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Nasimi N, Jamshidi S, Askari A, Zolfaghari N, Sadeghi E, Nouri M, Bellissimo N, Faghih S. Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis. Br J Nutr 2024; 131:1473-1487. [PMID: 38221822 DOI: 10.1017/s0007114524000060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Vitamin D is a vital indicator of musculoskeletal health, as it plays an important role through the regulation of bone and mineral metabolism. This meta-analysis was performed to investigate the effects of vitamin D supplementation/fortification on bone turnover markers in women. All human randomised clinical trials reported changes in bone resorption markers (serum C-terminal telopeptide of type-I collagen (sCTX) and urinary type I collagen cross-linked N-telopeptide (uNTX)) or bone formation factors (osteocalcin (OC), bone alkaline phosphatase (BALP) and procollagen type-1 intact N-terminal propeptide (P1NP)) following vitamin D administration in women (aged ≥ 18 years) were considered. Mean differences (MD) and their respective 95 % CI were calculated based on fixed or random effects models according to the heterogeneity status. Subgroup analyses, meta-regression models, sensitivity analysis, risk of bias, publication bias and the quality of the included studies were also evaluated. We found that vitamin D supplementation had considerable effect on sCTX (MD: -0·038, n 22) and OC (MD: -0·610, n 24) with high heterogeneity and uNTX (MD: -8·188, n 6) without heterogeneity. Our results showed that age, sample size, dose, duration, baseline vitamin D level, study region and quality of studies might be sources of heterogeneity in this meta-analysis. Subgroup analysis also revealed significant reductions in P1NP level in dose less than 600 μg/d and larger study sample size (>100 participants). Moreover, no significant change was found in BALP level. Vitamin D supplementation/fortification significantly reduced bone resorption markers in women. However, results were inconsistent for bone formation markers.
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Affiliation(s)
- Nasrin Nasimi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Aida Askari
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nazanin Zolfaghari
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nick Bellissimo
- Toronto Metropolitan University, School of Nutrition, Toronto, ONM5B-2K3, USA
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Alendronato de sódio e vitamina D na osteoporose pós-menopausa. SCIENTIA MEDICA 2022. [DOI: 10.15448/1980-6108.2022.1.42267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivo: avaliar a eficácia da utilização da terapia combinada de alendronato de sódio e vitamina D no metabolismo ósseo de mulheres em tratamento de osteoporose pós-menopausa.Métodos: trata-se de uma revisão sistemática, a qual foram pesquisados ensaios clínicos randomizados (ECR) indexados nas bases de dados BVS, ISI Web of Science, PubMed, SciELO, ScienceDirect e Scopus que comparavam a associação de alendronato sódico e vitamina D com a monoterapia de alendronato de sódio. Resultados: um total de seis ECR contemplou os critérios para serem inclusos nesse estudo, compreendendo um total de 4164 participantes e seus respectivos dados. Os estudos avaliaram diferentes domínios do metabolismo ósseo, como níveis séricos de vitamina D, paratormônio, densidade mineral óssea e marcadores de turnover ósseo. A terapia combinada produziu melhora significativa nos marcadores metabólicos ósseos. Conclusão: a terapia combinada de alendronato de sódio com vitamina D promove melhora no metabolismo ósseo de mulheres com osteoporose pós-menopausa.
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Riancho JA, Peris P, González-Macías J, Pérez-Castrillón JL. Executive summary clinical practice guideline of postmenopausal, glucocortcioid-induced and male osteoporosis (2022 update). Spanish Society for Bone and Mineral Metabolism Investigation (SEIOMM). Rev Clin Esp 2022; 222:432-439. [PMID: 35676194 DOI: 10.1016/j.rceng.2021.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/30/2021] [Indexed: 10/18/2022]
Abstract
This updated version of the Spanish Society for Research in Osteoporosis and Mineral Metabolism (SEIOMM) osteoporosis guides incorporate the most relevant information published in the last 7 years, since the 2015 guides, with imaging studies, such as vertebral fracture assessment and bone trabecular score analysis. In addition, therapeutic advances include new anabolic agents, comparative studies of drug efficacy, and sequential and combined therapy. Therefore, therapeutic algorithms are also updated.
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Affiliation(s)
- J A Riancho
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Departamento de Medicina y Psiquiatría, Universidad de Cantabria, IDIVAL, Santander, Spain.
