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Hasona NA, Moneim AA, Mohammed EA, Twab NAA, Azeem AAA, Teryak GM, Ewiss SS, Khalil RG. Osteocalcin, miR-143, and miR-145 Expression in Long-Standing Type 1 Diabetes Mellitus and Their Correlation with HbA1c. Indian J Clin Biochem 2024; 39:421-428. [PMID: 39005871 PMCID: PMC11239619 DOI: 10.1007/s12291-023-01131-6] [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: 01/15/2023] [Accepted: 03/01/2023] [Indexed: 03/17/2023]
Abstract
Inadequate management and control of hyperglycemia predisposes diabetic patients to a wide range of complications. Thus, this opens new windows for exploring and scrutinizing novel candidate biomarkers. This study was designed to scrutinize the relationship between HbA1c, osteocalcin, calcium, phosphorus, and expression levels of miR-143 and miR-145 in individuals with T1DM and explore their correlations and diagnostic potential for T1DM. 120 unrelated participants were included (i.e., 90 participants with type 1 diabetes mellitus and 30 healthy controls) and were allocated into two groups. Participants with T1DM were allocated into three subgroups (i.e., below 1 year, 1-8 years, and over 8 years) based on diabetic duration. Participants with T1DM experienced noticeable HbA1c elevation. However, osteocalcin, phosphorus, and calcium profiles notably declined in participants with diabetes compared with those in healthy controls. Moreover, the expression levels of miR-143 and miR-145 decreased in participants with diabetes with a significant difference between participants with diabetes and healthy controls. Additionally, significant alterations in HbA1c, osteocalcin, phosphorus, and calcium profiles and expression levels of miR-143 and miR-145 were observed with increasing diabetic duration (T1DM > 8 years compared with those with a diabetes duration of less than 1 year). This study suggests that miR-143 and miR-145 are prospective biomarkers of diabetes mellitus, which may help predict the progression of complications.
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Affiliation(s)
- Nabil A. Hasona
- Department of Biochemistry, Faculty of Science, Beni-Suef University, Salah Salim St., Beni Suef, 62511 Egypt
- Beni Suef National University, Beni Suef, Egypt
| | - Adel Abdel Moneim
- Molecular Physiology Division, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | - Esraa A. Mohammed
- Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | | | - Aya A. Abdel Azeem
- Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | - Gehad M. Teryak
- Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | - Sheryhan Sh. Ewiss
- Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | - Rehab G. Khalil
- Immunology Division, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
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2
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Yokoyama S, Honda T, Ishizu Y, Imai N, Ito T, Yamamoto K, Mizuno K, Kojima T, Kariya N, Nakamura M, Kawashima H. Risk factors for decreased bone mineral density in patients with metabolic dysfunction-associated steatotic liver disease: A cross-sectional study at a health examination center. Clin Nutr 2024; 43:1425-1432. [PMID: 38703510 DOI: 10.1016/j.clnu.2024.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/30/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND & AIMS Steatotic liver disease (SLD) is often detected in health examinations. However, although individuals with metabolic dysfunction-associated SLD (MASLD) may have decreased bone mineral density (BMD), the specific risk factors remain unclarified. The objective of this study was to identify the factors associated with decreased BMD in patients with MASLD. METHODS Individuals who underwent abdominal ultrasonography and BMD measurements at our healthcare center were included. The BMD of the calcaneus was assessed using an AOS-10SA bone densitometer. Decreased BMD was defined as a T-score below -1.0 SD or the administration of osteoporosis treatment. SLD was diagnosed based on specific ultrasonographic criteria. RESULTS A total of 1410 patients were diagnosed with MASLD. The median age was 52 years. Multivariate analysis using a logistic regression model revealed that the independent predictors of decreased BMD were a low body mass index (BMI) or a small waist circumference (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.34-0.67), hypertriglyceridemia (OR: 1.29, 95% CI: 1.00-1.65), and a weak grip strength (OR: 0.98, 95% CI: 0.97-1.00). Subgroup analyses of individuals aged 50 years or older, men, and individuals with a FIB-4 index of 1.3 or greater revealed that the absence of a high BMI or a large waist circumference was associated with decreased BMD. The subgroup analysis of men revealed that a weaker grip strength was associated with decreased BMD. CONCLUSION The present study suggested several potential risk factors for decreased BMD in patients with MASLD. Individuals with the abovementioned risk factors should be encouraged to undergo BMD measurement from the perspective of preventive medicine.
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Affiliation(s)
- Shinya Yokoyama
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Takashi Honda
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Yoji Ishizu
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Norihiro Imai
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Takanori Ito
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Kenta Yamamoto
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Kazuyuki Mizuno
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Tetsuhito Kojima
- Aichi Health Promotion Foundation. 1-18-4 Shimizu, Kita-ku, Nagoya, Aichi, 4620844, Japan.
| | - Naoyoshi Kariya
- Aichi Health Promotion Foundation. 1-18-4 Shimizu, Kita-ku, Nagoya, Aichi, 4620844, Japan.
| | - Masanao Nakamura
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Hiroki Kawashima
- Nagoya University Graduate School of Medicine Department of Gastroenterology and Hepatology. 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
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Bretón I, Ballesteros-Pomar MD, Calle-Pascual A, Alvarez-Sala LA, Rubio-Herrera MA. Micronutrients in Pregnancy after Bariatric Surgery: A Narrative Review. J Clin Med 2023; 12:5429. [PMID: 37629473 PMCID: PMC10455502 DOI: 10.3390/jcm12165429] [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: 06/12/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Bariatric surgery is increasingly used in women of childbearing age due to the rising prevalence of obesity and the effectiveness and availability of this treatment. Pregnancy in women with previous bariatric surgery deserves special attention. Weight loss induced by surgery reduces the risks that obesity poses to pregnancy. But on the other hand, decreased intake and malabsorption may increase the risk of malnutrition and micronutrient deficiency and negatively affect maternal and foetal health. The aim of this narrative review is to provide an updated analysis of the impact of different bariatric surgery techniques on mineral and micronutrient nutritional status during pregnancy and the possible effect on maternal-foetal health.
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Affiliation(s)
- Irene Bretón
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
| | - María D. Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, 24008 León, Spain
| | - Alfonso Calle-Pascual
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Luis Antonio Alvarez-Sala
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Miguel Angel Rubio-Herrera
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
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Li S, Sun J, Liu S, Zhou F, Gross ML, Li W. Missense VKOR mutants exhibit severe warfarin resistance but lack VKCFD via shifting to an aberrantly reduced state. Blood Adv 2023; 7:2271-2282. [PMID: 36508285 PMCID: PMC10225482 DOI: 10.1182/bloodadvances.2021006876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022] Open
Abstract
Missense vitamin K epoxide reductase (VKOR) mutations in patients cause resistance to warfarin treatment but not abnormal bleeding due to defective VKOR activity. The underlying mechanism of these phenotypes remains unknown. Here we show that the redox state of these mutants is essential to their activity and warfarin resistance. Using a mass spectrometry-based footprinting method, we found that severe warfarin-resistant mutations change the VKOR active site to an aberrantly reduced state in cells. Molecular dynamics simulation based on our recent crystal structures of VKOR reveals that these mutations induce an artificial opening of the protein conformation that increases access of small molecules, enabling them to reduce the active site and generating constitutive activity uninhibited by warfarin. Increased activity also compensates for the weakened substrate binding caused by these mutations, thereby maintaining normal VKOR function. The uninhibited nature of severe resistance mutations suggests that patients showing signs of such mutations should be treated by alternative anticoagulation strategies.
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Affiliation(s)
- Shuang Li
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO
| | - Jie Sun
- Department of Chemistry, Washington University in St. Louis, St. Louis, MO
| | - Shixuan Liu
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO
| | - Fengbo Zhou
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO
| | - Michael L. Gross
- Department of Chemistry, Washington University in St. Louis, St. Louis, MO
| | - Weikai Li
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO
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Jin M, Bok M, Rho H, Chon J, Lim H. A pro-inflammatory diet increases the risk of sarcopenia components and inflammatory biomarkers in postmenopausal women. Nutr Res 2022; 107:195-205. [PMID: 36323193 DOI: 10.1016/j.nutres.2022.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 12/27/2022]
Abstract
Inflammation is a risk factor for muscle wasting. The dietary inflammatory index (DII) is a tool used to predict the inflammatory potential of an individual's diet. We hypothesized that consuming a potentially pro-inflammatory diet may be associated with a decreased sarcopenia component in postmenopausal women. Therefore, this study aimed to investigate the association between DII, sarcopenia components (muscle mass, muscle strength, physical performance), and inflammatory biomarkers in postmenopausal women. This cross-sectional study included 70 healthy postmenopausal women aged 50 to 80 years. The DII was calculated based on 3-day food records, and participants were divided into 3 groups according to their DII score. Skeletal muscle mass was measured using dual-energy X-ray absorptiometry. Muscle strength was assessed based on handgrip and leg muscle strength. Associations between DII and sarcopenia components and inflammatory biomarkers were determined using analysis of covariance and a general linear model after adjusting for potential confounders. The DII scores ranged from -6.08 to 5.82. Higher DII scores were significantly associated with decreased appendicular skeletal muscle (ASM) (β = -0.520), height-adjusted ASM (β = -0.116), weight-adjusted ASM (β = -0.469), knee extensor strength (β = -3.175), knee flexion strength (β = -1.941), increased body fat percentage (β = 1.238), and erythrocyte sedimentation rate (β = 5.582) (all P < .05). The present study confirmed a lower DII score, indicating that an anti-inflammatory diet is associated with higher muscle mass and strength and lower levels of inflammatory biomarkers.
