1
|
Ozgurel SU, Reyes Fernandez PC, Chanpaisaeng K, Fleet JC. Male Lrp5A214V mice maintain high bone mass during dietary calcium restriction by altering the vitamin D endocrine system. J Bone Miner Res 2024; 39:315-325. [PMID: 38477773 PMCID: PMC11240165 DOI: 10.1093/jbmr/zjae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 03/14/2024]
Abstract
Environmental factors and genetic variation individually impact bone. However, it is not clear how these factors interact to influence peak bone mass accrual. Here we tested whether genetically programmed high bone formation driven by missense mutations in the Lrp5 gene (Lrp5A214V) altered the sensitivity of mice to an environment of inadequate dietary calcium (Ca) intake. Weanling male Lrp5A214V mice and wildtype littermates (control) were fed AIN-93G diets with 0.125%, 0.25%, 0.5% (reference, basal), or 1% Ca from weaning until 12 weeks of age (ie, during bone growth). Urinary Ca, serum Ca, Ca regulatory hormones (PTH, 1,25 dihydroxyvitamin D3 (1,25(OH)2D3)), bone parameters (μCT, ash), and renal/intestinal gene expression were analyzed. As expected, low dietary Ca intake negatively impacted bones and Lrp5A214V mice had higher bone mass and ash content. Although bones of Lrp5A214V mice have more matrix to mineralize, their bones were not more susceptible to low dietary Ca intake. In control mice, low dietary Ca intake exerted expected effects on serum Ca (decreased), PTH (increased), and 1,25(OH)2D3 (increased) as well as their downstream actions (ie, reducing urinary Ca, increasing markers of intestinal Ca absorption). In contrast, Lrp5A214V mice had elevated serum Ca with a normal PTH response but a blunted 1,25(OH)2D3 response to low dietary Ca that was reflected in the renal 1,25(OH)2D3 producing/degrading enzymes, Cyp27b1 and Cyp24a1. Despite elevated serum Ca in Lrp5A214V mice, urinary Ca was not elevated. Despite an abnormal serum 1,25(OH)2D3 response to low dietary Ca, intestinal markers of Ca absorption (Trpv6, S100g mRNA) were elevated in Lrp5A214V mice and responded to low Ca intake. Collectively, our data indicate that the Lrp5A214V mutation induces changes in Ca homeostasis that permit mice to retain more Ca and support their high bone mass phenotype.
Collapse
Affiliation(s)
- Serra Ucer Ozgurel
- Department of Nutritional Sciences, University of Texas, Austin, TX 78723, United States
| | - Perla C Reyes Fernandez
- Department of Physical Therapy, Indiana University -Purdue University, Indianapolis, IN 46202, United States
| | - Krittikan Chanpaisaeng
- National Center for Genetic Engineering and Biotechnology, Pathum Thani 12120, Thailand
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - James C Fleet
- Department of Nutritional Sciences, University of Texas, Austin, TX 78723, United States
| |
Collapse
|
2
|
Jeong C, Kim J, Lee J, Lim Y, Lim DJ, Baek KH, Ha J. Effect of Denosumab on Bone Density in Postmenopausal Osteoporosis: A Comparison with and without Calcium Supplementation in Patients on Standard Diets in Korea. J Clin Med 2023; 12:6904. [PMID: 37959369 PMCID: PMC10649665 DOI: 10.3390/jcm12216904] [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: 10/12/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
The side effects and safety issues tied to calcium supplementation raise questions about its necessity in osteoporosis treatment. We retrospectively evaluated 189 postmenopausal osteoporosis patients treated with denosumab for 12 months. Patients exhibited neither renal dysfunction nor compromised general dietary intake. Patients were divided into three groups as follows: group A, weekly vitamin D 7000 IU; group B, daily vitamin D 1000 IU with elemental calcium 100 mg; and group C, daily vitamin D 1000 IU with elemental calcium 500 mg. All groups showed significant increases in bone density: +6.4 ± 4.7% for the lumbar spine, +2.2 ± 3.5% for the femoral neck, and +2.4 ± 3.8% for the total hip in group A; +7.0 ± 10.9% for the lumbar spine, +2.3 ± 5.2% for the femoral neck, and +2.4 ± 3.8% for the total hip in group B; and + 6.7 ± 8.7% for the lumbar spine, +2.5 ± 8.4% for the femoral neck, and +2.3 ± 4.0% for the total hip in group C. Serum calcium levels increased over time in all three groups with no significant difference. Changes in CTX and P1NP levels did not differ between the groups (all p > 0.05). With regular dietary intake, calcium supplementation levels showed no significant effect on bone density, bone marker changes, or hypocalcemia incidence during denosumab treatment.
Collapse
Affiliation(s)
- Chaiho Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Jinyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.K.); (K.-H.B.)
| | - Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Yejee Lim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.K.); (K.-H.B.)