| | - P Peris
- Servicio de Reumatología, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | - J González-Macías
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria, IDIVAL, Santander, Spain
| | - J L Pérez-Castrillón
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Departamento de Medicina, Universidad de Valladolid, Valladolid, Spain
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Moradinejad M, Yazdi M, Mard SA, Razavi SM, Shamohammadi M, Shahsanaei F, Rakhshan V. Efficacy of the systemic co-administration of vitamin D3 in reversing the inhibitory effects of sodium alendronate on orthodontic tooth movement: A preliminary experimental animal study. Am J Orthod Dentofacial Orthop 2022; 162:e17-e27. [PMID: 35501223 DOI: 10.1016/j.ajodo.2021.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Bisphosphonates can severely slow down orthodontic tooth movement (OTM) by reducing bone turnover. This calls for materials and methods to reverse or neutralize their effects on OTM. We propose systemic vitamin D3 (D3) for this purpose. METHODS Thirty-two male Wistar rats were randomized into 4 groups of 8 each. Three groups were administered D3 (3 systemic doses of 24,000 IU/kg each), alendronate (ALN) (5 doses of 7 mg/kg each), and ALN+D3 (same doses as mentioned above). One group served as the negative control. The incisors were distalized at 30 g of force for 2 weeks. OTMs were measured blindly. Radicular pressure areas were searched histologically (blindly) for capillaries, Howship's lacunae, osteoclasts, and osteoblasts. Data were analyzed statistically (α = 0.05, α = 0.0083, β <0.1). RESULTS OTMs in the groups D3, ALN+D3, ALN, and control were 1.900 ± 0.237, 1.629 ± 0.219, 0.975 ± 0.145, and 1.565 ± 0.324 mm (analysis of variance, P <0.001), respectively. OTM in the ALN group was smaller than all other groups (Tukey, P <0.001). OTM in the D3 group was greater than in the control group (P = 0.054). The ALN+D3 group had greater OTM than the ALN group (P <0.001) but was not significantly different from the D3 (P = 0.153) or control (P = 0.951) groups. All histologic variables were significantly different across groups (Kruskal-Wallis, P <0.001). All the markers in the D3 group were more frequent than those of the other groups (Mann-Whitney U, P <0.001). There were fewer markers in the ALN group than in the control group (P ≤0.001). The ALN+D3 group had more markers than the ALN group in terms of capillaries, osteoclasts, and osteoblasts (P ≤0.007). The ALN+D3 group was similar to the control group regarding capillaries, osteoclasts, and osteoblasts (P ≥0.382). CONCLUSIONS Systemic vitamin D3 may accelerate OTM and increase histologic biomarkers of bone turnover. ALN reduces OTM and its histologic biomarkers. Systemic vitamin D3 can reverse this inhibitory effect of ALN on OTM back to normal.
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Affiliation(s)
- Mehrnaz Moradinejad
- Department of Orthodontics, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzie Yazdi
- Department of Orthodontics, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Seyed Ali Mard
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology, Implant Dental Research Center, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Shamohammadi
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
| | - Fatemeh Shahsanaei
- Department of Statistics, Shohadaye Hoveizeh, Campus of Technology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Riancho J, Peris P, González-Macías J, Pérez-Castrillón J. Resumen ejecutivo de las guías de práctica clínica en la osteoporosis posmenopáusica, glucocorticoidea y del varón (actualización 2022). Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM). REVISTA CLÍNICA ESPAÑOLA 2022. [DOI: 10.1016/j.rce.2021.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jorde R, Stunes AK, Kubiak J, Joakimsen R, Grimnes G, Thorsby PM, Syversen U. Effects of vitamin D supplementation on bone turnover markers and other bone-related substances in subjects with vitamin D deficiency. Bone 2019; 124:7-13. [PMID: 30959189 DOI: 10.1016/j.bone.2019.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/14/2019] [Accepted: 04/04/2019] [Indexed: 12/31/2022]
Abstract
In observational studies, vitamin D deficiency is a risk factor for low bone density and future fractures, whereas a causal relation has been difficult to show in randomized controlled trials (RCTs). Similarly, vitamin D deficiency has been associated with increased bone turnover, but RCTs with vitamin D have not shown conclusive effects. This could be due to inclusion of vitamin D sufficient subjects and low vitamin D doses. In the present study 399 subjects with mean baseline serum 25-hydroxyvitamin D (25(OH)D) 34.0 nmol/L completed a four months intervention with vitamin D3 20,000 IU per week versus placebo. Mean serum 25(OH)D increased to 89.0 nmol/L in the vitamin D group and decreased slightly in the placebo group. A small, but significant, decrease in the bone formation marker procollagen of type 1 amino-terminal propeptide (P1NP) was seen in the vitamin D group as compared to the placebo group (mean delta P1NP -1.2 pg/mL and 1.5 ng/mL, respectively, P < 0.01). No significant effects were seen on serum carboxyl-terminal telopeptide of type 1 collagen (CTX-1), Dickkopf-1, sclerostin, tumor necrosis factor-alpha, osteoprotegerin, receptor activator of nuclear factor ĸB ligand, or leptin. Subgroup analyses on subjects with low baseline serum 25(OH)D did not yield additional, significant results. In subjects with high baseline serum parathyroid hormone (PTH) > 6.5 pmol/L and post-intervention decrease in PTH, the decrease in P1NP was more pronounced, they also exhibited significantly reduced serum CTX-1 and increased serum sclerostin. In conclusion, supplementation with vitamin D appears to suppress bone turnover, possibly mediated by PTH reduction. Our findings need to be confirmed in even larger cohorts with vitamin D insufficient subjects.
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Affiliation(s)
- Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT, The Arctic University of Norway, 9038 Tromsø, Norway; Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway.
| | - Astrid Kamilla Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Julia Kubiak
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT, The Arctic University of Norway, 9038 Tromsø, Norway.
| | - Ragnar Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT, The Arctic University of Norway, 9038 Tromsø, Norway; Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway.
| | - Guri Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT, The Arctic University of Norway, 9038 Tromsø, Norway; Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway.
| | - Per Medbøe Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Aker Hospital, Oslo, Norway.