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Affiliation(s)
- Minju Jin
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea.
| | - Minkyung Bok
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02844, Republic of Korea.
| | - Hyunkyung Rho
- Department of Food and Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea.
| | - Jinmann Chon
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul 02447, Korea.
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02844, Republic of Korea.
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6
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Fawzy AM, Lip GYH. Warfarin and increased fracture risk? Answering the big question. Age Ageing 2022; 51:6530453. [PMID: 35191958 DOI: 10.1093/ageing/afab263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ameenathul M Fawzy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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7
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Xu Y, Shen L, Liu L, Zhang Z, Hu W. Undercarboxylated Osteocalcin and Its Associations With Bone Mineral Density, Bone Turnover Markers, and Prevalence of Osteopenia and Osteoporosis in Chinese Population: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2022; 13:843912. [PMID: 35898467 PMCID: PMC9309304 DOI: 10.3389/fendo.2022.843912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Undercarboxylated osteocalcin (ucOC) is one form of osteocalcin lacking full carboxylation, which plays an important role in bone homeostasis, glucose homeostasis, and energy metabolism. Our aim is to obtain the profile of serum ucOC level according to gender and age and explore its associations with bone mineral density (BMD), bone turnover markers (BTMs), and prevalence of osteopenia and osteoporosis in the Chinese population. METHODS This is a cross-sectional study with 900 subjects, composed of 431 men and 469 women. Clinical information was collected, and BMD values of the lumbar spine (L1-4), left femoral neck, and total hip were scanned. Biochemical markers including hepatic and renal function, serum calcium, serum phosphorus, procollagen type 1 N-propeptide (P1NP) β-CrossLaps of type I collagen-containing cross-linked C-telopeptide (β-CTX) intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), and ucOC were measured. RESULTS We found that the median ucOC level was higher in men than women [men, 2.6 ng/ml; women, 1.6 ng/ml; p < 0.001]. The profile according to age showed that ucOC levels were the lowest at the age of 40-49 years in both men [2.55 ng/ml (95% CI = 1.96-3.13 ng/ml)] and women [1.57 ng/ml (95% CI = 1.12-2.03 ng/ml)]; in patients younger than 49 years, they decreased with age; then over 50 years, they quickly increased. Furthermore, we found that a higher ucOC level was correlated with lower BMD values at the lumbar spine (men, r = -0.128, p = 0.013; women, r = -0.321, p < 0.001), femoral neck (men, r = -0.095, p = 0.062; women, r = -0.260, p < 0.001), and total hip (men, r = -0.123, p = 0.015; women, r = -0.209, p < 0.001) and higher P1NP (men, r = 0.307, p < 0.001; women, r = 0.239, p < 0.001) and β-CTX (men, r = 0.169, p = 0.001; women, r = 0.354, p < 0.001) levels in both men and women. Furthermore, we also showed that a 1 - SD increase in ucOC was associated with an odds ratio (OR) of 1.63 and 1.70 for having osteopenia or osteoporosis in men and women, respectively (men, 95% CI = 1.25-2.13, p = 0.004; women, 95% CI = 1.19-2.42, p = 0.004). CONCLUSIONS We first revealed the profile of serum ucOC levels according to gender and age in the Chinese population and demonstrated the associations of ucOC with BMD and BTMs and the risk of prevalent osteopenia or osteoporosis. Our findings provide a clue to elucidate the function of ucOC in bone metabolism.
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Affiliation(s)
- Yang Xu
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Li Shen
- Clinical Research Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Lianyong Liu
- Department of Endocrinology, Punan Hospital of Pudong New District, Shanghai, China
- *Correspondence: Weiwei Hu, ; Zhenlin Zhang, ; Lianyong Liu,
| | - Zhenlin Zhang
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Weiwei Hu, ; Zhenlin Zhang, ; Lianyong Liu,
| | - Weiwei Hu
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Weiwei Hu, ; Zhenlin Zhang, ; Lianyong Liu,
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8
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The Effects of Osteoporotic and Non-osteoporotic Medications on Fracture Risk and Bone Mineral Density. Drugs 2021; 81:1831-1858. [PMID: 34724173 PMCID: PMC8578161 DOI: 10.1007/s40265-021-01625-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 12/26/2022]
Abstract
Osteoporosis is a highly prevalent bone disease affecting more than 37.5 million individuals in the European Union (EU) and the United States of America (USA). It is characterized by low bone mineral density (BMD), impaired bone quality, and loss of structural and biomechanical properties, resulting in reduced bone strength. An increase in morbidity and mortality is seen in patients with osteoporosis, caused by the approximately 3.5 million new osteoporotic fractures occurring every year in the EU. Currently, different medications are available for the treatment of osteoporosis, including anti-resorptive and osteoanabolic medications. Bisphosphonates, which belong to the anti-resorptive medications, are the standard treatment for osteoporosis based on their positive effects on bone, long-term experience, and low costs. However, not only medications used for the treatment of osteoporosis can affect bone: several other medications are suggested to have an effect on bone as well, especially on fracture risk and BMD. Knowledge about the positive and negative effects of different medications on both fracture risk and BMD is important, as it can contribute to an improvement in osteoporosis prevention and treatment in general, and, even more importantly, to the individual's health. In this review, we therefore discuss the effects of both osteoporotic and non-osteoporotic medications on fracture risk and BMD. In addition, we discuss the underlying mechanisms of action.
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Liu Y, He Y, He B, Kong L. The anti-osteoporosis effects of Vitamin K in postmenopausal women. Curr Stem Cell Res Ther 2021; 17:186-192. [PMID: 33982655 DOI: 10.2174/1574888x16666210512020103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/12/2020] [Accepted: 12/29/2020] [Indexed: 11/22/2022]
Abstract
As a common systemically muscular-skeleton disorder in aging, osteoporosis is characterized by the uninterrupted deconstruction in osseous microarchitecture. Osteoporosis can consequently lead to a significantly high risk of osteoporotic fractures, such as osteoporotic vertebral compressive fractures [OVCF] in the spine and osteoporotic femoral neck fractures, which can significantly increase the numbers of mortality and morbidity in aging people, especially in postmenopausal women. In addition, vitamin K has been demonstrated to play a key role in inhibiting osteoporotic fractures among postmenopausal women, but its long-term benefits, potential harms, and effects of the combination between vitamin K and other anti-osteoporosis medicines such as bisphosphonates or teriparatide were just extensively studied. Therefore, the present review aimed to systematically reviewed published literature on the role of vitamin K in the treatment of osteoporosis. We currently, via multiple queries strategy, searched the relevant literature in Cochrane and PubMed from January 2010 to December 2019. Subsequently, we conducteda systematic review according to the standard guideline of Preferred Reporting Item for Systematic Reviews and Meta-Analyses [PRISMA]. Finally, ten relevant works of literature met our current criteria for inclusion, and then we followed the PRISMA guideline and systematically reviewed each study by the categorized data sources and analytical approaches in each study, meanwhile set up variables and defined each study outcomes.
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Affiliation(s)
- Yuan Liu
- Honghui Hospital Affiliated to Xi Spine surgery, China
| | | | - Baorong He
- Honghui Hospital Affiliated to Xi Spine surgery, China
| | - Lingbo Kong
- Honghui Hospital Affiliated to Xi Spine surgery, China
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10
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He J, Xie H, Yan C, Sun Y, Xu Z, Zhang X. Genetic Variation in VKORC1 and Risk for Osteoporosis. Arch Med Res 2020; 52:211-216. [PMID: 33234259 DOI: 10.1016/j.arcmed.2020.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/10/2020] [Accepted: 10/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS The vitamin K epoxide reductase complex subunit 1 (VKORC1) plays an important role in bone development and bone metabolism by influencing the vitamin K cycle. The aim of this study was to investigate the association between VKORC1 gene polymorphisms and bone mineral density and the risk of osteoporosis. MATERIALS AND METHODS We determined VKORC1 gene polymorphisms (rs9923231 and rs9934488) by using polymerase chain reaction-restriction and Sanger sequencing method in 606 postmenopausal women including 288 osteoporosis patients and 318 healthy controls. RESULTS No significant differences were observed in the rs9934488 polymorphisms between the osteoporosis group and controls. Subgroup analyses also indicated no positive result. VKORC1 rs9923231 polymorphism increased the risk of osteoporosis in the homozygous and allelic models. A significant correlation was observed in a subgroup of the elderly (age ≥55 years). Additionally, the genotypes of the rs9923231 polymorphism were significantly associated with low body mass index, and T-score, but not with age, serum calcium, or phosphorus. CONCLUSIONS In conclusion, VKORC1 rs9923231 polymorphism is a genetic contributor to osteoporosis risk and it should be confirmed in large well-designed studies.
