
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Affiliation(s)
- N Yazdekhasti
- Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Poststroke hip fracture: prevalence, clinical characteristics, mineral-bone metabolism, outcomes, and gaps in prevention. Stroke Res Treat 2013; 2013:641943. [PMID: 24187647 PMCID: PMC3800649 DOI: 10.1155/2013/641943] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 08/06/2013] [Accepted: 08/20/2013] [Indexed: 01/07/2023] Open
Abstract
Objective. To assess the prevalence, clinical and laboratory characteristics, and short-term outcomes of poststroke hip fracture (HF). Methods. A cross-sectional study of 761 consecutive patients aged ≥60 years (82.3 ± 8.8 years; 75% females) with osteoporotic HF. Results. The prevalence of poststroke HF was 13.1% occurring on average 2.4 years after the stroke. The poststroke group compared to the rest of the cohort had a higher proportion of women, subjects with dementia, history of TIA, hypertension, coronary artery disease, secondary hyperparathyroidism, higher serum vitamin B12 levels (>350 pmol/L), walking aid users, and living in residential care facilities. The majority of poststroke HF patients had vitamin D insufficiency (68%) and excess bone resorption (90%). This group had a 3-fold higher incidence of postoperative myocardial injury and need for institutionalisation. In multivariate analysis, independent indicators of poststroke HF were female sex (OR 3.6), history of TIA (OR 5.2), dementia (OR 4.1), hypertension (OR 3.2), use of walking aid (OR 2.5), and higher vitamin B12 level (OR 2.3). Only 15% of poststroke patients received antiosteoporotic therapy prior to HF. Conclusions. Approximately one in seven HFs occurs in older stroke survivors and are associated with poorer outcomes. Early implementation of fracture prevention strategies is needed.
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Varenna M, Manara M, Galli L, Binelli L, Zucchi F, Sinigaglia L. The association between osteoporosis and hypertension: the role of a low dairy intake. Calcif Tissue Int 2013; 93:86-92. [PMID: 23652773 DOI: 10.1007/s00223-013-9731-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/08/2013] [Indexed: 12/22/2022]
Abstract
Hypertension and related cardiovascular diseases are reported to be associated with osteoporosis. A nutritional pathway related to dairy intake has been postulated for both diseases. The aim of this study was to assess calcium intake from dairy sources as a possible pathogenic link between osteoporosis and hypertension. This was a cross-sectional observational study performed on 3,301 postmenopausal women referred for a densitometry screening. Osteoporosis was diagnosed by lumbar dual-energy X-ray absorptiometry and hypertension was defined by blood pressure data and/or the use of antihypertensive medication. Dairy food consumption was evaluated using a weekly food-frequency questionnaire. The odds of being affected by osteoporosis, hypertension, or both diseases were calculated for quartiles of dairy intake by logistic regression analyses. Women with hypertension were affected more frequently by osteoporosis (33.2 vs. 23.3 %; p = 0.000), and there was a higher prevalence of hypertension among women with osteoporosis (32.2 vs. 22.5 %; p = 0.000). The proportion of women with hypertension, osteoporosis, and both diseases significantly increased across decreasing quartiles of dairy intake. A dairy intake in the lowest quartile was a significant predictor of osteoporosis [OR (95 % CI): 1.43 (1.12, 1.82)] and hypertension [OR (95 % CI): 1.46 (1.15, 1.85)] when compared to the highest quartile. Similarly, a low dairy intake was associated with increased odds to have both the diseases [OR (95 % CI): 1.60 (1.10, 2.34)]. From these results we conclude that osteoporosis and hypertension are associated in postmenopausal women, and a low dairy intake may increase the risk of both diseases, acting as a possible pathogenic link.
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Affiliation(s)
- Massimo Varenna
- Bone Diseases Unit, Department of Rheumatology, Gaetano Pini Institute, Milan, Italy.