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| |
Collapse
|
3
|
Klöppel E, Souza MR, Barco VS, Gallego FQ, Sinzato YK, Corrente JE, Rodrigues T, Volpato GT, Damasceno DC. Calcium Supplementation on Glucose Tolerance, Oxidative Stress, and Reproductive Outcomes of Diabetic Rats and Their Offspring. Reprod Sci 2023; 30:2813-2828. [PMID: 37002533 DOI: 10.1007/s43032-023-01217-9] [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: 10/14/2022] [Accepted: 03/09/2023] [Indexed: 04/03/2023]
Abstract
Diabetes mellitus increases the risk of obstetric complications, morbidity, and infant mortality. Controlled nutritional therapy with micronutrients has been employed. However, the effect of calcium (Ca2+) supplementation on diabetic pregnancy is unclear. We aimed to evaluate whether diabetic rats supplemented with Ca2+ during pregnancy present better glucose tolerance, redox status, embryonic and fetal development, newborn weight, and the prooxidant and antioxidant balance of male and female pups. For this, newborn rats received the beta-cytotoxic drug streptozotocin for inducing diabetes on the day of birth. In adulthood, these rats were mated and treated with Ca2+ twice a day from day 0 to day 20 of pregnancy. On day 17, the pregnant rats were submitted to the oral glucose tolerance test (OGTT). At the end of pregnancy, they were anesthetized and killed to collect blood and pancreas samples. The uterine horns were exposed for an evaluation of maternal reproductive outcomes and embryofetal development, and the offspring's liver samples were collected for redox status measurement. Nondiabetic and diabetic rats supplemented with Ca2+ showed no influence on glucose tolerance, redox status, insulin synthesis, serum calcium levels, and embryofetal losses. The reduced rate of newborns classified as adequate for gestational age (AGA) and higher rates of LGA (large) and small (LGA) newborns and higher -SH and GSH-Px antioxidant activities in female pups were observed in diabetic dams, regardless of supplementation. Thus, maternal supplementation caused no improvement in glucose tolerance, oxidative stress biomarkers, embryofetal growth and development, and antioxidants in pups from diabetic mothers.
Collapse
Affiliation(s)
- Eduardo Klöppel
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
| | - Maysa Rocha Souza
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
- Laboratory of System Physiology and Reproductive Toxicology, Federal University of Mato Grosso_UFMT, Mato Grosso State, Barra Do Garças, Brazil
| | - Vinícius Soares Barco
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
| | - Franciane Quintanilha Gallego
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
| | - Yuri Karen Sinzato
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
| | - José Eduardo Corrente
- Research Support Office, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Tiago Rodrigues
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André, São Paulo, SP, Brazil
| | - Gustavo Tadeu Volpato
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil
- Laboratory of System Physiology and Reproductive Toxicology, Federal University of Mato Grosso_UFMT, Mato Grosso State, Barra Do Garças, Brazil
| | - Débora Cristina Damasceno
- Laboratory of Experimental Research On Gynecology and Obstetrics, Postgraduate Course On Tocogynecology, Botucatu Medical School, São Paulo State University_UNESP, Botucatu, São Paulo State, Brazil.
| |
Collapse
|
4
|
Jacobson Bensky M, Adler L, Banon T, Gabay L, Mintzker Y. Risk of major osteoporotic fractures among ultra-orthodox Jews. Osteoporos Int 2023; 34:111-118. [PMID: 36369595 PMCID: PMC9812995 DOI: 10.1007/s00198-022-06522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/01/2022] [Indexed: 11/13/2022]
Abstract
The Ultra-Orthodox Jewish population has behaviors that can influence the risk for osteoporotic fractures. We investigated whether this population is more prone to osteoporotic fractures than non-Orthodox Jewish. We did not find a significant difference in osteoporotic fracture rates between the two populations despite major differences in exposure to potential risk factors. INTRODUCTION The Ultra-Orthodox Jewish population is a conservative population with unique cultural behaviors such as modest clothing and specific dietary restrictions, which can influence bone density and risk for osteoporotic fractures. The aim of this study is to investigate whether the Ultra-Orthodox Jewish population is more prone to osteoporotic fractures than the non-Orthodox Jewish population. METHODS This retrospective cohort study utilized computerized records from Maccabi Health Service. Study population included patients 65 years and older without a history of osteoporotic fracture, who reside in regions of Ultra-Orthodox and non-Orthodox Jews. The primary outcome was the adjusted risk to osteoporotic fracture during 9 years of follow-up. Cox regression included patient characteristics and risk factors for osteoporosis. RESULTS A total of 115,134 patients were included in this study: 5397 patients residing in Ultra-Orthodox regions (51.0% female) and 109,737 patients residing in non-Orthodox regions (52.6% female). A total of 16,352 (14.2%) patients had an osteoporotic fracture during the study period. There was no significant difference in fracture rate between Ultra-Orthodox and non-Orthodox (14.3% vs. 14.2%, p = 0.827). Among Ultra-Orthodox and non-Orthodox females and males, there were no significant differences in fracture rates (19.1% vs. 19.1% p = 0.982 and 9.3% vs. 8.8% p = 0.311, respectively). The adjusted hazard risk for the Ultra-Orthodox Jews was 1.026, 95% CI: 0.95-1.11, p = 0.512. CONCLUSION We did not find a significant difference in the rate of osteoporotic fractures between Ultra-Orthodox and non-Orthodox populations despite major differences in exposure to potential risk factors. Results suggest that the perception of risk factors relevant for the religious communities should be re-evaluated.