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Affiliation(s)
- Jin He
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China
| | - Hua Xie
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China
| | - Chengyuan Yan
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China
| | - Yawen Sun
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China
| | - Zhonghua Xu
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China.
| | - Xing Zhang
- Department of Orthopedics, Jintan Hospital Affiliated to Jiangsu University, Changzhou 213200, China
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11
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van der Burgh AC, Oliai Araghi S, Zillikens MC, Koromani F, Rivadeneira F, van der Velde N, Hoorn EJ, Uitterlinden AG, Ikram MA, Stricker BH. The impact of thiazide diuretics on bone mineral density and the trabecular bone score: the Rotterdam Study. Bone 2020; 138:115475. [PMID: 32531338 DOI: 10.1016/j.bone.2020.115475] [Citation(s) in RCA: 6] [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: 12/05/2019] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022]
Abstract
The decreased risk of osteoporotic fractures in thiazide diuretics (TD) users is possibly not only caused by an increase in bone mineral density (BMD), but by an increase in other determinants of bone strength as well, such as the trabecular bone score (TBS). To test this hypothesis, we studied the association between TD use and both lumbar spine BMD (LS-BMD) and lumbar spine TBS (LS-TBS) cross-sectionally in 6096 participants from the Rotterdam Study, as well as the association between TD use and bone turnover estimated by serum osteocalcin levels. We found that past and current use of TD were associated with an increase of LS-BMD (β = 0.021 g/cm2 (95% CI: 0.006;0.036) and β = 0.016 g/cm2 (95% CI: 0.002;0.031), respectively). Use of ≥1 defined daily dose (DDD) (β = 0.028, 95% CI: 0.010;0.046; p for trend within DDD of use <0.001) and use of >365 days (β = 0.033, 95% CI: 0.014;0.052; p for trend within duration of use <0.001) were positively associated with LS-BMD. No significant association between TD use and LS-TBS was observed. Mean serum osteocalcin levels were significantly different between users and non-users of TD (20.2 ng/ml (SD 8.3) and 22.5 ng/ml (SD 17.0), respectively, p < 0.001). Furthermore, linear regression analysis showed that the use of TD was associated with a 3.2 ng/l (95% CI: -4.4.; -2.0) lower serum osteocalcin level compared to non-use of TD, when adjusted for Rotterdam Study cohort, age, and sex. Our results may implicate that the decreased fracture risk in TD users is explained by increased bone mass rather than by improved bone microarchitecture. Alternatively, changes in bone microarchitecture might not be detected through TBS and more sophisticated techniques are possibly needed to study a potential effect of TD on bone microarchitecture.
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Affiliation(s)
- Anna C van der Burgh
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Sadaf Oliai Araghi
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ewout J Hoorn
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Bruno H Stricker
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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12
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Ostroumova OD, Goloborodova IV. Clinical and Pathophysiological Aspects of the Effect of Anticoagulants on Bone Tissue. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-06-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- O. D. Ostroumova
- Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)
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13
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Abstract
Fruits come in a wide variety of colors, shapes, and flavors. This chapter will cover selected fruits that are known to be healthy and highly nutritious. These fruits were chosen due to their common usage and availability. Since it is not possible to cover all health benefits or essential nutrients and important phytochemicals of the fruit composition, this chapter will focus on the key valuable constituents and their potential health effects.
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Affiliation(s)
- Sawsan G Mohammed
- Qatar Research Leadership Program (QRLP), Qatar Foundation, Doha, Qatar.
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar.
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14
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15
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Yokoyama S, Ieda S, Nagano M, Nakagawa C, Iwase M, Hosomi K, Takada M. Association between oral anticoagulants and osteoporosis: Real-world data mining using a multi-methodological approach. Int J Med Sci 2020; 17:471-479. [PMID: 32174777 PMCID: PMC7053309 DOI: 10.7150/ijms.39523] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/08/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction: Warfarin and direct oral anticoagulants (DOACs) have been widely used in antithrombotic therapy. Although warfarin use has been suspected to be associated with osteoporosis risk, several studies have shown otherwise. Conversely, a few reports have found an association between DOACs and osteoporosis. This study therefore clarifies the association between oral anticoagulants and osteoporosis by analyzing real-world data using different methodologies, algorithms, and databases. Methods: Real-world data from the US Food and Drug Administration Adverse Event Reporting System (FAERS; 2004-2016) and Japanese administrative claims database (2005-2017; JMDC Inc., Tokyo) were used. Reporting odds ratio (ROR) and information component (IC) were calculated through disproportionality analysis (DPA) using reports recorded in the FAERS. Sequence symmetry analysis (SSA) was employed to calculate the adjusted sequence ratio (SR) using the JMDC Claims Database. For the adjusted SR and ROR, a significant signal was detected when the lower limit of the two-sided 95% confidence interval (CI) was more than 1. For the IC, a significant signal was detected when the lower limit of the 95% CI was more than 0. Results: DPA for warfarin found significant signals for osteoporosis in ROR (1.43, 95% CI: 1.32-1.54) and IC (0.50, 95% CI: 0.39-0.61). SSA showed a significant association between warfarin use and osteoporosis or bisphosphonate use. Moreover, a significant association was observed in males and females, albeit only for warfarin. Conclusion: Multi-methodological data mining revealed that warfarin use, not DOACs, is significantly associated with osteoporosis regardless of sex difference.
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Affiliation(s)
- Satoshi Yokoyama
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
| | - Shoko Ieda
- Department of Pharmacy, Kindai University Hospital, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Mirai Nagano
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
| | - Chihiro Nakagawa
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
| | - Makoto Iwase
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
| | - Kouichi Hosomi
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
| | - Mitsutaka Takada
- Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan
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16
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Exocrine Pancreatic Insufficiency and Nutritional Complications. Respir Med 2020. [DOI: 10.1007/978-3-030-42382-7_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Abstract
Nuts are fruits composed of two parts: an inedible hard shell and an edible seed. Nuts are known as an energy-dense and nutrient-rich food source. In general, nuts are recognized as a good source of fat, fiber, and protein. Nuts are extremely beneficial parts of any diet since their consumption may lower risk for some diseases, such as cardiovascular diseases and cancer. They are acknowledged for their low glycemic index owning to high unsaturated fat and protein content and relatively low carbohydrate content. They have been shown to increase cognitive function as well.
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Affiliation(s)
- Sawsan G Mohammed
- Qatar Research Leadership Program (QRLP), Qatar Foundation, Doha, Qatar.
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar.
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18
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Signorelli SS, Scuto S, Marino E, Giusti M, Xourafa A, Gaudio A. Anticoagulants and Osteoporosis. Int J Mol Sci 2019; 20:ijms20215275. [PMID: 31652944 PMCID: PMC6862478 DOI: 10.3390/ijms20215275] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 12/20/2022] Open
Abstract
Anticoagulant agents are widely used in the treatment of thromboembolic events and in stroke prevention. Data about their effects on bone tissue are in some cases limited or inconsistent (oral anti-vitamin K agents), and in others are sufficiently strong (heparins) to suggest caution in their use in subjects at risk of osteoporosis. This review analyses the effects of this group of drugs on bone metabolism, on bone mineral density, and on fragility fractures. A literature search strategy was developed by an experienced team of specialists by consulting the MEDLINE platform, including published papers and reviews updated to March 2019. Literature supports a detrimental effect of heparin on bone, with an increase in fracture rate. Low molecular weight heparins (LMWHs) seem to be safer than heparin. Although anti-vitamin K agents (VKAs) have a significant impact on bone metabolism, and in particular, on osteocalcin, data on bone mineral density (BMD) and fractures are contrasting. To date, the new direct oral anticoagulants (DOACs) are found to safe for bone health.
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Affiliation(s)
| | - Salvatore Scuto
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Elisa Marino
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Michele Giusti
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Anastasia Xourafa
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
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19
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Tomlinson DJ, Erskine RM, Morse CI, Onambélé GL. Body Fat Percentage, Body Mass Index, Fat Mass Index and the Ageing Bone: Their Singular and Combined Roles Linked to Physical Activity and Diet. Nutrients 2019; 11:E195. [PMID: 30669348 PMCID: PMC6356293 DOI: 10.3390/nu11010195] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/20/2018] [Accepted: 01/16/2019] [Indexed: 12/17/2022] Open
Abstract
This study took a multi-analytical approach including group differences, correlations and unit-weighed directional z-score comparisons to identify the key mediators of bone health. A total of 190 participants (18⁻80 years) were categorized by body fat%, body mass index (BMI) and fat mass index (FMI) to examine the effect of differing obesity criteria on bone characteristics. A subset of 50 healthy-eating middle-to-older aged adults (44⁻80 years) was randomly selected to examine any added impact of lifestyle and inflammatory profiles. Diet was assessed using a 3-day food diary, bone mineral density (BMD) and content (BMC) by dual energy x-ray absorptiometry in the lumbar, thoracic, (upper and lower) appendicular and pelvic areas. Physical activity was assessed using the Baecke questionnaire, and endocrine profiling was assessed using multiplex luminometry. Obesity, classed via BMI, positively affected 20 out of 22 BMC- and BMD-related outcome measures, whereas FMI was associated with 14 outcome measures and adiposity only modulated nine out of 22 BMC- and BMD-related outcome measures. Whilst bivariate correlations only linked vitamin A and relative protein intake with BMD, the Z-score composite summary presented a significantly different overall dietary quality between healthy and osteopenic individuals. In addition, bivariate correlations from the subset revealed daily energy intake, sport-based physical activity and BMI positive mediators of seven out of 10 BMD sites with age and body fat% shown to be negative mediators of bone characteristics. In conclusion, whilst BMI is a good indicator of bone characteristics, high body fat% should also be the focus of osteoporosis risk with ageing. Interestingly, high BMI in conjunction with moderate to vigorous activity supplemented with an optimal diet (quality and quantity) are identified as positive modulators of bone heath.