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Kim YH, Jung KI, Song CH. Effects of serum calcium and magnesium on heart rate variability in adult women. Biol Trace Elem Res 2012; 150:116-22. [PMID: 23054869 DOI: 10.1007/s12011-012-9518-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 10/01/2012] [Indexed: 02/05/2023]
Abstract
The present study was designed to evaluate the association of serum calcium (Ca) and magnesium (Mg) levels with heart rate variability (HRV). One hundred and sixteen adult women were recruited in this cross-sectional study. Serum Ca and Mg levels were measured, and HRV in each time and frequency domain was recorded for 5 min. Mean heart rate and standard deviation of the normal to normal interval (SDNN) and root mean square of differences of successive RR interval (RMSSD) in time domain and total power (TP), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio in frequency domain were compared according to the tertiles of serum Ca and Mg levels and Ca/Mg ratio. The associations between serum Ca and Mg levels and Ca/Mg ratio with HRV were evaluated using regression analyses. Mean heart rate tended to increase from the lowest to the highest tertile of Ca levels (p = 0.081), whereas it decreased significantly with higher Mg levels (p = 0.026). Increasing SDNN value was observed from the lowest to the highest tertile of Mg levels (p = 0.009). SDNN value decreased significantly from the lowest to the highest tertile of Ca/Mg ratio (p = 0.030). Participants in the lowest tertile of Ca/Mg ratio had significantly higher TP and LF values compared to those in the middle and highest tertiles (p < 0.05). Decreasing SDNN, TP, and LF values were significantly associated with higher Ca/Mg ratios (p < 0.05). Associations of serum Mg level and Ca/Mg ratio with HRV could be one of the mechanisms involved in cardiovascular diseases.
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Affiliation(s)
- Yeong-Hoon Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Finch NC, Syme HM, Elliott J. Parathyroid hormone concentration in geriatric cats with various degrees of renal function. J Am Vet Med Assoc 2012; 241:1326-35. [DOI: 10.2460/javma.241.10.1326] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial. Am J Hypertens 2012; 25:1215-22. [PMID: 22854639 DOI: 10.1038/ajh.2012.111] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Low 25-hydroxy-vitamin D (25(OH)D) levels are inversely related to blood pressure (BP) and have been associated with incident hypertension. In people living at northern latitudes diminished cholecalciferol synthesis in the winter increases the risk of vitamin D deficiency. We wanted to test the hypothesis that daily cholecalciferol supplementation in the winter lowers BP in patients with hypertension. METHODS We investigated the effect of 75 µg (3,000 IU) cholecalciferol per day in a randomized, placebo-controlled, double-blind study in 130 hypertensive patients residing in Denmark (56º N). Ambulatory BP (24-h BP) and arterial stiffness were measured before and after 20 weeks of treatment, that took place between October and March. RESULTS A total of 112 patients (mean age 61 ± 10) with a baseline p-25(OH)D of 23 ± 10 ng/ml completed the study. Compared with placebo, a nonsignificant 3/1 mm Hg (P = 0.26/0.18) reduction was found in 24-h BP. In patients with vitamin D insufficiency (<32 ng/ml) at baseline (n = 92), 24-h BP decreased by 4/3 mm Hg (P = 0.05/0.01). Central BP (CBP) estimated by applanation tonometry and calibrated with a standardized office BP was reduced by 7/2 mm Hg (P = 0.007/0.15) vs. placebo. No differences in carotid-femoral pulse wave velocity (PWV) or central augmentation index (AIx) were found between treatment arms. CONCLUSIONS Cholecalciferol supplementation, by a dose that effectively increased vitamin D levels, did not reduce 24-h BP, although central systolic BP decreased significantly. In a post-hoc subgroup analysis of 92 subjects with baseline p-25(OH)D levels <32 ng/ml, significant decreases in 24-h systolic and diastolic BP occurred during cholecalciferol supplementation.