Collapse
Affiliation(s)
| | - Limor Adler
- Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tal Aviv University, Tel Aviv, Israel
| | - Tamar Banon
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Linoy Gabay
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Yishai Mintzker
- Maccabi Healthcare Services, Tel Aviv, Israel
- Bar-Ilan University Faculty of Medicine, Ramat Gan, Israel
| |
Collapse
|
5
|
Suzuki K, Tsujiguchi H, Hara A, Miyagi S, Nguyen TTT, Kambayashi Y, Shimizu Y, Suzuki F, Takazawa C, Nakamura M, Tsuboi H, Kannon T, Tajima A, Nakamura H. Bone Strength of the Calcaneus Is Associated with Dietary Calcium Intake in Older Japanese Men, but Not Women. Nutrients 2022; 14:nu14245225. [PMID: 36558384 PMCID: PMC9781445 DOI: 10.3390/nu14245225] [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: 10/30/2022] [Revised: 11/25/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
The relationship between calcium intake and bone strength in older Asian individuals, including Japanese, is controversial; therefore, we herein investigated this relationship in older Japanese populations. We performed a cross-sectional analysis of 314 participants older than 65 years who voluntarily participated in a medical examination and responded to questionnaires. The osteo-sono assessment index (OSI) measured at the right calcaneus using a quantitative ultrasonic device was used as an indicator of bone strength. The daily dietary intake of calcium was assessed using a brief-type self-administered diet history questionnaire. A two-way analysis of covariance revealed a significant interaction between sex and calcium intake on the OSI (p < 0.01). A multiple regression analysis showed a positive correlation between calcium intake and the OSI in males (p < 0.01), but not females (p = 0.27). In females, grip strength divided by body weight positively correlated with the OSI (p = 0.04). The present results suggest that a higher calcium intake contributes to bone strength in older Japanese males. Although a higher grip strength may contribute to bone strength in females, the potential of estrogen as a confounding factor needs to be considered.
Collapse
Affiliation(s)
- Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Correspondence: ; Tel.: +81-76-265-2218
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Kanazawa 920-8640, Ishikawa, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Kanazawa 920-8640, Ishikawa, Japan
| | - Sakae Miyagi
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Kanazawa 920-8640, Ishikawa, Japan
- Innovative Clinical Research Center, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
| | - Thao Thi Thu Nguyen
- Department of Epidemiology, Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Hai Phong 04000-05000, Vietnam
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, Imabari 794-0085, Ehime, Japan
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, Komatsu 923-8511, Ishikawa, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Fukushima, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Shiga, Japan
| | - Takayuki Kannon
- Department of Biomedical Data Science, School of Medicine, Fujita Health University, Toyoake 470-1101, Aichi, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Ishikawa, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Kanazawa 920-8640, Ishikawa, Japan
| |
Collapse
|
6
|
Kim KJ, Kim MS, Hong N, Bae JH, Kim KJ, Kim NH, Rhee Y, Lee J, Kim SG. Cardiovascular risks associated with calcium supplementation in patients with osteoporosis: a nationwide cohort study. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2022; 8:568-577. [PMID: 34244740 DOI: 10.1093/ehjcvp/pvab054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 11/14/2022]
Abstract
AIMS This study aimed to evaluate the real effects of calcium supplementation on cardiovascular outcomes within a population-based cohort. METHODS AND RESULTS From a nationwide health screening database in South Korea, a total of 11 297 patients with osteoporosis who had taken calcium supplementation with or without vitamin D for at least 90 days [total calcium group; calcium supplementation only (CaO), n = 567; calcium supplementation in combination with vitamin D (CaD), n = 10 730] were matched at a 1:1 ratio to patients who had not taken calcium supplements (control group) by using propensity scores. The overall mean age was 59.9 ± 8.8 years and the percentage of women was 87.9% in our study population. Over a median follow-up of 54 months, the incidence rate of composite cardiovascular diseases (CVDs) per 1000 person-years was not different between the groups: 9.73 in the total calcium group and 8.97 in the control group [adjusted hazard ratio (HR): 1.12; 95% confidence interval (CI): 0.99-1.28; P = 0.08]. However, calcium supplementation without vitamin D was associated with an increased risk of composite CVD (HR: 1.54; 95% CI: 1.17-2.04; P < 0.01), especially non-fatal myocardial infarction (HR: 1.89; 95% CI: 1.23-2.91; P < 0.01), compared with no calcium supplementation. CONCLUSION Our population-based study supported that taking calcium supplementation combined with vitamin D did not appear to be harmful to cardiovascular health, but reminded that calcium supplementation without vitamin D should be used carefully even in populations with low dietary calcium intake.