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Affiliation(s)
- David J Tomlinson
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
- Institute of Sport, Exercise and Health, University College London, London W1T 7HA, UK.
| | - Christopher I Morse
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
| | - Gladys L Onambélé
- Musculoskeletal Sciences and Sport Medicine Research Centre, Manchester Metropolitan University, Crewe CW1 5DU, UK.
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20
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Kostev K, Hadji P, Jacob L. Impact of Osteoporosis on the Risk of Dementia in Almost 60,000 Patients Followed in General Practices in Germany. J Alzheimers Dis 2018; 65:401-407. [DOI: 10.3233/jad-180569] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | | | - Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
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21
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Gu ZC, Zhou LY, Shen L, Zhang C, Pu J, Lin HW, Liu XY. Non-vitamin K Antagonist Oral Anticoagulants vs. Warfarin at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Pharmacol 2018; 9:348. [PMID: 29692734 PMCID: PMC5903161 DOI: 10.3389/fphar.2018.00348] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 03/26/2018] [Indexed: 01/31/2023] Open
Abstract
Warfarin is a traditional oral anticoagulant for preventing thrombotic events in patients with atrial fibrillation (AF) and venous thromboembolism. Along with the widespread clinical use, the potential association between warfarin use and fracture risk have been addressed gradually. Non-vitamin K antagonist oral anticoagulants (NOACs), targeting thrombin or Xa factor, have been recommended as an optimal alternative due to their favorable property of thromboembolism prophylaxis and reduced bleeding risk. However, evidence of the fracture risk with NOACs use is limited. Therefore, the present study investigated this issue by a meta-analysis. Medline, Embase, Cochrane Library and the ClinicalTrials.gov Website were searched for randomized controlled trials (RCTs) that reported the fracture data of NOACs and warfarin. The primacy outcome was a composite of any fracture. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models according to between-study heterogeneity. Heterogeneity was assessed through I2 test and Q statistic, and the number of patients needed to treat (NNT) was calculated based on fracture incidence. Subgroup analyses were conducted according to individual NOACs, indications, and duration of follow up. Finally, 12 RCTs involving 89,549 patients were included, among which 44,816 (50%) receiving NOACs and 44,733 (50%) receiving warfarin. Overall, 1,139 (1.3%) patients including 515 NOACs users (1.1%) and 624 warfarin users (1.4%) developed fracture. Risk of fracture was significantly lower in NOACs compared to warfarin (RR: 0.82, 95%CI: 0.73–0.93, P = 0.001), with a NNT of 333. No significantly decreased risk was detected according to fracture sites. Subgroup analysis confirmed that the estimate of decreased fracture risk was derived mainly from AF patients receiving long-term anticoagulation treatment. The meta-regression did not detect any potential confounding on fracture risk. No heterogeneity between the studies (I2 = 15.0%) and no publication bias was identified. In conclusion, the use of NOACs was associated with a lower risk of fracture compared to warfarin, but with a relatively low absolute risk reduction. Therefore, screening for the fracture risk should be considered before initiating anticoagulation treatment. For patients who are at high risk of fracture or expected long-term treatment of anticoagulation, NOACs may represent a preferable alternative to warfarin.
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Affiliation(s)
- Zhi-Chun Gu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ling-Yun Zhou
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Long Shen
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Chi Zhang
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hou-Wen Lin
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao-Yan Liu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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22
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23
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Cerit L. Atrial fibrillation, hip fracture, and oral anticoagulant therapy. Int J Cardiol 2017; 249:259. [PMID: 29121729 DOI: 10.1016/j.ijcard.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Levent Cerit
- Department of Cardiology, Near East University, Nicosia, Cyprus.
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24
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Donaldson CJ, Harrington DJ. Therapeutic warfarin use and the extrahepatic functions of vitamin K-dependent proteins. Br J Biomed Sci 2017; 74:163-169. [PMID: 28657840 DOI: 10.1080/09674845.2017.1336854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The impact of warfarin therapy on the functions of extrahepatic vitamin K-dependent proteins (VKDP) is less clearly understood and less widely recognised in clinical practice than that on the hepatic counterparts (clotting factors II, VII, IX and X). Warfarin inhibits osteocalcin, an abundant extrahepatic VKDP involved in the mineralisation and maturation of bone and thus, primarily by this mechanism, may have an adverse effect on bone health. Whilst some studies do link warfarin use to an increase in osteoporosis and fracture risk others have not. Warfarin also inhibits the extrahepatic VKDP matrix gla protein (MGP) which acts to prevent ectopic calcification of the vasculature. Studies have consistently found a correlation between warfarin use and vascular calcification with inhibition of MGP believed to be the main cause. Inhibition of MGP also appears to explain warfarin's well established teratogenic effect. Further adverse effects may also arise from warfarin's inhibition of other known extrahepatic VKDPs. The available evidence is intriguing, and suggests that the impact of warfarin on the extrahepatic functions of vitamin K-dependent proteins warrants further careful consideration.
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Affiliation(s)
- C J Donaldson
- a Faculty of Life Sciences and Medicine , King's College London , London , UK
| | - D J Harrington
- b The Nutristasis Unit, Viapath, St. Thomas' Hospital , London , UK.,c Division of Women's Health , School of Medicine, King's College London , London , UK
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25
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Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health. J Nutr Metab 2017; 2017:6254836. [PMID: 28698808 PMCID: PMC5494092 DOI: 10.1155/2017/6254836] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/10/2017] [Indexed: 12/21/2022] Open
Abstract
Objective To review the evidence for the use of vitamin K supplementation in clinical conditions such as osteoporosis, vascular calcification, arthritis, cancer, renal calculi, diabetes, and warfarin therapy. Quality of Evidence PubMed was searched for articles on vitamin K (K1 and K2) along with books and conference proceedings and health conditions listed above. Level I and II evidence supports the use of vitamins K1 and K2 in osteoporosis and Level II evidence supports vitamin K2 in prevention of coronary calcification and cardiovascular disease. Evidence is insufficient for use in diabetes, arthritis, renal calculi, and cancer. Main Message Vitamin K2 may be a useful adjunct for the treatment of osteoporosis, along with vitamin D and calcium, rivaling bisphosphonate therapy without toxicity. It may also significantly reduce morbidity and mortality in cardiovascular health by reducing vascular calcification. Vitamin K2 appears promising in the areas of diabetes, cancer, and osteoarthritis. Vitamin K use in warfarin therapy is safe and may improve INR control, although a dosage adjustment is required. Conclusion Vitamin K supplementation may be useful for a number of chronic conditions that are afflicting North Americans as the population ages. Supplementation may be required for bone and cardiovascular health.
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26
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Lin SY, Hsu WH, Lin CC, Lin CL, Tsai CH, Kao CH. Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study. PLoS One 2017; 12:e0179358. [PMID: 28604838 PMCID: PMC5467899 DOI: 10.1371/journal.pone.0179358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/27/2017] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Chronic exocrine pancreatic insufficiency can lead to osteoporosis. However, the incidence and risk of osteoporosis after acute inflammation of pancreas remained known. Thus, we conducted a population-based cohort study to clarify the association between acute pancreatitis (AP) and osteoporosis. METHODS Patients newly diagnosed with AP with index date between 2000 and 2011 were identified from the National Health Insurance Research Database. Osteoporosis were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We applied age-, sex-, and comorbidities-adjusted variable Cox proportional hazard models for assessing the association between AP and osteoporosis. Moreover, these models were used to adjust for the influences of patient characteristics and comorbidities. RESULTS In this study, 4,016 patients were included in the AP cohort (males, 67.9%; mean age, 51.8 years) and 4,016 matched controls in the non-AP cohort. After a mean follow-up period of 4.97 and 5.21 years in the AP and non-AP cohorts, respectively, the incidence of osteoporosis was 8.22 per 1000 person-years in the AP cohort. The AP cohort had a higher risk [adjusted hazard ratio (aHR) = 1.27, 95% confidence interval (CI) = 1.02-1.58] of osteoporosis than did the non-AP cohort. The risk of osteoporosis was highest in the female patients of the AP cohort (aHR = 2.26, 95% CI = 1.85-2.76) and patients aged 50-64 years (aHR = 4.14, 95% CI = 3.13-5.47). CONCLUSION AP patients are at a risk of osteoporosis, especially female gender and age 50-64 years. Those with > 3 episodes of AP had highest significant risk of developing osteoporosis.
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Affiliation(s)
- Shih-Yi Lin
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Wu-Huei Hsu
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Chest, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chung-Hao Tsai
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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28
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Burke EA, McCallion P, Carroll R, Walsh JB, McCarron M. An exploration of the bone health of older adults with an intellectual disability in Ireland. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:99-114. [PMID: 27097825 DOI: 10.1111/jir.12273] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/22/2015] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Many risk factors have been confirmed for poor bone health among the general population including age, gender and corticosteroid use. There is a paucity of investigation among people with intellectual disability; however, research points to differing risks namely anti-epileptic medication use, Down syndrome and poor behaviour lifestyle. METHODS Data was extracted from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing in Ireland. In total, 753 participants took part, and data was gathered on participants' health status, behavioural health, health screenings and activities of daily living. The prevalence of osteoporosis and related risk factors were specifically examined. RESULTS Overall, 8.1% reported a doctor's diagnosis of osteoporosis with over 20% reporting history of fracture. Risk identified included older age (P < 0.0001), female gender (P < 0.0001), difficulty walking (P < 0.0001) with older age and being female the stronger predictors for osteoporosis, odds ratio = 6.53; 95% confidence interval 2.82-15.11 and odds ratio = 4.58; 95% confidence interval 2.29-9.17, respectively. There was no gender difference regarding the level of fractures; however, epilepsy and anti-epileptic medication were strong predictors. Overall, 11.1% attended for bone screening diagnostics. CONCLUSION Despite low levels of reported doctor's diagnosis of osteoporosis risk factor prevalence was high. Considering the insidious nature of osteoporosis and the low levels of diagnostic screening, prevalence could be possibly higher.