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Pérez-Alonso M, Briongos LS, Ruiz-Mambrilla M, Velasco EA, Olmos JM, de Luis D, Dueñas-Laita A, Pérez-Castrillón JL. Association Between Bat Vitamin D Receptor 3' Haplotypes and Vitamin D Levels at Baseline and a Lower Response After Increased Vitamin D Supplementation and Exposure to Sunlight. INT J VITAM NUTR RES 2019; 90:290-294. [PMID: 30789807 DOI: 10.1024/0300-9831/a000534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective: The aim of this study was to evaluate the relationship between vitamin D levels at baseline and after 12 weeks of supplementation/exposure to sunlight and VDR genotypes (BsmI, TaqI and ApaI) and haplotypes in a homogeneous population of postmenopausal women. Methods: We made a prospective study in which 151 women were randomized to two groups: One with 1000 mg of calcium and 800 IU vitamin D supplementation (102 women) and a placebo group with neither calcium or vitamin D supplementation (49 women). The follow-up was from May to September 2012.Vitamin D was determined by chemiluminescent immunoassay. Genotypes were determined using the Sequenomi Plexplatform and haplotypes using PHASE software. Results: Baseline (25 ± 10 ng/mlvs.23 ± 9 ng/ml, p > 0.05) and 12-week (32 ± 8 ng/mlvs.29 ± 10 ng/ml, p > 0.05) vitamin D levels were similar between the two groups. The genetic study was made in the total population. There were no differences in baseline and final levels of vitamin D in terms of genotypes and haplotypes, except for the Bat haplotype, whose baseline values were lower (25OHD: 21 ± 10 ng/mlvs. 21 ± 10 ng/ml, p = 0.038). The rate of nonresponders in this group was 15 % (p = 0.001), compared with 9 %, 2 % and 3 % in the other groups. Conclusions: The Bat haplotype was associated with lower baseline levels of vitamin D and a worse response to supplementation and, therefore, may be a risk factor for vitamin D deficiency.
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Affiliation(s)
| | | | | | - Eladio A Velasco
- Institute of Molecular and Genetic Biology, University of Valladolid, Spain
| | - José M Olmos
- Department of Internal Medicine, University Hospital Marques de Valdecilla, University of Cantabria, Spain
| | - Daniel de Luis
- Department of Endocrinology, University Hospital Valladolid, University of Valladolid, Spain
| | - Antonio Dueñas-Laita
- Department of Clinical Pharmacology, University Hospital Río Hortega, University of Valladolid, Spain
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Vlot MC, den Heijer M, de Jongh RT, Vervloet MG, Lems WF, de Jonge R, Obermayer-Pietsch B, Heijboer AC. Clinical utility of bone markers in various diseases. Bone 2018; 114:215-225. [PMID: 29920402 DOI: 10.1016/j.bone.2018.06.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022]
Abstract
Measurements of bone markers (BMs) in peripheral blood or urine are a pivotal part of bone research within modern clinical medicine. In recent years the use of BMs increased substantially as they can be useful either to diagnose bone (related) disease and to follow its natural history, but also to monitor the effects of interventions. However, the use of BMs is still complicated mainly due to (pre)analytical variability of these substances, limited accessibility of assays, variable cut-off values in different countries and laboratories and heterogeneous results with regard to clinical implications of measuring BMs in several studies. This review will provide the clinician with a practical guide, based on current evidence, in which circumstances to test which bone markers for optimal diagnostic purposes, in order to improve patient care in different areas of bone diseases including Paget's disease, primary osteoporosis, tumor induced osteomalacia, hypophosphatemic rickets, van Buchem disease, chronic kidney disease, rheumatoid arthritis, neoplasma/multiple myeloma, type 2 diabetes mellitus and primary hyperparathyroidism. The clinician should consider fasting state, recent fractures, aging, menopausal status, concomitant liver and kidney disease when ordering and interpreting BM measurements as these factors might result in misleading BM concentrations. We found that BMs are clearly useful in the current diagnosis of tumor induced osteomalacia, van Buchem disease, Paget's disease and hypophosphatemic rickets. In addition, BMs are useful to monitor disease activity in chronic kidney disease, Paget's disease and are useful to monitor treatment adherence in osteoporosis.
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Affiliation(s)
- M C Vlot
- Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Department of Internal Medicine, Endocrinology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - M den Heijer
- Department of Internal Medicine, Endocrinology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - R T de Jongh
- Department of Internal Medicine, Endocrinology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - M G Vervloet
- Department Nephrology, Amsterdam Cardiovascular Sciences (ACS) VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - W F Lems
- Department of Rheumatology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - R de Jonge
- Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - B Obermayer-Pietsch
- Department of Internal Medicine, Endocrinology and Diabetology, Medical University of Graz, Graz 8036, Austria
| | - A C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Department of Clinical Chemistry, Laboratory of Endocrinology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
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Liao EY, Zhang ZL, Xia WB, Lin H, Cheng Q, Wang L, Hao YQ, Chen DC, Tang H, Peng YD, You L, He L, Hu ZH, Song CL, Wei F, Wang J, Zhang L. Clinical characteristics associated with bone mineral density improvement after 1-year alendronate/vitamin d3 or calcitriol treatment: Exploratory results from a phase 3, randomized, controlled trial on postmenopausal osteoporotic women in China. Medicine (Baltimore) 2018; 97:e11694. [PMID: 30075569 PMCID: PMC6081166 DOI: 10.1097/md.0000000000011694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/02/2018] [Indexed: 02/05/2023] Open
Abstract
Baseline and on-treatment characteristics, including age, obesity, calcium intake, and bone turnover markers, may predict the bone mineral density (BMD) response in women with postmenopausal osteoporosis (PMO) to 1 to 2 years of antiresorptive therapy and/or vitamin D supplementation. This study aimed to explore clinical characteristics associated with 12-month BMD improvement in Chinese women with postmenopausal osteoporosis (PMO).In this post hoc analysis of a previous phase 3 multicenter, randomized controlled trial, Chinese PMO women who were treated with once weekly alendronate 70 mg/vitamin D3 5600 IU (ALN/D5600) or once daily calcitriol 0.25 mcg, and had measurements of 1-year lumbar spine BMD (LS-BMD) and on-treatment bone turnover markers (BTMs) were included in the analysis.In Chinese PMO patients on ALN/D5600, 1-year LS-BMD change was negatively correlated with age (β = -0.00084, P < .01), dietary calcium (β = -0.0017, P = .07), and procollagen type 1 N-terminal propeptide (P1NP) change at month 6 (β = -0.000469, P = .0016), but positively with body mass index (BMI) (β = 0.00128, P = .08); baseline P1NP above the median was associated with a significantly greater BMD percentage change at the lumbar spine (P = .02) and the total hip (P = .0001). In the calcitriol group, a significant 1-year LS-BMD increase was associated with BMI (β = 0.0023, P = .02), baseline P1NP (β = 0.00035, P = .0067), history of prior vertebral fracture(s) (β = 0.034, P < .0001) and baseline serum 25(OH)D level (β = -0.00083, P = .02).The presented findings from Chinese postmenopausal osteoporotic women suggested clinically meaningful baseline and on-treatment characteristics predicting BMD improvement after 1 year of ALN/D5600 treatment, which differed from calcitriol treatment with baseline identifiable associations. The study remained exploratory and further accumulation of evidence is needed.