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Alemzadeh R, Kichler J. Parathyroid hormone is associated with biomarkers of insulin resistance and inflammation, independent of vitamin D status, in obese adolescents. Metab Syndr Relat Disord 2012; 10:422-9. [PMID: 22849753 DOI: 10.1089/met.2012.0056] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND 25-Hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) have been shown to correlate with several markers of metabolic syndrome in adult populations. We evaluated the relationship between circulating intact parathyroid hormone (iPTH) and 25(OH)D and indices of metabolic syndrome in obese adolescents. METHODS Body mass index (BMI), body composition, 25(OH)D, iPTH, fasting lipids, glucose, high-sensitivity C-reactive protein (hsCRP), glycosylated hemoglobin (HbA1c), insulin, and the homeostatic model assessment for insulin resistance (HOMA-IR) were evaluated in 133 obese adolescents. RESULTS Vitamin D deficiency [25(OH)D <50 nmol/L] was present in 45.1% of all patients, with higher prevalence in African-American (AA) and Hispanic (H) than Caucasian (C) subgroups (63.9% and 56.4% vs. 25.9%; P<0.001). iPTH and 25(OH)D were inversely correlated (r=-0.75; P<0.0001), with AA displaying a higher iPTH: 25(OH)D ratio than H and C subgroups (P<0.05). Whereas fat mass (FM) was negatively correlated with 25(OH)D (r=-0.30; p<0.001), it was positively correlated with iPTH levels (r=0.38; P<0.0001). Metabolic syndrome was identified in 57.9% of the cohort with higher iPTH, iPTH:25(OH)D ratio, but lower 25(OH)D than participants without metabolic syndrome (P<0.02). Whereas iPTH showed main effects for hsCRP (β=0.24, t=2.61, P<0.05) and triglycerides:high-density lipoprotein cholesterol (TG:HDL-C) (β=0.21, t=2.13, p<0.05), independent of serum 25(OH)D, it did not reveal a main effect for HOMA-IR. CONCLUSIONS Metabolic syndrome is associated with a higher iPTH:25(OH)D ratio than those without metabolic syndrome, implying greater risk of cardiovascular morbidities among AA subjects than other ethnic groups. Furthermore, the serum iPTH level is a predictor of chronic inflammation and dyslipidemia, independent of 25(OH)D.
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Affiliation(s)
- Ramin Alemzadeh
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Paik JM, Farwell WR, Taylor EN. Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int 2012; 23:1727-36. [PMID: 21932115 PMCID: PMC3741045 DOI: 10.1007/s00198-011-1776-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 08/23/2011] [Indexed: 01/05/2023]
Abstract
UNLABELLED Many determinants of parathyroid hormone (PTH) are unknown. In the National Health and Nutrition Examination Survey (NHANES), numerous factors not classically associated with calcium-phosphorus homeostasis, such as uric acid and smoking, are independently associated with PTH in adults without chronic kidney disease. Associations between serum phosphorus and PTH may vary by race. INTRODUCTION Although PTH may be an important biomarker for osteoporosis and cardiovascular disease, many determinants of PTH are unknown. We investigated associations between demographic, dietary, and serum factors and PTH level. METHODS We studied 4,026 white, 1,792 black, and 1,834 Mexican-American adult participants without chronic kidney disease from the 2003-2004 and 2005-2006 NHANES. RESULTS The mean serum PTH level was 38.3 pg/ml for whites, 42.6 pg/ml for blacks, and 41.3 pg/ml for Mexican-Americans. After adjusting for diet, body mass index, serum levels of calcium, phosphorus, 25-hydroxyvitamin D, creatinine, and other factors, smokers compared to non-smokers had lower PTH, ranging from -4.2 pg/ml (95% confidence interval (CI) -7.3 to -1.1) in Mexican-Americans to -6.1 pg/ml (95% CI -8.7 to -3.5) in blacks. After multivariate adjustment, PTH was higher in females compared to males, ranging from 1.1 pg/ml (95% CI -1.2 to 3.4) in Mexican-Americans to 4.5 pg/ml (95% CI 1.9 to 7.0) in blacks, and in older (>60 years) compared to younger participants (<30 years), ranging from 3.7 pg/ml (95% CI 1.3 to 6.1) in Mexican-Americans to 8.0 pg/ml (95% CI 5.4 to 10.7) in blacks. Higher uric acid was associated with higher PTH. In whites only, lower serum phosphorus and lower serum retinol were associated with higher PTH. CONCLUSIONS Numerous factors not classically associated with calcium-phosphorus homeostasis are independently associated with PTH and should be considered in future studies of PTH and chronic disease. Additional research is needed to elucidate mechanisms underlying identified associations with PTH and to explore possible racial differences in phosphorus handling.