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Affiliation(s)
- E A Burke
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - P McCallion
- Center for Excellence in Aging and Community Wellness, University at Albany, NY, USA
| | - R Carroll
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - J B Walsh
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - M McCarron
- Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
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29
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Cardeira J, Gavaia PJ, Fernández I, Cengiz IF, Moreira-Silva J, Oliveira JM, Reis RL, Cancela ML, Laizé V. Quantitative assessment of the regenerative and mineralogenic performances of the zebrafish caudal fin. Sci Rep 2016; 6:39191. [PMID: 27991522 PMCID: PMC5171864 DOI: 10.1038/srep39191] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/21/2016] [Indexed: 12/31/2022] Open
Abstract
The ability of zebrafish to fully regenerate its caudal fin has been explored to better understand the mechanisms underlying de novo bone formation and to develop screening methods towards the discovery of compounds with therapeutic potential. Quantifying caudal fin regeneration largely depends on successfully measuring new tissue formation through methods that require optimization and standardization. Here, we present an improved methodology to characterize and analyse overall caudal fin and bone regeneration in adult zebrafish. First, regenerated and mineralized areas are evaluated through broad, rapid and specific chronological and morphometric analysis in alizarin red stained fins. Then, following a more refined strategy, the intensity of the staining within a 2D longitudinal plane is determined through pixel intensity analysis, as an indicator of density or thickness/volume. The applicability of this methodology on live specimens, to reduce animal experimentation and provide a tool for in vivo tracking of the regenerative process, was successfully demonstrated. Finally, the methodology was validated on retinoic acid- and warfarin-treated specimens, and further confirmed by micro-computed tomography. Because it is easily implementable, accurate and does not require sophisticated equipment, the present methodology will certainly provide valuable technical standardization for research in tissue engineering, regenerative medicine and skeletal biology.
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Affiliation(s)
- João Cardeira
- ProRegeM PhD Programme, Department of Biomedical Sciences and Medicine, University of Algarve, Campus de Gambelas, Faro, Portugal.,Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, Faro, Portugal
| | - Paulo J Gavaia
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, Faro, Portugal.,Department of Biomedical Sciences and Medicine, University of Algarve, Campus de Gambelas, Faro, Portugal
| | - Ignacio Fernández
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, Faro, Portugal
| | - Ibrahim Fatih Cengiz
- 3B's Research Group, Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR, Portugal.,ICVS/3B's, PT Government Associated Laboratory, Portugal
| | | | - Joaquim Miguel Oliveira
- 3B's Research Group, Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR, Portugal.,ICVS/3B's, PT Government Associated Laboratory, Portugal
| | - Rui L Reis
- 3B's Research Group, Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR, Portugal.,ICVS/3B's, PT Government Associated Laboratory, Portugal
| | - M Leonor Cancela
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, Faro, Portugal.,Department of Biomedical Sciences and Medicine, University of Algarve, Campus de Gambelas, Faro, Portugal
| | - Vincent Laizé
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, Faro, Portugal
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Avila ML, Pullenayegum E, Williams S, Shammas A, Stimec J, Sochett E, Marr K, Brandão LR. Timing of low bone mineral density and predictors of bone mineral density trajectory in children on long-term warfarin: a longitudinal study. Osteoporos Int 2016; 27:1547-1557. [PMID: 26572757 DOI: 10.1007/s00198-015-3411-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/05/2015] [Indexed: 01/06/2023]
Abstract
UNLABELLED We studied bone mineral density (BMD) of children exposed to long-term warfarin. BMD Z-scores ≤ -2.0 were estimated to occur in less than one fifth of the patients after 10 years of warfarin exposure, and BMI and growth hormone deficiency predicted BMD changes over time. These predictors can help identify high-risk patients. INTRODUCTION Children with chronic diseases are at increased risk of developing thrombosis, which may require long-term warfarin therapy. Warfarin could further jeopardize the bone health of a population already at risk for bone fragility. Our objective was to investigate the occurrence and timing of low bone mineral density (BMD) and the predictors that influence BMD trajectory in children receiving warfarin for >1 year. METHODS We analyzed the results of an institutional protocol that includes dual-energy X-ray absorptiometry, with or without spinal X-rays and laboratory biomarkers, as required. RESULTS Low BMD (age, sex, race, and height-for-age-Z-score adjusted BMD Z-score ≤ -2.0) was detected in 13 % (9/70) of the patients at some point during their follow-up; these patients were more likely to have complex underlying medical conditions and low body mass index (BMI) percentile. BMD Z-scores remained within normal range in 87 % of children. Survival analysis showed that the estimated 10-year abnormal BMD-free rate for the entire group was 81 % (95 % confidence interval [CI] 69 to 93 %). Trajectory analysis revealed that BMI percentiles at baseline and growth hormone deficiency (GHD) were associated with lower BMD Z-scores at the first assessment, whereas baseline BMI percentile was the only predictor of BMD Z-score over time. CONCLUSIONS Our findings identified BMI and GHD as risk factors influencing BMD in children exposed to long-term warfarin, creating an opportunity for early detection and intervention in these patients.
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Affiliation(s)
- M L Avila
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - E Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - S Williams
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - A Shammas
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - J Stimec
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - E Sochett
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - K Marr
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada
| | - L R Brandão
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, M5G-1X8, ON, Canada.
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Liang Y, Tan A, Liang D, Yang X, Liao M, Gao Y, Jiang Y, Yao Z, Lin X, Lu Z, Wu C, Zhang S, Hu Y, Qin X, Mo Z, Li H, Zhang H. Low osteocalcin level is a risk factor for impaired glucose metabolism in a Chinese male population. J Diabetes Investig 2015; 7:522-8. [PMID: 27181428 PMCID: PMC4931202 DOI: 10.1111/jdi.12439] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 09/29/2015] [Accepted: 10/14/2015] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION This study was to assess the association between serum osteocalcin level and glucose metabolism in a Chinese male population. MATERIALS AND METHODS We carried out a cross-sectional study with a cohort of participants from the Fangchenggang Area Male Health and Examination Survey. The cross-sectional study was carried out among 2,353 men, including 2,139 participants with normal glucose tolerance, 148 with impaired fasting glucose and 66 with type 2 diabetes. A subsample of 1,109 men with measurement of osteocalcin was observed in the cohort. After a 4-year follow-up period, 1,049 non-diabetic and 983 participants with normal glucose tolerance who submitted the available information were enrolled in the cohort. Participants were divided into group-H (≥23.33 ng/mL) and group-L (<23.33 ng/mL) by osteocalcin level. RESULTS In the cross-sectional study, osteocalcin levels were highest in participants with normal glucose tolerance, followed by those with impaired fasting glucose and type 2 diabetes (P < 0.001). In partial correlation analysis adjusted for age, serum osteocalcin level was related to glucose level (r = -0.082, P < 0.001), insulin level (r = -0.079, P < 0.001) and insulin resistance (r = -0.065, P = 0.002). Compared with group-H, group-L was associated with an increased risk of type 2 diabetes (odds ratio 2.107, 95% confidence interval 1.123-3.955), impaired fasting glucose (odds ratio 2.106; 95% CI 1.528-2.902), and insulin resistance (odds ratio 1.359, 95% confidence interval 1.080-1.710) adjusted for age, education levels, cigarette smoking and lipid profiles. In the cohort study, the increased risk of impaired fasting glucose was significant in group-L vs group-H (3.3% vs 1.2%, P = 0.026). CONCLUSIONS Low serum osteocalcin level was a risk factor for impaired glucose metabolism and subsequent type 2 diabetes.
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Affiliation(s)
- Yaojie Liang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Aihua Tan
- Department of Chemotherapy, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Danyan Liang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaobo Yang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Ming Liao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Institute of Urology and Nephrology, Guangxi Medical University, Nanning, Guangxi, China
| | - Yong Gao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yonghua Jiang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Ziting Yao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Xinggu Lin
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Zheng Lu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Institute of Urology and Nephrology, Guangxi Medical University, Nanning, Guangxi, China
| | - Chunlei Wu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Shijun Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Department of Pharmacology, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanlin Hu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Xue Qin
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Institute of Urology and Nephrology, Guangxi Medical University, Nanning, Guangxi, China
| | - Hong Li
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Haiying Zhang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
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Kim MS, Kim ES, Sohn CM. Dietary intake of vitamin K in relation to bone mineral density in Korea adults: The Korea National Health and Nutrition Examination Survey (2010-2011). J Clin Biochem Nutr 2015; 57:223-7. [PMID: 26566308 PMCID: PMC4639586 DOI: 10.3164/jcbn.14-98] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 04/02/2015] [Indexed: 11/22/2022] Open
Abstract
Low vitamin K nutritional status has been associated with increased risk of fracture, however inconsistent results exist to support the role of vitamin K on bone mineral density depending on ethnic difference and gender. Our objective was to determine vitamin K intake in Korean adults, examine correlation between vitamin K intake and bone mineral density. This study analyzed raw data from the fifth Korea National Health and Nutrition Examination Survey for adults (2,785 men, 4,307 women) aged over 19 years. Cross-sectional analyses showed only positive association between vitamin K intake and femur bone mineral density in men after adjusting bone-related factors. However, women in high tertiles of vitamin K intake had a significantly higher bone mineral density both in femur and lumber as compared to women in lowest tertiles (p<0.05). The risk for osteoporosis was decreased as vitamin K intake increased in women, but this effect was not persisted after adjusting factors. The findings of this study indicate that low dietary vitamin K intake was associated with low bone mineral density in subjects. From these results we may suggest an increase in dietary vitamin K intakes for maintaining bone mineral density. (2010-02CON-21-C, 2011-02CON-06-C).