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Affiliation(s)
- Er-Yuan Liao
- The Second Xiangya Hospital, Central South University, Changsha
| | - Zhen-Lin Zhang
- The Sixth People's Hospital, Shanghai Jiaotong University
| | | | - Hua Lin
- Nanjing Drum Tower Hospital, Nanjing
| | - Qun Cheng
- Huadong Hospital Affiliated to Fudan University
| | | | | | - De-Cai Chen
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu
| | - Hai Tang
- Beijing Friendship Hospital, Capital Medical University
| | | | - Li You
- The First People's Hospital
| | | | | | | | - Fang Wei
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - Jue Wang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - Lei Zhang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
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Suzuki T, Nakamura Y, Kato H. Vitamin D and Calcium Addition during Denosumab Therapy over a Period of Four Years Significantly Improves Lumbar Bone Mineral Density in Japanese Osteoporosis Patients. Nutrients 2018; 10:E272. [PMID: 29495518 PMCID: PMC5872690 DOI: 10.3390/nu10030272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/13/2018] [Accepted: 02/23/2018] [Indexed: 01/22/2023] Open
Abstract
This study investigated whether or not vitamin D and calcium supplementation affected bone metabolism and bone mineral density (BMD) over a period of four years of denosumab therapy in patients with primary osteoporosis. Patients were divided into a denosumab monotherapy group (22 cases) or a denosumab plus vitamin D and calcium supplementation group (combination group, 21 cases). We measured serum bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRACP)-5b, urinary N-terminal telopeptide of type-I collagen (NTX), and BMD of the lumbar 1-4 vertebrae (L-BMD) and bilateral hips (H-BMD) at baseline and at 12, 24, 36, and 48 months of treatment. There were no significant differences in patient background. Serum BAP, TRACP-5b, and urinary NTX were significantly and comparably inhibited in both groups from 12 to 48 months versus baseline values. L-BMD was significantly increased at every time point in both groups, while H-BMD was significantly increased at every time point in the combination group only. There were significant differences between the groups for L-BMD at 24, 36, and 48 months (P < 0.05) and for H-BMD at 12 months (P < 0.05). Compared with denosumab monotherapy, combination therapy of denosumab plus vitamin D and calcium significantly increased H-BMD at 12 months and L-BMD from 24 to 48 months. These findings indicate that continuous vitamin D and calcium supplementation is important, especially for 12 months to improve H-BMD and from 24 to 48 months to improve L-BMD.
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Affiliation(s)
- Takako Suzuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan.
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan.
- Department of Orthopedic Surgery, Showa-Inan General Hospital, Akaho 3230, Komagane 399-4117, Japan.
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan.
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Nakamura Y, Suzuki T, Kamimura M, Murakami K, Ikegami S, Uchiyama S, Kato H. Vitamin D and calcium are required at the time of denosumab administration during osteoporosis treatment. Bone Res 2017; 5:17021. [PMID: 29021920 PMCID: PMC5634512 DOI: 10.1038/boneres.2017.21] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/15/2017] [Accepted: 02/15/2017] [Indexed: 01/15/2023] Open
Abstract
To evaluate the differences in outcomes of treatment with denosumab alone or denosumab combined with vitamin D and calcium supplementation in patients with primary osteoporosis. Patients were split into a denosumab monotherapy group (18 cases) or a denosumab plus vitamin D supplementation group (combination group; 23 cases). We measured serum bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRACP)-5b and urinary N-terminal telopeptide of type-I collagen (NTX) at baseline, 1 week, as well as at 1 month and 2, 4, 8 and 12 months. We also measured bone mineral density (BMD) of L1–4 lumbar vertebrae (L)-BMD and bilateral hips (H)-BMD at baseline and at 4, 8 and 12 months. There was no significant difference in patient background. TRACP-5b and urinary NTX were significantly suppressed in both groups from 1 week to 12 months (except at 12 months for NTX). In the combination group, TRACP-5b was significantly decreased compared with the denosumab monotherapy group at 2 and 4 months (P<0.05). BAP was significantly suppressed in both groups at 2–12 months. L-BMD significantly increased at 8 and 12 months (8.9%) in the combination group and at 4, 8 and 12 months (6.0%) in the denosumab monotherapy group, compared with those before treatment. H-BMD was significantly increased in the combination group (3.6%) compared with the denosumab group (1.2%) at 12 months (P<0.05). Compared with denosumab monotherapy, combination therapy of denosumab with vitamin D and calcium stopped the decrease in calcium caused by denosumab, inhibited bone metabolism to a greater extent, and increased BMD (especially at the hips).