Collapse
Affiliation(s)
- Kyoung Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Min Sun Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| |
Collapse
|
7
|
Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data. Nutrients 2022; 14:nu14122538. [PMID: 35745268 PMCID: PMC9230596 DOI: 10.3390/nu14122538] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 01/27/2023] Open
Abstract
Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.
Collapse
|
8
|
Bu SY, Choi MJ, Choi DS, Jung YM, Jang IS, Yang N, Kim K, Park CY. Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium. Nutr Res Pract 2022; 16:S89-S112. [PMID: 35651839 PMCID: PMC9127516 DOI: 10.4162/nrp.2022.16.s1.s89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.
Collapse
Affiliation(s)
- So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea
| | - Mi Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Da Seul Choi
- Graduate School of Education, Chonnam National University, Gwangju 61186, Korea
| | - You-Mi Jung
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - In-Sil Jang
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Narae Yang
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
| |
Collapse
|
9
|
Prevalence of lactose intolerance and malabsorption among children of two ethnic groups from the urban areas of Malaysia and its relation to calcium intake and bone health status. Arch Osteoporos 2021; 17:10. [PMID: 34967925 DOI: 10.1007/s11657-021-01053-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/21/2021] [Indexed: 02/03/2023]
Abstract
Lactase insufficiency could develop into lactose intolerance (LI) and disrupt the intake of calcium, which is a core nutrient for bone development in children. However, data regarding the prevalence of LI and bone health status (BHS) among Malaysian children are scarcely reported. PURPOSE This study aimed to determine the prevalence of LI and lactose malabsorption (LM) in Malay and Chinese children and examine its relationship with calcium intake (CI) and BHS. METHODS A total of 400 children participated in this study. The prevalence of lactose tolerance (LT) was assessed using hydrogen breath test, LT test, and visual analogue scales. Assessment of CI was performed using a 24-h dietary recall interview (24-h DR) and food frequency questionnaire (FFQ). Calcaneal broadband ultrasound attenuation (BUA) was measured using a quantitative ultrasonometer. RESULTS The prevalence of LI among Chinese children (37%) was significantly higher (p = 0.002) than among Malay children (22.5%). However, 61.5% of Malay and 54.5% of Chinese children were found to have LM. CI of the children fulfilled 30.5% and 33.9% of the Malaysian recommended CI (1300 mg/day) for 24-h DR and FFQ, respectively. The BUA score of Malay children was significantly higher (p < 0.001) than that of Chinese children. However, LT and CI were not correlated with BHS (p > 0.05, respectively). CONCLUSIONS LI was diagnosed among Malay and Chinese children. However, the higher prevalence of LM is rather worrying as it could develop to LI. The prevalence possibly has been worsened by insufficient CI. Thus, effective approaches to increase CI are highly needed as bone development occurs rapidly at this age and is important for the attainment of the optimum peak bone mass during late adolescence.
Collapse
|
10
|
The Effect of Smoking on Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing in Female. Int J Dent 2021; 2021:2221112. [PMID: 34961818 PMCID: PMC8710148 DOI: 10.1155/2021/2221112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Smoking is a bad habit that affects both systemic and oral conditions. Nicotine in cigarettes reduces estrogen production that can alter salivary calcium levels. Nicotine also causes vasoconstriction of the gingival blood vessels and decreases gingival bleeding. Low dietary calcium intake is also suspected to influence the low serum calcium levels in smokers. In this study, we evaluated the effect of smoking on salivary calcium levels, calcium intake, and BOP in women. Method This was an analytical study using a cross-sectional approach. The subjects were 26 female smokers and 37 nonsmokers. Unstimulated saliva was collected by the spitting method. Salivary calcium levels were measured using an Atomic Absorption Spectrophotometer (AAS). The calcium intake was obtained by the Semiquantitative Food Frequency Questionnaire. BOP was measured by a gingival bleeding index by Ainamo and Bay in 1975. Results All the basic characteristics including age, BMI, level of education, and occupation were statistically different between groups. The mean calcium level of female smokers was significantly lower than that of nonsmokers, whereas the mean BOP of female smokers was significantly higher. The total calcium intake per day of the two groups was not statistically different. The mean salivary calcium level and BOP decreased when the duration of smoking was longer. There was a positive correlation between salivary calcium level and BOP in the smokers' group. Conclusion A low level of education may be contributing to the smoking habit of subjects in this study. Salivary calcium levels were correlated with BOP in female smokers, which might be affected by the duration of smoking.