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Affiliation(s)
- Mi-Sung Kim
- Department of Food and Nutrition, Wonkwang University, Iksandae-ro, Iksan, Jeonbuk 570-749, Korea
| | - Eun-Soo Kim
- Department of Food and Nutrition, Wonkwang University, Iksandae-ro, Iksan, Jeonbuk 570-749, Korea
| | - Cheong-Min Sohn
- Department of Food and Nutrition, Wonkwang University, Iksandae-ro, Iksan, Jeonbuk 570-749, Korea
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A review of the effect of diet on cardiovascular calcification. Int J Mol Sci 2015; 16:8861-83. [PMID: 25906474 PMCID: PMC4425113 DOI: 10.3390/ijms16048861] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/19/2015] [Accepted: 04/07/2015] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular (CV) calcification is known as sub-clinical atherosclerosis and is recognised as a predictor of CV events and mortality. As yet there is no treatment for CV calcification and conventional CV risk factors are not consistently correlated, leaving clinicians uncertain as to optimum management for these patients. For this reason, a review of studies investigating diet and serum levels of macro- and micronutrients was carried out. Although there were few human studies of macronutrients, nevertheless transfats and simple sugars should be avoided, while long chain ω-3 fats from oily fish may be protective. Among the micronutrients, an intake of 800 μg/day calcium was beneficial in those without renal disease or hyperparathyroidism, while inorganic phosphorus from food preservatives and colas may induce calcification. A high intake of magnesium (≥380 mg/day) and phylloquinone (500 μg/day) proved protective, as did a serum 25(OH)D concentration of ≥75 nmol/L. Although oxidative damage appears to be a cause of CV calcification, the antioxidant vitamins proved to be largely ineffective, while supplementation of α-tocopherol may induce calcification. Nevertheless other antioxidant compounds (epigallocatechin gallate from green tea and resveratrol from red wine) were protective. Finally, a homocysteine concentration >12 µmol/L was predictive of CV calcification, although a plasma folate concentration of >39.4 nmol/L could both lower homocysteine and protect against calcification. In terms of a dietary programme, these recommendations indicate avoiding sugar and the transfats and preservatives found in processed foods and drinks and adopting a diet high in oily fish and vegetables. The micronutrients magnesium and vitamin K may be worthy of further investigation as a treatment option for CV calcification.
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Ruiz-Suárez N, Henríquez-Hernández LA, Valerón PF, Boada LD, Zumbado M, Camacho M, Almeida-González M, Luzardo OP. Assessment of anticoagulant rodenticide exposure in six raptor species from the Canary Islands (Spain). THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 485-486:371-376. [PMID: 24742545 DOI: 10.1016/j.scitotenv.2014.03.094] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 05/10/2023]
Abstract
Anticoagulant rodenticides are highly toxic compounds that are widely used for pest control of rodents, but that also may threaten the wildlife's health. This work aimed to assess the exposure to first- and second-generation anticoagulant rodenticides (ARs) in six birds of prey species from the Canary Islands (Spain). The concentrations of seven widely used ARs were determined by LC-MS/MS in 104 liver samples of six species of birds of prey (Buteo buteo, Accipiter nisus, Falco pelegrinoides, Falco tinnunculus, Asio otus, and Tyto alba). We determined that 61% of the livers had detectable residues of at least one AR. The most frequently detected AR was bromadiolone, which was detected in 60.3% of the positive cases. The detection frequencies of these compounds varied widely, depending on the species. More than 75% of the A. nisus, T. alba, and A. otus individuals had detectable rodenticide residues in the liver. However, F. tinnunculus exhibited the highest concentrations of AR, with median values above 100 ng/g w.w. We did not detect first-generation ARs in any of the samples. When grouped, nocturnal species exhibited higher AR concentrations than diurnal species (P<0.001). The residue levels were higher among small mammal-eaters than bird-eaters (P<0.01). While most animals exhibited no macroscopic signs of coagulation disorders, approximately 35% exceeded the threshold levels of toxicity, which suggests that these compounds could weaken these animals in their natural environment. In conclusion, the control of rodent populations by ARs suggests that these compounds will enter the food chain and thus threaten the vulnerable populations of raptors on the Canary Islands. Our findings require authorities to ban or strictly control the use of these rodenticides in the natural environment for the conservation of raptors and other predatory species.
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Affiliation(s)
- Norberto Ruiz-Suárez
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Luis A Henríquez-Hernández
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Pilar F Valerón
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Luis D Boada
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Manuel Zumbado
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - María Camacho
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Maira Almeida-González
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain
| | - Octavio P Luzardo
- Unidad de Toxicología, Departamento de Ciencias Clínicas, Facultad de Veterinaria/Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Apartado de correos 550, 35080 Las Palmas de Gran Canaria, Spain.
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Association of VKORC1-1639G>A polymorphism with susceptibility to ossification of the posterior longitudinal ligament of the spine: a Korean study. Acta Neurochir (Wien) 2013; 155:1937-42. [PMID: 23732872 DOI: 10.1007/s00701-013-1747-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 04/29/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Abnormalities of bone metabolism may be involved in the pathogenesis of ossification of the posterior longitudinal ligament (OPLL) of the spine. Besides its hemostatic effect, vitamin K epoxide reductase complex subunit 1 (VKORC1) plays a pivotal role in bone mineralization. The aim of this study is to investigate whether single nucleotide polymorphisms (SNPs) of the VKORC1 gene are associated with the occurrence of OPLL in a Korean population. METHOD A total of 98 patients with OPLL and 200 controls were genotyped for the VKORC1-1639G>A SNP (rs9923231) by polymerase chain reaction and restriction fragment length polymorphism analysis. All the patients (n = 98) in this study underwent surgery (60, posterior-only approach; 36, anterior-only approach; 2, combined anterior and posterior approach) during their admission. We analyzed this association separately according to the gender and OPLL subgroup: OPLL continuous group (continuous type plus mixed type) and OPLL segmental group (segmental and localized type). RESULTS We found that the genotype VKORC1-1639G>A frequency was significantly associated with the occurrence of the OPLL in the female group (adjusted odds ratio = 5.22, 95 % confidence interval: 1.675 to 16.269, p = 0.004). However, there was no overall association between the OPLL susceptibility and VKORC1-1639G>A polymorphism. A subgroup analysis did not show any significant correlation between VKORC1-1639G>A polymorphism and subgroup of OPLL either. CONCLUSION Our results suggest that the VKORC1-1639G>A SNP may increase susceptibility to OPLL in women. However, there was only a statistical association in the female group despite a number of stratified analyses. Therefore, the findings should be interpreted with caution, and further genetic study is needed to improve our understanding of the role of VKORC1 polymorphisms in determining the risk of OPLL occurrence.
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El Khassawna T, Böcker W, Govindarajan P, Schliefke N, Hürter B, Kampschulte M, Schlewitz G, Alt V, Lips KS, Faulenbach M, Möllmann H, Zahner D, Dürselen L, Ignatius A, Bauer N, Wenisch S, Langheinrich AC, Schnettler R, Heiss C. Effects of multi-deficiencies-diet on bone parameters of peripheral bone in ovariectomized mature rat. PLoS One 2013; 8:e71665. [PMID: 23977109 PMCID: PMC3745426 DOI: 10.1371/journal.pone.0071665] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 07/03/2013] [Indexed: 12/28/2022] Open
Abstract
Many postmenopausal women have vitamin D and calcium deficiency. Therefore, vitamin D and calcium supplementation is recommended for all patients with osteopenia and osteoporosis. We used an experimental rat model to test the hypothesis that induction of osteoporosis is more efficiently achieved in peripheral bone through combining ovariectomy with a unique multi-deficiencies diet (vitamin D depletion and deficient calcium, vitamin K and phosphorus). 14-week-old Sprague-Dawley rats served as controls to examine the initial bone status. 11 rats were bilaterally ovariectomized (OVX) and fed with multi-deficiencies diet. Three months later the treated group and the Sham group (n = 8) were euthanized. Bone biomechanical competence of the diaphyseal bone was examined on both, tibia and femur. Image analysis was performed on tibia via µCT, and on femur via histological analysis. Lower torsional stiffness indicated inferior mechanical competence of the tibia in 3 month OVX+Diet. Proximal metaphyseal region of the tibia showed a diminished bone tissue portion to total tissue in the µCT despite the increased total area as evaluated in both µCT and histology. Cortical bone showed higher porosity and smaller cross sectional thickness of the tibial diaphysis in the OVX+Diet rats. A lower ALP positive area and elevated serum level of RANKL exhibited the unbalanced cellular interaction in bone remodeling in the OVX+Diet rat after 3 month of treatment. Interestingly, more adipose tissue area in bone marrow indicated an effect of bone loss similar to that observed in osteoporotic patients. Nonetheless, the presence of osteoid and elevated serum level of PTH, BGP and Opn suggest the development of osteomalacia rather than an osteoporosis. As the treatment and fracture management of both osteoporotic and osteomalacia patients are clinically overlapping, this study provides a preclinical animal model to be utilized in local supplementation of minerals, drugs and growth factors in future fracture healing studies.