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Affiliation(s)
- Yukio Nakamura
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan
| | - Takako Suzuki
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Mikio Kamimura
- Center of Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Matsumoto, Japan
| | - Kohei Murakami
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shota Ikegami
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shigeharu Uchiyama
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Kato
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Kamimura M, Uchiyama S, Nakamura Y, Ikegami S, Mukaiyama K, Kato H. Short-term bisphosphonate treatment reduces serum 25(OH) vitamin D 3 and alters values of parathyroid hormone, pentosidine, and bone metabolic markers. Ther Clin Risk Manag 2017; 13:161-168. [PMID: 28243105 PMCID: PMC5315201 DOI: 10.2147/tcrm.s120749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This study aimed to clarify the effects of short-term bisphosphonate (BP) administration in Japanese osteoporotic patients retrospectively. Daily minodronate (MIN) at 1 mg/day (MIN group) or weekly risedronate (RIS) at 17.5 mg/week (RIS group) was primarily prescribed for each patient. We analyzed the laboratory data of 35 cases (18 of MIN and 17 of RIS) before the start of treatment and at 4 months afterward. The changes in 25(OH)D3, whole parathyroid hormone (PTH), serum pentosidine, and the bone turnover markers urinary cross-linked N-telopeptide of type I collagen (NTX), serum tartrate-resistant acid phosphatase (TRACP)-5b, bone-specific alkaline phosphatase (BAP), and undercarboxylated osteocalcin were evaluated. Overall, serum 25(OH)D3 was significantly decreased from 21.8 to 18.4 ng/mL at 4 months, with a percent change of −14.7%. Whole PTH increased significantly from 23.4 to 30.0 pg/mL, with a percent change of 32.1%. Serum pentosidine rose from 0.0306 to 0.0337 μg/mL, with a percent change of 15.2%. In group comparisons, 25(OH)D3 and pentosidine showed comparable changes in both groups after 4 months of treatment, whereas whole PTH became significantly more increased in the MIN group. All bone turnover markers were significantly decreased at 4 months in both groups. Compared with the RIS group, the MIN group exhibited significantly larger value changes for urinary NTX, serum TRACP-5b, and BAP at the study end point. This study demonstrated that serum 25(OH)D3 became significantly decreased after only 4 months of BP treatment in Japanese osteoporotic patients and confirmed that MIN more strongly inhibited bone turnover as compared with RIS.
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Affiliation(s)
- Mikio Kamimura
- Center for Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Matsumoto, Japan
| | - Shigeharu Uchiyama
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Keijiro Mukaiyama
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Zhang L, Yuan QY. Vitamin D should be supplemented more actively in elderly patients with coronary heart disease combined with COPD. Int J Chron Obstruct Pulmon Dis 2016; 11:1359-65. [PMID: 27382272 PMCID: PMC4922805 DOI: 10.2147/copd.s105671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective It is not clear whether vitamin D should be actively supplemented in elderly patients suffering from an acute attack of COPD (AECOPD) and coronary heart disease (CHD). Patients and methods The patients were divided into three groups according to specific criteria: patients with AECOPD (group A), patients with COPD combined with CHD (group B), and patients with CHD (group C). We measured the levels of vitamin D and analyzed the correlation between vitamin D and important electrolytes, including prealbumin, creatinine, hemoglobin, cystatin C, blood fat, blood calcium, and blood magnesium, and the nutrition state of the whole body. The serum B-type natriuretic peptide (BNP) was measured using an ELISA kit. Results The vitamin D level in group B was the lowest, followed by group A. When compared with group C, they all had statistical significance (P<0.05), but there was no statistical difference between groups A and B. There was no difference among the three groups when prealbumin, creatinine, hemoglobin, cystatin C, blood fat, blood calcium, and blood magnesium were compared. The level of BNP in the three groups increased, but it had no obvious correlation with the level of vitamin D (P>0.05). Conclusion When elderly patients have coronary artery disease with AECOPD, vitamin D levels were obviously lower and were negatively correlated with the BNP. Low vitamin D levels, as well as poor nutrition, affect cardiopulmonary function and quality of living of elderly patients, especially female patients. Therefore, vitamin D should be supplemented more actively in the female patients suffering from AECOPD and CHD.
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Affiliation(s)
| | - Qiao-Ying Yuan
- Department of Nutriology, Southwest Hospital, The Third Military Medical University, Chongqing, People's Republic of China
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González-Macías J, del Pino-Montes J, Olmos J, Nogués X. Clinical practice guidelines for postmenopausal, glucocorticoid-induced and male osteoporosis. Spanish Society for Research on Bone and Mineral Metabolism (3rd updated version 2014). Rev Clin Esp 2015. [DOI: 10.1016/j.rceng.2015.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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González-Macías J, Del Pino-Montes J, Olmos JM, Nogués X. Clinical practice guidelines for posmenopausal, glucocorticoid-induced and male osteoporosis. Spanish Society for Research on Bone and Mineral Metabolism (3rd updated version 2014). Rev Clin Esp 2015; 215:515-26. [PMID: 26434811 DOI: 10.1016/j.rce.2015.08.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 07/26/2015] [Accepted: 08/24/2015] [Indexed: 01/22/2023]
Abstract
These guidelines update issues covered in previous versions and introduce new ones that have arisen in recent years. The former refer mainly to the therapeutic developments that have been made during this time (zoledronate, denosumab, bazedoxifene), which have led to a change in the drug selection algorithm. The latter deal with therapeutic management, the description of new adverse effects (which have led to changes in therapeutic behaviour patterns, as is the case with atypical fracture of the femur), treatment duration (with consideration for the so-called "therapeutic holidays"), the so-called sequential treatment and changes in treatment imposed by certain circumstances. A new algorithm has been introduced for sequential treatment. Attention has also been paid to vertebroplasty and kyphoplasty.