Collapse
|
11
|
Oboh I, Coleman C, Cremona A. The influence of lactation and its duration on bone mineral density in pregnancy and postpartum: A systematic review with meta-analysis. Clin Nutr ESPEN 2021; 46:121-132. [PMID: 34857185 DOI: 10.1016/j.clnesp.2021.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is a plethora of research on the association of parity and duration of lactation with bone mineral density (BMD) during and after pregnancy. However, there are no consensus conclusions on the impact of the duration of lactation on BMD. AIMS The aim of this study was to examine the effect of pregnancy, and the duration of lactation on BMD during pregnancy, postpartum phase and 12 months post-delivery. METHODS The search terms 'parity' 'lactation' 'BMD' were searched for using PubMed, CINAHL, SCOPUS and EMBASE databases in English language. Two independent reviewers assessed the quality of the included studies using Critical Appraisal Skills Program (CASP) appraisal tool and extracted data on BMD (g/cm2) in Excel. A meta-analysis was conducted with a random effect model using Cochrane Review Manager (Rev 5.4) to analyse the outcome. Heterogeneity was assessed with Chi Squared and I2 test. The duration of lactation was grouped into short lactation duration (SLD), ≤4 months and longer lactation duration (LLD) > 6 months. RESULTS Twenty-one studies were included in this review with four studies included in the meta-analysis. BMD reduced during pregnancy and lactation. Recovery and net gains in BMD followed weaning. However, at 12 months postpartum, women in the LLD group had significant losses at the lumbar spine while those in the SLD recovered BMD. Between the SLD and LLD groups, the change in BMD was not significant 0.48 g/cm2 (95% CI -0.14, 1.10, p = 0.13). BMD losses were greater in primiparous women than multiparous women. CONCLUSION Women who breastfed for >6 months had significantly reduced BMD. However, compared to women that breastfed for a ≤4 months there was no significant change in BMD. Further investigation is needed to clarify the association between lactation and BMD in a postpartum population in those women extending breastfeeding beyond one year.
Collapse
Affiliation(s)
- Isabella Oboh
- University Hospital Limerick (UHL), Limerick, Ireland
| | - Cynthia Coleman
- College of Medicine, Nursing and Health Science, School of Medicine, Regenerative Medicine Institute (REMEDI), National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Alexandra Cremona
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Irish Nutrition and Dietetics Institute, Dublin, Ireland.
| |
Collapse
|
12
|
An HJ, Seo YG. Differences in Fat-Free Mass According to Serum Vitamin D Level and Calcium Intake: Korea National Health and Nutrition Examination Survey 2008-2011. J Clin Med 2021; 10:jcm10225428. [PMID: 34830710 PMCID: PMC8623334 DOI: 10.3390/jcm10225428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022] Open
Abstract
We analyzed the differences in fat-free mass (FFM) according to serum vitamin D level (VitD) and daily calcium intake (Ca) in 14,444 adults aged over 19 years. We used data from the 4th and 5th Korea National Health and Nutrition Examination Surveys (2008–2011). FFM was measured using dual-energy X-ray absorptiometry. VitD was classified as insufficient or sufficient (cutoff: 20 ng/mL). Ca was classified as unsatisfactory or satisfactory (recommended daily intake: 700 mg). In men, the FFM of group 2 (VitD ≥ 20 ng/mL; Ca < 700 mg), group 3 (VitD < 20 ng/mL; Ca ≥ 700 mg) and group 4 (VitD ≥ 20 ng/mL; Ca ≥ 700 mg) was 0.50 kg (95% confidence interval (CI), 0.084–0.92), 0.78 kg (95% CI, 0.26–1.29) and 1.58 kg (95% CI, 0.95–2.21) higher than that of group 1 (VitD < 20 ng/mL; Ca < 700 mg), respectively. In women, a 1 ng/mL increase in VitD was associated with a 0.023 kg increase in FFM (95% CI, 0.003–0.043) and a 1 g increase in Ca was associated with a 0.62 kg increase in FFM (95% CI, 0.067–1.16). High VitD and Ca were associated with a high FFM.
Collapse
|
13
|
Harahap IA, Suliburska J. Probiotics and Isoflavones as a Promising Therapeutic for Calcium Status and Bone Health: A Narrative Review. Foods 2021; 10:2685. [PMID: 34828966 PMCID: PMC8621960 DOI: 10.3390/foods10112685] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 12/21/2022] Open
Abstract
Probiotics have potential clinical effects for treating and preventing osteoporosis. Meanwhile, isoflavones have attracted much attention due to their ability to prevent postmenopausal symptoms. Research has established that probiotics and isoflavones can regulate hormones, immune cells, and the gastrointestinal system, acting as links in the gut-bone axis. However, combining the effects of probiotics and isoflavones on calcium status and bone health is a more novel and a still-evolving research area. Lactobacillus and Bifidobacterium are the foremost strains that influence bone health to a significant extent. Among the isoflavones, daidzein, genistein, and the metabolites of genistein (such as equol) stimulate bone formation. It can be concluded that probiotics and isoflavones promote bone health by regulating calcium uptake, gut microbiota, and various metabolic pathways that are associated with osteoblast activity and bone formation. Nevertheless, further experiments of probiotics and isoflavones are still necessary to confirm the association between calcium bioavailability and bone health.