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Affiliation(s)
- Thaqif El Khassawna
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
| | - Wolfgang Böcker
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | | | - Nathalie Schliefke
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Britta Hürter
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Marian Kampschulte
- Department of Radiology, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Gudrun Schlewitz
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Katrin Susanne Lips
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
| | - Miriam Faulenbach
- Department of Radiology, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Henriette Möllmann
- Department of Radiology, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Daniel Zahner
- Animal Laboratory, Justus-Liebig University of Giessen, Giessen, Germany
| | - Lutz Dürselen
- Institute of Orthopedic Research and Biomechanics, Centre of Musculoskeletal Research, University of Ulm, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Centre of Musculoskeletal Research, University of Ulm, Ulm, Germany
| | - Natali Bauer
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Sabine Wenisch
- Department of Veterinary Anatomy, Justus-Liebig University of Giessen, Giessen, Germany
| | | | - Reinhard Schnettler
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
| | - Christian Heiss
- Laboratory of Experimental Trauma Surgery, Justus-Liebig University, Giessen, Germany
- Department of Trauma Surgery, University Hospital of Giessen-Marburg, Giessen, Germany
- * E-mail:
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Wang Q, Zhang B, Xu Y, Xu H, Zhang N. The Relationship between Serum Osteocalcin Concentration and Glucose Metabolism in Patients with Type 2 Diabetes Mellitus. Int J Endocrinol 2013; 2013:842598. [PMID: 23533407 PMCID: PMC3603198 DOI: 10.1155/2013/842598] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/09/2013] [Accepted: 02/12/2013] [Indexed: 01/22/2023] Open
Abstract
To study the correlations between serum osteocalcin and glucose metabolism in patients with type 2 diabetes, 66 cases were collected to determine total osteocalcin, undercarboxylated osteocalcin, fasting blood glucose, fasting insulin, and HbA1c. Osteocalcin concentrations were compared between groups of different levels of HbA1c, and parameters of glucose metabolism were compared between groups of different levels of total osteocalcin and undercarboxylated osteocalcin. The relationship between osteocalcin and parameters of glucose metabolism was also analyzed. We found that the total osteocalcin concentration of high-HbA1c group was significantly lower than that of low-HbA1c group. The fasting blood glucose of low-total-osteocalcin group was significantly higher than that of high-total-osteocalcin group in male participants, while the fasting blood glucose of low-undercarboxylated-osteocalcin group was significantly higher than that of high-undercarboxylated-osteocalcin group in all participants and in male participants. Total osteocalcin was inversely correlated with HbA1c, and undercarboxylated osteocalcin was inversely correlated with fasting blood glucose. However, no significant correlation was found between osteocalcin and HOMA-IR. Total osteocalcin was an independent related factor of HbA1c level. In summary, decreased serum total osteocalcin and undercarboxylated osteocalcin are closely related to the exacerbation of glucose metabolism disorder but have no relations with insulin resistance.
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Affiliation(s)
- Qingqing Wang
- Department of Endocrinology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Beibei Zhang
- Department of Endocrinology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Yulan Xu
- Department of Endocrinology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Hongdi Xu
- Department of Endocrinology, Zhejiang Qingchun Hospital, Hangzhou 310016, China
| | - Nan Zhang
- Department of Endocrinology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
- *Nan Zhang:
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Morishima Y, Kamisato C, Honda Y, Furugohri T, Shibano T. The effects of warfarin and edoxaban, an oral direct factor Xa inhibitor, on gammacarboxylated (Gla-osteocalcin) and undercarboxylated osteocalcin (uc-osteocalcin) in rats. Thromb Res 2013; 131:59-63. [DOI: 10.1016/j.thromres.2012.08.304] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 08/07/2012] [Accepted: 08/21/2012] [Indexed: 11/26/2022]
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Update on nutrients involved in maintaining healthy bone. ACTA ACUST UNITED AC 2012; 60:197-210. [PMID: 23273614 DOI: 10.1016/j.endonu.2012.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/30/2012] [Accepted: 09/12/2012] [Indexed: 11/22/2022]
Abstract
Osteoporosis is a leading cause of morbidity and mortality in the elderly and influences quality of life, as well as life expectancy. Currently, there is a growing interest among the medical scientists in search of specific nutrients and/or bioactive compounds of natural origin for the prevention of disease and maintenance of bone health. Although calcium and vitamin D have been the primary focus of nutritional prevention of osteoporosis, a recent research has clarified the importance of several additional nutrients and food constituents. Based on this review of the literature, supplementation with vitamins B, C, K, and silicon could be recommended for proper maintenance of bone health, although further clinical studies are needed. The results of studies on long-chain polyunsaturated fatty acids, potassium, magnesium, copper, selenium, and strontium are not conclusive, although studies in vitro and in animal models are interesting and promising.
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Tarroni P, Villa I, Mrak E, Zolezzi F, Mattioli M, Gattuso C, Rubinacci A. Microarray analysis of 1,25(OH)₂D₃ regulated gene expression in human primary osteoblasts. J Cell Biochem 2012; 113:640-9. [PMID: 21956231 DOI: 10.1002/jcb.23392] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Though extensive studies have been conducted, questions regarding the molecular effectors and pathways underlying the regulatory role of 1,25(OH)(2)D(3) in human osteoblasts other than cell differentiation and matrix protein production remain unanswered. This study aims to identify genes and pathways that are modulated by 1,25(OH)(2)D(3) treatment in human osteoblasts. Primary osteoblast cultures obtained from human bone tissue samples were treated with 1,25(OH)(2)D(3) (10(-7) M) for 24 h and their transcritptomes were profiled by microarray analysis using the Affymetrix GeneChip. Statistical analysis was conducted to identify genes whose expression is significantly modulated following 1,25(OH)(2)D(3) treatment. One hundred and fifty-eight genes were found to be differentially expressed. Of these, 136 were upregulated, indicating clear transcriptional activation by 1,25(OH)(2)D(3). Biostatistical evaluation of microarray data by Ingenuity Pathways Analysis (IPA) revealed a relevant modulation of genes involved in vitamin D metabolism (CYP24), immune functions (CD14), neurotransmitter transporters (SLC1A1, SLC22A3), and coagulation [thrombomodulin (THBD), tissue plasminogen activator (PLAT), endothelial protein C receptor (PROCR), thrombin receptor (F2R)]. We identified a restricted number of highly regulated genes and confirmed their differential expression by real-time quantitative PCR (RT qPCR). The present genome-wide microarray analysis on 1,25(OH)(2)D(3) -treated human osteoblasts reveals an interplay of critical regulatory and metabolic pathways and supports the hypothesis that 1,25(OH)(2)D(3) can modulate the coagulation process through osteoblasts, activates osteoclastogenesis through inflammation signaling, modulates the effects of monoamines by affecting their reuptake.
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Affiliation(s)
- Paola Tarroni
- Axxam Spa, San Raffaele Biomedical Science Park, 20132 Milan, Italy.
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Gagné L, Maizes V. Osteoporosis. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Songpatanasilp T, Chailurkit LO, Chantprasertyothin S, Ongphiphadhanakul B, Taechakraichana N. Effect of GGCX gene polymorphism on the responses of serum undercarboxylated osteocalcin and bone turnover markers after treatment with vitamin K2 (menatetrenone) among postmenopausal Thai women. J Bone Miner Metab 2011; 29:606-14. [PMID: 21344298 DOI: 10.1007/s00774-011-0263-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 01/12/2011] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to evaluate the influence of gamma-glutamyl transferase (GGCX) gene polymorphisms on the response of serum undercarboxylated osteocalcin (ucOC) and bone turnover markers 3 months after treatment with menatetrenone. One hundred and forty postmenopausal Thai women were enrolled and assigned to receive 45 mg/day treatment of menatetrenone (MK-4) concurrently with calcium 1.2 g and vitamin D 400 IU for 3 months. Demographic characteristics, GGCX genotyping, serum bone turnover markers and ucOC levels were obtained from all participants at baseline. We evaluated the reduction of ucOC at 3 months and the reduction of beta-CTx and P1NP at 1 and 3 months. The responses were compared between the different genotypes of GG and GA + AA groups. There was a significant reduction of serum ucOC, beta-CTx and P1NP from the baseline at 3 months (p < 0.001) though there was no significant difference between genotypes (GG vs. GA + AA; p > 0.05). Nonetheless, a subgroup analysis of postmenopausal women who 65 years of age or over (N = 37) revealed a significant difference between the two groups in the reduction of ucOC. Menatetrenone significantly reduced serum ucOC as well as beta-CTX and P1NP from the baseline. GGCX polymorphism appeared to have an influence over the reduction of ucOC especially in older women (age ≥65). Furthermore, the groups which have "A" allele trend to being more efficient in reducing the serum ucOC level than the group which does not have it.