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Affiliation(s)
- J González-Macías
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla. IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Universidad de Cantabria, Santander, España
| | - J Del Pino-Montes
- Servicio de Reumatología, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad RETICEF), Universidad de Salamanca, Alfonso X el Sabio, Salamanca, España
| | - J M Olmos
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla. IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Universidad de Cantabria, Santander, España
| | - X Nogués
- Servicio de Medicina Interna, Hospital del Mar, URFOA-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques). Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Universidad Autónoma de Barcelona, Barcelona, España.
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Xiaomei W, Hang X, Lingling L, Xuejun L. Bone metabolism status and associated risk factors in elderly patients with chronic obstructive pulmonary disease (COPD). Cell Biochem Biophys 2015; 70:129-34. [PMID: 24633456 DOI: 10.1007/s12013-014-9868-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The prevalence of osteoporosis in older patients with chronic obstructive pulmonary disease (COPD) is higher than in the age-matched elderly patients, but the exact cause in relation to COPD is not clear. We hypothesized that the underlying causes for this difference are related to bone metabolism with the possible risk factors that include the duration of COPD, GOLD grade, cor pulmonale, the frequencies of acute exacerbations within the past year, smoking and inhaled corticosteroid therapy. We conducted a matched-pair study of 100 patients aged older than 65 years at the Southwest Hospital from May to November 2012. The enrolled patients with COPD were matched to controls for age and gender. Clinical characteristics of cohorts were recorded. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry and osteoporosis was diagnosed according to the definition of WHO. All cohorts accepted bone metabolism marker measurement, including Procollagen type 1 aminoterminal propeptide (P1NP), β-C-telopeptides of type I collagen (βCTX), and N-terminal midmolecule fragment osteocalcin (N-MID OC). Statistical analysis was calculated using the student's t test, ANOVA and multiple regression analysis at a significance level set at a p < 0.05. Circulating biochemical markers of bone formation (P1NP), resorption (βCTX) and turnover (N-MID OC) were significantly lower in the COPD group than control group, while mean 25-OH Vitamin D was similar in two groups. The P1NP, βCTX, and N-MID OC were still lower in men with COPD, but only P1NP was lower in women with COPD compared to that of controls. Multiple regression analysis in COPD group suggests that age, the frequency of acute exacerbation, and BMD are independent risk factors for P1NP. The frequency of acute exacerbation within the past one year and 25-OH D level are independent risk factors for βCTX; the frequency of acute exacerbation is the only independent risk factor for N-MID OC. These were significant differences in bone metabolism in patients with or without COPD. These results should help us to further understand the cause of osteoporosis and fractures and conduce to prevent osteoporosis in patients with COPD.
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Affiliation(s)
- Wang Xiaomei
- Department of Geriatrics, Southwest Hospital, Third Military Medical University, Gao Tan Yan Street, Sha Ping Ba District, Chongqing, 400038, People's Republic of China,
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Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, Hao YQ, Chen DC, Tang H, De Peng Y, You L, He L, Hu ZH, Song CL, Wei F, Wang J, Zhang L, Santora AC. Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension. Osteoporos Int 2015; 26:2365-74. [PMID: 25929192 PMCID: PMC4532726 DOI: 10.1007/s00198-015-3141-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 04/13/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED This study compares efficacy of ALN/D5600 versus that of calcitriol in osteoporotic Chinese postmenopausal women. ALN/D5600 produced greater bone mineral density (BMD) increases, greater bone turnover marker decreases, and less vitamin D insufficiency. This study provided detailed clinical information regarding ALN/D5600 treatment versus calcitriol 0.25 μg/day. The study did not evaluate fracture risk. INTRODUCTION The aim of this study is to investigate efficacy of alendronate 70 mg/vitamin D3 5600 IU combination tablets (ALN/D5600) versus calcitriol in osteoporotic Chinese postmenopausal women. METHODS This study is a 6-month, randomized, open-label, active-comparator study with 6-month extension (clinicaltrials.gov number NCT01350934) in postmenopausal women aged >55 years with osteoporosis (low bone mineral density (BMD) with/without prior fragility fracture). Patients were randomized to ALN/D5600 once weekly or calcitriol 0.25 μg daily. The primary efficacy end point of the base study was percent change from baseline in lumbar spine BMD (month 6). Hypercalcemia and hypercalciuria were safety events of special interest. RESULTS A total of 219 patients (ALN/D5600 n = 111, calcitriol n = 108) were randomized. Baseline characteristics were similar, 30.3 % baseline 25-hydroxyvitamin D (25(OH)D) ≤15 ng/mL. At months 6 and 12, changes in lumbar spine BMD from baseline were 3.5 versus 1.6 % and 5.2 versus 2.3 % for ALN/D5600 versus calcitriol (between-group differences p < 0.001), respectively. Between-group differences for ALN/D5600 versus calcitriol were significant (p < 0.001) at months 6 and 12 for change from baseline in procollagen type 1 N-terminal propeptide (-59.1 versus -16.8 %, -68.1 versus -17.0 %) and serum C-telopeptides (-79.2 versus -27.2 %, -76.2 versus -24.2 %). Drug-related adverse events (AEs) and discontinuations due to drug-related AEs occurred in 15 (14.0 %) versus 8 (7.4 %) patients and 3 (2.8 %) versus 0 patients in the ALN/D5600 and calcitriol group, respectively. Hypercalciuria 12-month incidence (24-h urine Ca >300 mg) was 8.4 (ALN/D5600) versus 13.9 % (calcitriol) (p > 0.05). One patient (calcitriol) had hypercalcemia. CONCLUSIONS ALN/D5600 produced greater increases in lumbar spine BMD and greater decreases in bone turnover markers versus calcitriol in osteoporotic Chinese women. It is not known whether the greater increase in BMD results in fewer fractures. ALN/D5600 was generally well tolerated in Chinese patients.