Collapse
|
14
|
Pilutin A, Misiakiewicz-Has K, Kolasa-Wołosiuk A, Trybek G, Urban F, Marchlewicz M, Leszczyński B, Wróbel A, Wiszniewska B. Morphology and serum and bone tissue calcium and magnesium concentrations in the bones of male rats chronically treated with letrozole, a nonsteroidal cytochrome P450 aromatase inhibitor. Connect Tissue Res 2021; 62:454-463. [PMID: 32419518 DOI: 10.1080/03008207.2020.1771329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose/Aim of the study: The role of estrogen (E) in the regulation of bone turnover in women is well established, though the contributions of E versus testosterone (T) in the control of bone turnover in men are poorly understood. The aim of this study was to examine the association between chronic treatment with letrozole, a nonsteroidal inhibitor blocking the aromatase activity and thus the conversion of androgens into estrogens, and cortical bone morphology in the femur and humerus of male adult rats.Materials and Methods: Adult male rats were treated with letrozole for 6 months and the body and femur weight, morphology, collagen structure, blood serum, and bone tissue concentrations of calcium and magnesium were examined.Results: Long-term aromatase inhibition resulted in a decrease in femur mass, a wavelike arrangement of bone and lamellae with an altered organization of collagen in compact bone, a increased concentration of calcium in blood serum, and no change in calcium bone tissue concentration, magnesium serum, or bone tissue concentration. MicroCT study of the humerus revealed significant decreases of whole bone tissue volume, cortical bone thickness, cortical bone volume, and external cortical bone thickness with letrozole treatment.Conclusion: Chronic treatment with letrozole affected cortical bone structure and produced histomorphological changes in male rat bone similar to that observed in the aging processes.
Collapse
Affiliation(s)
- Anna Pilutin
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Grzegorz Trybek
- Department of Dental Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Fabian Urban
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| | - Mariola Marchlewicz
- Department of Aesthetic Dermatology, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Leszczyński
- M. Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Andrzej Wróbel
- M. Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Barbara Wiszniewska
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
15
|
Kim BT. Efficacy and safety of calcium and vitamin D supplementation to prevent osteoporotic fracture. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.4.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Dietary supplementation of calcium and vitamin D has been deemed one of the most important tools to fight against osteoporotic fractures increasing with aging of the population globally. Reports from early clinical trials demonstrated that supplementation of calcium and vitamin D for patients with osteoporosis can reduce the incidence of fragility fractures by decreasing bone loss and falls. However, following trials failed to demonstrate the efficacy of calcium and vitamin D for the prevention of osteoporotic fractures, questioning the need of calcium and vitamin D supplementation. Even metanalyses and system reviews presented opposite conclusions , depending on clinical trials included. Recent studies reported that excessive calcium supplement can increase cardiovascular risk such as non-fatal myocardial infarction and that excessive vitamin D supplement can produce more frequent falls than it is supposed to be. However, in spite of some arguments regarding the efficacy and safety of calcium and vitamin D supplementation, it seems to be essential to provide 800 to 1,000 mg elementary calcium and 800 to 1,000 IU vitamin D for the elderly whose intake of calcium and vitamin D is insufficient to prevent osteoporotic fracture.
Collapse
|
16
|
Kopiczko A. Determinants of bone health in adults Polish women: The influence of physical activity, nutrition, sun exposure and biological factors. PLoS One 2020; 15:e0238127. [PMID: 32960898 PMCID: PMC7508391 DOI: 10.1371/journal.pone.0238127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/10/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose The aim of this study was to assess the determinants of bone health in the group of women over 40 years old. Lifestyle factors such as past and present physical activity, past and present sun exposure, current dietary intake of calcium and vitamin D, nutritional status as measured by BMI, family history of osteoporosis and current hormonal status were analysed. Methods The study involved 500 women over 40 years old. All examined women was the same ethnicity- European origin. Methods used: densitometry method (DXA), bioelectrical impedance analysis, International Physical Activity Questionnaire, nutrition questionnaire, past and present sun exposure questionnaire. Past and present physical activity, past and present sun exposure and sufficient level of calcium in the diet proved to be the most important factors determining mineralization of bone tissue of women. In order to indicate an independent association of the correct bone tissue mineralization with individual factors, multivariate analysis was used—logistic regression. Results The norm BMD in the distal part of the forearm was strongly influenced: recommended dietary calcium intake (OR = 5.95; p = 0.003), moderately (OR = 1.88; p = 0.053) and high (OR = 14.0; p<0.001) past physical activity, sufficient (OR = 4.97; p<0.001) and high (OR = 18.9; p = 0.004) level of present physical activity, sufficient past (OR = 5.15; p<0.001) and sufficient present sun exposure (OR = 10.0; p<0.001). The chance for the BMD prox norm was also increased several times: high past physical activity (OR = 68.4; p<0.0001) and sufficient past sun exposure (OR = 10.6; p<0.001), moderate past activity (OR = 4.20; p<0.001), sufficient (OR = 6.13; p<0.001) and high (OR = 10.0; p<0.001) present physical activity, sufficient present sun exposure (OR = 9.09; p<0.0001), recommended intake of calcium (OR = 9.57; p<0.001) and vitamin D (OR = 2.68; p = 0.052). Whereas e significantly lower likelihood for the BMD prox norm was found in women with the oldest hormonal status (postmenopausal period) (OR = 0.18; p<0.001), with osteoporosis in the family (OR = 0.37; p<0.001) and living in an agglomeration (OR = 0.68; p = 0.03). Conclusion Interventions to increase physical activity, especially outdoors, may help reduce risk of osteoporosis, fractures and subsequent healthcare costs.