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Affiliation(s)
- Thawee Songpatanasilp
- Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Rajthevee, Bangkok, Thailand.
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Zwart SR, Booth SL, Peterson JW, Wang Z, Smith SM. Vitamin K status in spaceflight and ground-based models of spaceflight. J Bone Miner Res 2011; 26:948-54. [PMID: 21541997 PMCID: PMC3179302 DOI: 10.1002/jbmr.289] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 10/01/2010] [Accepted: 11/05/2010] [Indexed: 01/27/2023]
Abstract
Bone loss is a well-documented change during and after long-duration spaceflight. Many types of countermeasures to bone loss have been proposed, including vitamin K supplementation. The objective of this series of studies was to measure change in vitamin K status in response to microgravity under a variety of spaceflight and spaceflight analog (model) conditions, including long-duration spaceflight studies (n = 15), three bed rest studies (n = 15, 49, and 24), and a 14-day saturation dive (n = 6). In crew members who flew 2-6 months on the International Space Station, in-flight and postflight plasma phylloquinone concentrations were unchanged from the preflight mean. Consistent with this finding, urinary γ-carboxyglutamic acid (GLA), a measure of vitamin K-dependent protein turnover, did not change in response to flight. Serum undercarboxylated osteocalcin (%ucOC), a measure of vitamin K function, was generally unchanged in response to flight. Spaceflight findings were corroborated by findings of no changes in phylloquinone, urinary GLA, or %ucOC during or after bed rest in three separate bed rest studies (21-90 days in duration) or after a 14-day saturation dive. The data presented here do not support either a need for vitamin K supplementation during spaceflight or the suggestion of using vitamin K as a bone loss countermeasure in spaceflight.
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Affiliation(s)
- Sara R Zwart
- Division of Space Life Sciences, Universities Space Research AssociationHouston, TX, USA
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Center on Aging at Tufts UniversityBoston, MA, USA
| | - James W Peterson
- Jean Mayer USDA Human Nutrition Center on Aging at Tufts UniversityBoston, MA, USA
| | - Zuwei Wang
- Enterprise Advisory Services, Inc.Houston, TX, USA
| | - Scott M Smith
- Human Adaptation and Countermeasures Division, NASA Lyndon B. Johnson Space CenterHouston, TX, USA
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Abstract
Impaired glucose metabolism is common and contributes to the risk of diabetes and cardiovascular disease. Deletion of the gene for the osteoblast-derived protein, osteocalcin, leads to insulin resistance in mice, while the addition of osteocalcin increases insulin secretion from β-cells and adiponectin expression in adipocytes. Osteocalcin deficiency in γ-carboxyl groups, undercarboxylated osteocalcin, was found to improve insulin secretion and sensitivity in experiments. Recent studies have examined the relevance of these findings to glucose metabolism and cardiovascular risk in humans. Low total osteocalcin levels are associated with insulin resistance, diabetes and metabolic syndrome in observational studies. New therapeutic approaches to diabetes and heart disease may be anticipated if this bone-derived protein is involved in the regulation of glucose metabolism and cardiovascular risk.
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Affiliation(s)
- Bu B Yeap
- a School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia and Department of Endocrinology and Diabetes, Level 2, T Block, Fremantle Hospital, Alma Street, Fremantle, Western Australia 6160, Australia.
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Abstract
Binder phenotype (BP), or maxillonasal dysostosis, consists of 6 characteristics: arhinoid face, abnormal position of nasal bones, intermaxillary hypoplasia/malocclusion, reduced/absent anterior nasal spine, atrophy of nasal mucosa, and absence of frontal sinus. The purposes of this study were (1) to review the characteristic facial findings, other malformations, and diagnoses in 8 patients with BP; (2) to compare these patients to those in the literature; and (3) to discuss developmental mechanisms, including genetic and environmental factors, involved in this facial defect. An initial 24 cases of BP were identified from the Iowa Registry of Congenital & Inherited Disorders during the period of 1998 to 2008. Chromosome analysis performed in all 24 cases revealed the following: trisomy 21, trisomy 18, and mosaic trisomy 18. Of the 24 patients, 8 met the specific diagnostic characteristics of BP. All 8 patients were evaluated in the genetics clinic at University of Iowa Children's Hospital, having diagnoses of vitamin K epoxide reductase deficiency, Xp22.3 deletion with chondrodysplasia punctata, Stickler syndrome, fetal warfarin syndrome, Robinow syndrome, and unknown etiology. This study, unlike those in the literature, ascertained cases through a population-based active surveillance registry and therefore may better represent the incidence of BP (∼1 per 18,000). Most cases were sporadic with a recognizable pattern of malformation, highlighting that chromosomal, genetic, and exogenous factors may cause BP. Of 8 cases remaining after exclusion of chromosome syndromes, 3 cases had in common the involvement of the vitamin K-dependent metabolic pathway, which likely represents a significant pathogenetic mechanism of BP. Clinical characterization of BP, as in these cases, may allow further understanding of other causative developmental mechanisms.
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Crawford DC, Brown-Gentry K, Rieder MJ. VKORC1 common variation and bone mineral density in the Third National Health and Nutrition Examination Survey. PLoS One 2010; 5:e15088. [PMID: 21179439 PMCID: PMC3001474 DOI: 10.1371/journal.pone.0015088] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 10/20/2010] [Indexed: 12/25/2022] Open
Abstract
Osteoporosis, defined by low bone mineral density (BMD), is common among postmenopausal women. The distribution of BMD varies across populations and is shaped by both environmental and genetic factors. Because the candidate gene vitamin K epoxide reductase complex subunit 1 (VKORC1) generates vitamin K quinone, a cofactor for the gamma-carboxylation of bone-related proteins such as osteocalcin, we hypothesized that VKORC1 genetic variants may be associated with BMD and osteoporosis in the general population. To test this hypothesis, we genotyped six VKORC1 SNPs in 7,159 individuals from the Third National Health and Nutrition Examination Survey (NHANES III). NHANES III is a nationally representative sample linked to health and lifestyle variables including BMD, which was measured using dual energy x-ray absorptiometry (DEXA) on four regions of the proximal femur. In adjusted models stratified by race/ethnicity and sex, SNPs rs9923231 and rs9934438 were associated with increased BMD (p = 0.039 and 0.024, respectively) while rs8050894 was associated with decreased BMD (p = 0.016) among non-Hispanic black males (n = 619). VKORC1 rs2884737 was associated with decreased BMD among Mexican-American males (n = 795; p = 0.004). We then tested for associations between VKORC1 SNPs and osteoporosis, but the results did not mirror the associations observed between VKORC1 and BMD, possibly due to small numbers of cases. This is the first report of VKORC1 common genetic variation associated with BMD, and one of the few reports available that investigate the genetics of BMD and osteoporosis in diverse populations.
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Affiliation(s)
- Dana C Crawford
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States of America.
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McCann JC, Ames BN. Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? Am J Clin Nutr 2009; 90:889-907. [PMID: 19692494 DOI: 10.3945/ajcn.2009.27930] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The triage theory posits that some functions of micronutrients (the approximately 40 essential vitamins, minerals, fatty acids, and amino acids) are restricted during shortage and that functions required for short-term survival take precedence over those that are less essential. Insidious changes accumulate as a consequence of restriction, which increases the risk of diseases of aging. For 16 known vitamin K-dependent (VKD) proteins, we evaluated the relative lethality of 11 known mouse knockout mutants to categorize essentiality. Results indicate that 5 VKD proteins that are required for coagulation had critical functions (knockouts were embryonic lethal), whereas the knockouts of 5 less critical VKD proteins [osteocalcin, matrix Gla protein (Mgp), growth arrest specific protein 6, transforming growth factor beta-inducible protein (Tgfbi or betaig-h3), and periostin] survived at least through weaning. The VKD gamma-carboxylation of the 5 essential VKD proteins in the liver and the 5 nonessential proteins in nonhepatic tissues sets up a dichotomy that takes advantage of the preferential distribution of dietary vitamin K1 to the liver to preserve coagulation function when vitamin K1 is limiting. Genetic loss of less critical VKD proteins, dietary vitamin K inadequacy, human polymorphisms or mutations, and vitamin K deficiency induced by chronic anticoagulant (warfarin/coumadin) therapy are all linked to age-associated conditions: bone fragility after estrogen loss (osteocalcin) and arterial calcification linked to cardiovascular disease (Mgp). There is increased spontaneous cancer in Tgfbi mouse knockouts, and knockdown of Tgfbi causes mitotic spindle abnormalities. A triage perspective reinforces recommendations of some experts that much of the population and warfarin/coumadin patients may not receive sufficient vitamin K for optimal function of VKD proteins that are important to maintain long-term health.
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Affiliation(s)
- Joyce C McCann
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA.
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Insights into liaison between antiepileptic drugs and bone. Drug Discov Today 2009; 14:428-35. [DOI: 10.1016/j.drudis.2009.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 01/06/2009] [Accepted: 01/06/2009] [Indexed: 10/21/2022]
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Vitamin K supplementation to decrease variability of International Normalized Ratio in patients on vitamin K antagonists: a literature review. Curr Opin Hematol 2008; 15:504-8. [DOI: 10.1097/moh.0b013e328304b3c5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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