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Affiliation(s)
- J M Paik
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Jungert A, Roth HJ, Neuhäuser-Berthold M. Serum 25-hydroxyvitamin D3, parathyroid hormone and blood pressure in an elderly cohort from Germany: a cross-sectional study. Nutr Metab (Lond) 2012; 9:20. [PMID: 22433818 PMCID: PMC3362780 DOI: 10.1186/1743-7075-9-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 03/21/2012] [Indexed: 11/18/2022] Open
Abstract
Background Although several studies indicate a link between vitamin D status and blood pressure (BP), the results are inconsistent. The purpose of this study is to investigate whether in predominantly non-obese elderly people without vitamin D deficiency or very high intact parathyroid hormone (iPTH) levels serum 25-hydroxyvitamin D3 [25(OH)D3] and iPTH are independently associated with BP. Methods Cross-sectional data of 132 non-institutionalised subjects (90 women and 42 men, aged 66- 96 years) from Giessen, Germany, were analysed. Serum 25(OH)D3 and iPTH were measured by an electrochemiluminescence immunoassay and BP was determined with a sphygmomanometer. We performed univariate and multiple regression analyses to examine the influence of 25(OH)D3 and iPTH on BP with adjustments for age, body composition and lifestyle factors. Results While iPTH had no impact on BP, 25(OH)D3 was negatively associated with systolic BP in men, but not in women. After splitting the cohort into antihypertensive medication users and non-users, 25(OH)D3 was a significant predictor for systolic and diastolic BP only in men not receiving antihypertensive medicine, even after multiple adjustment. Adjustment for 25(OH)D3 resulted in an inverse association of iPTH with diastolic BP also only in men without intake of antihypertensive medicine. Conclusions In elderly men without vitamin D deficiency and not taking antihypertensive medicine, 25(OH)D3 may be a negative determinant of BP, independent of iPTH, body composition and lifestyle factors. Furthermore, iPTH may be an independent negative determinant of diastolic BP in men not taking antihypertensive medicine.
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Affiliation(s)
- Alexandra Jungert
- Institute of Nutritional Science, Justus-Liebig-University, Goethestrasse 55, 35390 Giessen, Germany.
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Awad AB, Alappat L, Valerio M. Vitamin D and Metabolic Syndrome Risk Factors: Evidence and Mechanisms. Crit Rev Food Sci Nutr 2012; 52:103-12. [DOI: 10.1080/10408391003785458] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Kestenbaum B, Katz R, de Boer I, Hoofnagle A, Sarnak MJ, Shlipak MG, Jenny NS, Siscovick DS. Vitamin D, parathyroid hormone, and cardiovascular events among older adults. J Am Coll Cardiol 2011; 58:1433-41. [PMID: 21939825 DOI: 10.1016/j.jacc.2011.03.069] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 03/04/2011] [Accepted: 03/10/2011] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate associations of 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) concentrations separately and in combination with incident cardiovascular events and mortality during 14 years of follow-up in the CHS (Cardiovascular Health Study). BACKGROUND Vitamin D deficiency and PTH excess are common in older adults and may adversely affect cardiovascular health. METHODS A total of 2,312 participants who were free of cardiovascular disease at baseline were studied. Vitamin D and intact PTH were measured from previously frozen serum using mass spectrometry and a 2-site immunoassay. Outcomes were adjudicated cases of myocardial infarction, heart failure, cardiovascular death, and all-cause mortality. RESULTS There were 384 participants (17%) with serum 25-OHD concentrations <15 ng/ml and 570 (25%) with serum PTH concentrations ≥ 65 pg/ml. After adjustment, each 10 ng/ml lower 25-OHD concentration was associated with a 9% greater (95% confidence interval [CI]: 2% to 17% greater) relative hazard of mortality and a 25% greater (95% CI: 8% to 44% greater) relative hazard of myocardial infarction. Serum 25-OHD concentrations <15 ng/ml were associated with a 29% greater (95% CI: 5% to 55% greater) risk for mortality. Serum PTH concentrations ≥ 65 pg/ml were associated with a 30% greater risk for heart failure (95% CI: 6% to 61% greater) but not other outcomes. There was no evidence of an interaction between serum 25-OHD and PTH concentrations and cardiovascular events. CONCLUSIONS Among older adults, 25-OHD deficiency is associated with myocardial infarction and mortality; PTH excess is associated with heart failure. Vitamin D and PTH might influence cardiovascular risk through divergent pathways.
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Affiliation(s)
- Bryan Kestenbaum
- Kidney Research Institute, University of Washington, Seattle, WA, USA.