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Affiliation(s)
- Z L Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, The Sixth People's Hospital, Shanghai Jiaotong University, 600 Yi-Shan Road, Shanghai, 200233, China,
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Associations between frailty and serum N-terminal propeptide of type I procollagen and 25-hydroxyvitamin D in older Spanish women: The Toledo Study for Healthy Aging. Exp Gerontol 2015; 69:79-84. [PMID: 26031553 DOI: 10.1016/j.exger.2015.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 11/21/2022]
Abstract
Frail older people are at high risk for fractures and falls increasing the rates of institutionalization and mortality. Bone markers have been related to both aging and fractures. However, no previous reports have shown a potential relationship between serum bone markers such as N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (β-CTX) and parathyroid hormone (PTH) with frailty in elderly female populations. This study is aimed at examining the associations of bone metabolism markers and frailty in older Spanish women through a descriptive cross-sectional analysis based on a cohort of the Toledo Study for Healthy Aging (TSHA). The levels of serum PINP, β-CTX, PTH and 25-hydroxyvitamin D (25(OH)D) were assessed in 592 participants (median age 74years) who were defined as robust, prefrail and frail according to Fried's approach. Frail subjects had significantly high levels of PINP, β-CTX and PTH and low production of 25(OH)D. After adjustment for confounders, high PINP levels (defined by the upper quartile) and low levels of 25(OH)D (lower quartile) remained significantly associated to frailty [OR for PINP: 2.19 (95% CI, 1.15-4.18; P=0.017); OR for 25(OH)D: 1.65 (95% CI, 1.02-2.67; P=0.042)]. Women with both high PINP levels and low 25(OH)D levels presented a 5.85-fold increased frailty risk (95% CI, 1.64-20.93; P=0.007). The main contribution of this paper is the novel definition of PINP and 25(OH)D markers as potential biomarkers of frailty and targets for intervention.
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Hernández JL, Olmos JM, Romaña G, Llorca J, Martínez J, Castillo J, de Juan J, Pérez-Pajares I, Ruiz S, González-Macías J. Influence of vitamin D status on the effect of statins on bone mineral density and bone turnover markers in postmenopausal women. J Clin Endocrinol Metab 2014; 99:3304-9. [PMID: 24878047 DOI: 10.1210/jc.2014-1102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study sought to assess whether the association between statin use and bone mineral density (BMD) and bone turnover markers is modulated by serum 25-hydroxyvitamin D (25OHD) levels in postmenopausal women. Design, Participants, and Settings: Approximately 1422 postmenopausal women were recruited from the Camargo Cohort after excluding those with any known medical disorder or drug that might affect bone metabolism. Participants were categorized into four groups: 25OHD levels of 20 ng/mL or less and not taking statins (group 1; n = 492); 25OHD levels greater than 20 ng/mL and on statins (group 2; n = 143); 25OHD levels of 20 ng/mL or less and using statins (group 3; n = 112); and 2OHD levels greater than 20 ng/mL and non-statin use (group 4; n = 675). Multivariate analyses were performed to compare BMD and bone turnover markers between groups. RESULTS Women in group 2 had an adjusted femoral neck and total hip BMD higher than women in group 1 (P < .0001 and P = .003, respectively). A trend toward a significant difference was observed regarding lumbar BMD (P = .08). Serum aminoterminal propeptide of type 1 collagen and C-terminal telopeptide of type 1 collagen levels were lower in group 2 than in group 1, in crude and adjusted models, although only serum C-terminal telopeptide of type 1 collagen difference was significant (P = .009). CONCLUSIONS Women on statins and serum 25OHD levels above 20 ng/mL have greater BMD and less bone resorption than those without either of the factors. Differences, however, are not significant in women with only one of them. Vitamin D and statins seem to interact positively in their effects on bone metabolism.