Collapse
Affiliation(s)
- Anna Kopiczko
- Department of Biomedical Sciences, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
- * E-mail:
| |
Collapse
|
17
|
Yao X, Hu J, Kong X, Zhu Z. Association between Dietary Calcium Intake and Bone Mineral Density in Older Adults. Ecol Food Nutr 2020; 60:89-100. [PMID: 32779476 DOI: 10.1080/03670244.2020.1801432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Calcium is a requisite nutrient in maintaining bone health. High calcium intake has been recommended for osteoporosis prevention. However, the relationship of dietary calcium intake with bone mineral density (BMD) in the elderly remained controversial. We aimd to evaluate the association between them in older adults. Using data from the Nutrition and Health Examination Survey (NHANES, 2001-2006), we conducted multivariate logistic regression analyses to explore the association of dietary calcium intake with lumbar BMD in older adults. Subgroup analyses were also performed. We included 2904 older adults aged ≥ 60 (43.63% men) for analysis. Higher dietary calcium intake was associated with greater lumbar BMD after adjusting for other covariates. In the subgroup analysis stratified by sex, this positive association existed in women, but not in men. In conclusion, for older adults aged ≥ 60, higher dietary calcium intake is associated with a higher lumbar BMD in women, but not in men.
Collapse
Affiliation(s)
- Xiaocong Yao
- Department of Osteoporosis Care and Control, The First People's Hospital of Xiaoshan District , Hangzhou, Zhejiang, China
| | - Jintao Hu
- Department of Orthopedics, The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University , Hangzhou, Zhejiang, China
| | - Xiuhua Kong
- Department of Nutrition, The First People's Hospital of Xiaoshan District , Hangzhou, Zhejiang, China
| | - Zhongxin Zhu
- Department of Osteoporosis Care and Control, The First People's Hospital of Xiaoshan District , Hangzhou, Zhejiang, China.,Department of Orthopedics, Institute of Orthopaedics and Traumatology of Zhejiang Chinese Medical University , Hangzhou, Zhejiang, China
| |
Collapse
|
18
|
Wu YY, Chang CL, Wang JH, Wei WT. Magnesium oxide and hip fracture in the elderly: a population-based retrospective cohort analysis. Osteoporos Int 2020; 31:1231-1238. [PMID: 31960100 DOI: 10.1007/s00198-020-05278-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/01/2020] [Indexed: 10/25/2022]
Abstract
UNLABELLED Using national insurance claims of Taiwan, we found that magnesium oxide (MgO) use is associated with an increased risk of hip fracture in the elderly. Further studies are warranted to explore the mechanisms associated with MgO use that lead to hip fracture. PURPOSE The purpose of this study was to investigate the association between MgO use and hip fracture risk in the elderly (age > 65 years). METHODS This nationwide population-based retrospective study was conducted from 1996 to 2013. Individuals with (n = 26,069) and without (n = 26,069) MgO use were enrolled after propensity score matching. Primary outcome was a hip fracture. After adjusting for age, sex, comorbidities, and medications, multivariate Cox proportional hazards regression models were used to calculate incidences and risk of hip fracture [hazard ratio (HR)]. RESULTS During the mean follow-up duration of 4.8 years in the MgO cohort and 5.7 years in the non-MgO cohort, respectively 1547 and 1107 cases developed a hip fracture. MgO use was identified as a risk factor for hip fracture in both univariate [crude HR, 1.68; 95% confidence interval (CI), 1.55-1.81; p < 0.001] and multivariate [adjusted HR (aHR), 1.66; 95% CI, 1.54-1.80; p < 0.001] Cox proportional hazards regression models. The cumulative incidence of hip fracture was significantly higher in the MgO cohort than in the non-MgO cohort (1.23 per 100 person-years vs. 0.74 per 100 person-years, logrank test, p < 0.001). CONCLUSION MgO use is an independent risk factor for hip fracture in the elderly.