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Vitamin D, parathyroid hormone, and blood pressure in the National Health and Nutrition Examination Surveys . Am J Hypertens 2011; 24:911-7. [PMID: 21525968 DOI: 10.1038/ajh.2011.73] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Previous research shows serum 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) are each associated with blood pressure (BP), but it is unclear whether these associations are independent. METHODS Cross-sectional data from the US National Health and Nutrition Examination Surveys (NHANES) during 2003-2006. Analyses were restricted to 7,561 participants aged ≥20 years with measurements of 25(OH)D, PTH, BP, BP treatment, smoking, physical activity, serum calcium, and creatinine. Results were adjusted for these plus demographic variables. RESULTS Serum 25(OH)D was more strongly associated (inversely) with systolic than diastolic BP. Adjusted mean (standard error) difference in BP for the lowest 25(OH)D quintile (≤13 ng/ml) was 3.5 (0.7) mm Hg for systolic BP and 1.8 (0.6) mm Hg for diastolic BP, compared with the highest quintile (≥30 ng/ml). In contrast, PTH was positively associated with both systolic and diastolic BP (P < 0.0001). Adjusted mean (standard error) difference in BP for the highest PTH quintile (≥59 ng/l) was 5.9 (0.8) mm Hg for systolic BP and 4.5 (0.5) mm Hg for diastolic BP, compared with the lowest quintile (≤27 ng/l). When both 25(OH)D and PTH were included in the same model, the associations of PTH with systolic and diastolic BP were unchanged. However, the associations between 25(OH)D and BP were attenuated, with mean (standard error) difference between the highest and lowest quintiles being 2.2 (0.6) mm Hg for systolic BP (P < 0.01) and 0.8 (0.6) mm Hg for diastolic BP. CONCLUSION PTH may mediate most of the association between 25(OH)D and BP, which was not significant when also adjusting for body mass index.
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Casas-Agustench P, López-Uriarte P, Ros E, Bulló M, Salas-Salvadó J. Nuts, hypertension and endothelial function. Nutr Metab Cardiovasc Dis 2011; 21 Suppl 1:S21-S33. [PMID: 21546229 DOI: 10.1016/j.numecd.2011.01.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 12/14/2010] [Accepted: 01/12/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS High blood pressure (BP) is considered a major risk factor for cardiovascular disease. Among lifestyle factors, diet plays a key role in the prevention and control of high BP. Therefore, it is important to elucidate which dietary components can exert beneficial effects on BP through modulation of endothelial function (EF) or by other mechanisms. In this paper we review the role of nutrients, foods, particularly nuts, and dietary patterns on BP control. DATA SYNTHESIS Because nuts are low in sodium and contain significant amounts of mono- and polyunsaturated fatty acids, fiber, minerals such as magnesium, potassium and calcium, and antioxidants, they have been suggested as potentially protective foods against hypertension. Limited evidence from prospective studies and clinical trials suggests that nut consumption has a beneficial effect on both BP and EF. However, BP changes were a secondary outcome in nut feeding trials and no study used ambulatory BP monitoring as the standard for BP measurements. CONCLUSIONS Further clinical trials, ideally using ambulatory BP monitoring, are needed to establish the potential protective effect of nut consumption on hypertension and vascular reactivity.
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Affiliation(s)
- P Casas-Agustench
- Human Nutrition Unit, Hospital Universitari Sant Joan de Reus, Departament de Bioquímica i Biotecnologia, IISPV, Universitat Rovira i Virgili, Reus, Spain
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Elsurer R, Afsar B, Guner E, Yildiz I. Targeting Parathyroid Hormone Level in Diabetic Patients With Stage 3 to 5 Chronic Kidney Disease: Does Metabolic Syndrome Matter? J Ren Nutr 2011; 21:219-25. [DOI: 10.1053/j.jrn.2010.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Indexed: 11/11/2022] Open
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Suliburska J, Bogdański P, Pupek-Musialik D, Krejpcio Z. Dietary intake and serum and hair concentrations of minerals and their relationship with serum lipids and glucose levels in hypertensive and obese patients with insulin resistance. Biol Trace Elem Res 2011; 139:137-50. [PMID: 20195917 DOI: 10.1007/s12011-010-8650-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 02/08/2010] [Indexed: 02/02/2023]
Abstract
Inadequate minerals intake, as well as disruption of some metabolic processes in which microelements are cofactors, are suggested to lead to the development of hypertension. The role of minerals in the pathogenesis of hypertension still remains to be explained. In the present study, we sought to determine associations between serum and hair mineral concentrations and serum lipids and glucose levels. Forty obese hypertensive subjects with insulin resistance and 40 healthy volunteers were recruited in the study. Blood pressure, BMI, and insulin resistance were recorded in all subjects. Levels of lipids, glucose, sodium and potassium, iron, copper, zinc, magnesium, and calcium were assessed in serum. Iron, copper, zinc, magnesium, and calcium were assessed in hair. Dietary intake of the analyzed minerals was estimated. We found distinctly higher concentrations of serum iron and serum and hair calcium as well as markedly lower levels of hair zinc in the hypertensive subjects. The study group manifested also significantly lower daily intake of calcium, magnesium, and iron. We observed a relationship between the concentrations of iron, zinc, and copper in serum and hair and high and low range of cholesterol, triglycerides, and glucose serum levels in the studied patients. Moreover, this study demonstrated significant correlation between serum and hair concentrations of selected minerals and their dietary intake and levels of serum lipids and glucose and blood pressure in the study and the control groups. The obtained results seem to indicate the association between lipid and glucose metabolism and iron, copper, zinc, and calcium concentrations in blood and hair of hypertensive and obese patients with insulin resistance.