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Affiliation(s)
- José L Hernández
- Bone Metabolic Unit (J.L.H., J.M.O., J.M., S.R., J.G.-M.), Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, University of Cantabria, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad, and Epidemiology Unit (J.L.), Medical School, University of Cantabria, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, 39008 Santander, Spain; and Centro de Salud Camargo (G.R., J.C., J.d.J., I.P.-P.), 39600 Santander, Spain
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Robbins JA, Aragaki A, Crandall CJ, Manson JE, Carbone L, Jackson R, Lewis CE, Johnson KC, Sarto G, Stefanick ML, Wactawski-Wende J. Women's Health Initiative clinical trials: interaction of calcium and vitamin D with hormone therapy. Menopause 2014; 21:116-23. [PMID: 23799356 PMCID: PMC3830603 DOI: 10.1097/gme.0b013e3182963901] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aims to test the added value of calcium and vitamin D (CaD) in fracture prevention among women taking postmenopausal hormone therapy (HT). METHODS This is a prospective, partial-factorial, randomized, controlled, double-blind trial among Women's Health Initiative postmenopausal participants aged 50 to 79 years at 40 centers in the United States with a mean follow-up of 7.2 years. A total of 27,347 women were randomized to HT (0.625 mg of conjugated estrogens alone, or 0.625 mg of conjugated equine estrogens plus 2.5 mg of medroxyprogesterone acetate daily), and 36,282 women were randomized to 1,000 mg of elemental calcium (carbonate) plus 400 IU of vitamin D3 daily, each compared with placebo. A total of 16,089 women participated in both arms. The predefined outcomes were adjudicated hip fractures and measured bone mineral density. RESULTS Interaction between HT and CaD on hip fracture (P interaction = 0.01) was shown. The effect of CaD was stronger among women assigned to HT (hazard ratio [HR], 0.59; 95% CI, 0.38-0.93) than among women assigned to placebo (HR, 1.20; 95% CI, 0.85-1.69). The effect of HT on hip fracture was stronger among women assigned to active CaD (HR, 0.43; 95% CI, 0.28-0.66) than among women assigned to placebo (HR, 0.87; 95% CI, 0.60-1.26). CaD supplementation enhanced the antifracture effect of HT at all levels of personal calcium intake. There was no interaction between HT and CaD on change in hip or spine bone mineral density. CONCLUSIONS Postmenopausal women at normal risk for hip fracture who are on CaD supplementation experience significantly reduced incident hip fractures beyond HT alone at all levels of personal baseline total calcium intake.
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Affiliation(s)
- John A Robbins
- Corresponding author: Department of Medicine, University of California Davis, Sacramento, CA, 4150 V Street, Suite 2400, Sacramento, CA, 95817, Work 916 734-7005, Fax 916 734-2732,
| | - Aaron Aragaki
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | - Joann E Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Laura Carbone
- Veterans Affairs Medical Center Memphis, TN and Department of Medicine, University of TN Health Science Center, Memphis, TN
| | - Rebecca Jackson
- Department of Medicine, Ohio State University, Columbus Ohio
| | - Cora E. Lewis
- Division of Preventive Medicine, University of Alabama, Birmingham, Alabama
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Gloria Sarto
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo NY
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Thomas T, Briot K. Effets osseux et musculaires de la vitamine D. Presse Med 2013; 42:1351-7. [DOI: 10.1016/j.lpm.2013.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/01/2013] [Indexed: 12/31/2022] Open
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Karczmarewicz E, Czekuc-Kryskiewicz E, Płudowski P. Effect of vitamin D status on pharmacological treatment efficiency: Impact on cost-effective management in medicine. DERMATO-ENDOCRINOLOGY 2013; 5:299-304. [PMID: 24194969 PMCID: PMC3772917 DOI: 10.4161/derm.25279] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 06/05/2013] [Indexed: 12/14/2022]
Abstract
At least 80% of the whole Polish population, including prepubertal children and adolescents, adults and seniors, are vitamin D deficient, defined as 25(OH)D < 50 nmol/L. 83% of Polish newborns start their lives at the state of vitamin D deficiency because 78% of their mothers are also deficient. It was observed that treating patient vitamin D deficiency to vitamin D status serum 25(OH)D) 75-100 nmol/L increased effectiveness of therapies in infectious diseases (chronic hepatitis C, tuberculosis), osteoporosis, multiple sclerosis, epilepsy, Chronic Kidney Diseases and atopic dermatitis. . For these reasons doctors should take special attention to vitamin D status in patients suffering for these diseases properly implementing recent vitamin D recommendation.
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Affiliation(s)
- Elzbieta Karczmarewicz
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
| | - Edyta Czekuc-Kryskiewicz
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
| | - Paweł Płudowski
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
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Karczmarewicz E, Czekuć-Kryśkiewicz E, Płudowski P. Effect of vitamin D status on pharmacological treatment efficiency: Impact on cost-effective management in medicine. DERMATO-ENDOCRINOLOGY 2013; 5:1-6. [PMID: 24494037 PMCID: PMC3897577 DOI: 10.4161/derm.25531] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 05/25/2013] [Accepted: 06/19/2013] [Indexed: 01/28/2023]
Abstract
At least 80% of the whole Polish population, including prepubertal children and adolescents, adults and seniors, are vitamin D deficient, defined as 25(OH)D < 50 nmol/L. 83% of Polish newborns start their lives at the state of vitamin D deficiency because 78% of their mothers are also deficient. It was observed that treating patient vitamin D deficiency to vitamin D status serum 25(OH)D) 75-100 nmol/L increased effectiveness of therapies in infectious diseases (chronic hepatitis C, tuberculosis), osteoporosis, multiple sclerosis, epilepsy, Chronic Kidney Diseases and atopic dermatitis. . For these reasons doctors should take special attension to vitamin D status in patients suffering for these diseases properly implementing recent vitamin D recommendation.
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Affiliation(s)
- Elżbieta Karczmarewicz
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
| | - Edyta Czekuć-Kryśkiewicz
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
| | - Paweł Płudowski
- Department of Biochemistry and Experimental Medicine; The Children's Memorial Health Institute; Warsaw, Poland
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