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Affiliation(s)
- Joanna Suliburska
- Department of Human Nutrition and Hygiene, Life Sciences University in Poznan, Wojska Polskiego 31, PL 60-624 Poznan, Poland.
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Serum 25-hydroxyvitamin D and parathyroid hormone levels in relation to blood pressure in a cross-sectional study in older Chinese men. J Hum Hypertens 2011; 26:20-7. [PMID: 21248778 DOI: 10.1038/jhh.2010.126] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vitamin D status, parathyroid hormone (PTH) level and their associations with blood pressure in Chinese population are unknown. This study examined these associations in older Chinese men. Blood pressure, serum 25-hydroxyvitamin D (25OHD) and PTH was measured in 939 community-dwelling Chinese men aged 65 years and older. Linear regression analyses were performed with adjustments for age, body mass index, education, season of measurement, medication use, self-reported history of stroke and Parkinson's disease, and other lifestyle factors. In either crude or adjusted models, serum 25OHD was not associated with blood pressure, whereas increasing PTH levels was associated with higher blood pressure. Men in the highest quartile of serum PTH level had a mean difference of 3.4 mm Hg and 2.8 mm Hg higher in as systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively, than men in the lowest quartile of serum PTH level (P(trend)=0.019 for SBP and <0.001 for DBP). In conclusion, the findings support an association between serum PTH and blood pressure, but not for serum 25OHD in older Chinese men whose vitamin D status is optimal. The lack of association between serum 25OHD and blood pressure may possibly because of the relatively high serum 25OHD levels of the study sample.
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The metabolic syndrome and carotid intima-media thickness in relation to the parathyroid hormone to 25-OH-D(3) ratio in a general population. Am J Hypertens 2011; 24:102-9. [PMID: 20596035 DOI: 10.1038/ajh.2010.124] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Parathyroid hormone (PTH) and vitamin D interactively regulate calcium fluxes across membranes, and thereby modulate insulin sensitivity, blood pressure, and arterial calcification. We hypothesized that lower calcium intake as reflected by circulating PTH and 25-OH-D₃ might be associated with the metabolic syndrome (MS) and arterial calcification. METHODS In a random population sample (n = 542; 50.5% women; mean age, 49.8 ± 13.1 years), we measured MS prevalence (International Diabetes Federation (IDF) and American Heart Association (AHA) criteria), PTH and 25-OH-D₃, serum and 24-h urinary calcium, MS components, carotid intima-media thickness (CIMT), and calcium intake from dairy products. We assessed associations in multivariable-adjusted analyses, using linear and logistic regressions. RESULTS The prevalence of MS was 21.0% (IDF criteria) and 23.6% (AHA criteria). MS prevalence, blood pressure, waist circumference, body mass index, fasting blood glucose, insulin and triglycerides, and CIMT increased (P ≤ 0.042) across quartiles of the PTH/25-OH-D₃ ratio, whereas serum and 24-h urinary calcium decreased (P ≤ 0.029). Waist circumference and fasting blood glucose decreased across quartiles of habitual calcium intake (P ≤ 0.04). In models that included MS (IDF) and PTH/25-OH-D₃, the regression coefficients relating CIMT to PTH/25-OH-D₃ ratio and MS were +51 µm (P = 0.013) and +19 µm (P = 0.45), respectively. Multivariable-adjusted analyses were confirmatory. CONCLUSIONS MS prevalence and CIMT were positively associated with PTH/25-OH-D₃. CIMT was not associated with MS. Prospective studies and intervention trials should address the causality of these associations.
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