Collapse
Affiliation(s)
- Y Y Wu
- Department of Psychiatry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - C L Chang
- Management office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - J H Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - W T Wei
- Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| |
Collapse
|
19
|
Heidari B, Hajian-Tilaki K, Babaei M. Effectiveness and safety of routine calcium supplementation in postmenopausal women. A narrative review. Diabetes Metab Syndr 2020; 14:435-442. [PMID: 32371186 DOI: 10.1016/j.dsx.2020.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/12/2020] [Accepted: 04/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND To determine whether routine administration of calcium supplementation is useful in postmenopausal women, while it is associated with an increased risk of cardiovascular complications. METHODS A literature search was performed using Medline/PubMed, Scopus and Google Scholar by using relevant keywords. RESULTS Calcium supplement exerts a small protective effect against bone loss which disappears after cessation. Antifracture effect of supplemental calcium is limited to older frail women or community-dwelling residents who are vitamin D deficient and have inadequate dietary calcium intake. The results of studies on the association between calcium supplementation and cardiovascular complications are contradictory and do not lead to a decisive conclusion CONCLUSION: Current data do not support routine calcium supplementation to all postmenopausal women for prevention of bone loss or bone fracture.
Collapse
Affiliation(s)
- Behzad Heidari
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran; Clinical Research Developmemt Unit, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
| | | | - Mansour Babaei
- Clinical Research Developmemt Unit, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran; Department of Medicine Division of Rheumatology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
20
|
Wang L, Yin L, Cheng X, Li K, Wang Y, Zhang Y, Duanmu YY, Liu X, Deng G, Wang Y, Veronese N, Li W, Tian W. The association of calcium intake with osteoporotic vertebral fractures in a large Chinese cohort. Aging (Albany NY) 2020; 12:5500-5515. [PMID: 32221046 PMCID: PMC7138559 DOI: 10.18632/aging.102974] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/19/2020] [Indexed: 12/17/2022]
Abstract
The effect of calcium on prevention of osteoporosis and related fracture which are aging issues is unclear. The aim of this study is to explore the association of calcium intake with vertebral fracture. This study enrolled 3,457 participants from China Action on Spine and Hip Status (CASH) study from 2013 and 2017. Dietary calcium intake was collected using validated food frequency questionnaires (FFQ). Vertebral fracture of CT images was defined as the primary outcome. The mean calcium intake of men and women were 522.75mg/day and 507.21mg/day, respectively. 6% reduction in the odds of fracture risk was observed per 100 unit increase of calcium intake from food among females (OR, 0.94; 95% CI, 0.89-0.99), but results among males were not significant. We divided calcium intake into quintiles when modelling its associations with fracture risk, negative associations of fracture risk with calcium intake were found among females. In a population with low usual calcium intake, higher dietary calcium intake was associated with fewer vertebral fracture in women and that no such association was seen in men.
Collapse
Affiliation(s)
- Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Lu Yin
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Kai Li
- Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yuebo Wang
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Yong Zhang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yang-Yang Duanmu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xiaoyun Liu
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Guijuan Deng
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Yang Wang
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Nicola Veronese
- Aging Branch (N.V.), National Research Council, Neuroscience Institute, Padova, Italy
| | - Wei Li
- Medical Research and Biometrics Center, National Center for Cardiovascular Disease, Beijing 102300, China
| | - Wei Tian
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | | |
Collapse
|
21
|
Yu WW, Linton D, Porteous J, Eatson H, Jain R, Sale JEM. Is a 'healthy diet' and a 'calcium-rich diet' the same thing? Qualitative study examining perceptions of a calcium-rich diet in individuals who have received bone health education. J Hum Nutr Diet 2020; 33:496-504. [PMID: 32128920 DOI: 10.1111/jhn.12730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In the present study, we aimed to (i) examine perceptions of achieving calcium and vitamin D recommended dietary allowance (RDA) and (ii) determine how participants talked about food in relation to RDA recommendations. METHODS Participants aged ≥50 years who were prescribed osteoporosis medication and received two modes of bone health education were eligible. Relying on a qualitative description design, we interviewed participants 1 month after they had attended an education session and received a self-management booklet. Calcium and vitamin D intakes were estimated by in-depth questions about diet and supplements and compared with perceptions of achieved RDA levels. Interview transcripts were analysed based on an analytic hierarchical process. RESULTS Forty-five participants (29 reporting previous fragility fractures) were included. Calcium and vitamin D RDA appeared to be potentially achieved by 64% and 93% of participants, respectively, primarily because of reliance on supplements. Few participants talked about vitamin D in relation to food intake and 49% of participants were unclear about the calcium content of food. Most considered that a healthy diet was equivalent to a calcium-rich diet. We noted no differences in our findings in the subset of individuals with fragility fractures. CONCLUSIONS Despite reporting a prescription for osteoporosis medication and receiving bone health education, a substantial number of individuals appeared to have sub-optimal calcium levels. This may be attributed to the challenge of achieving RDA with diet alone and the misconception of a healthy diet as a calcium-rich diet.
Collapse
Affiliation(s)
- W W Yu
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - D Linton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - J Porteous
- Osteoporosis Canada, Toronto, Ontario, Canada
| | - H Eatson
- Osteoporosis Canada, Toronto, Ontario, Canada
| | - R Jain
- Osteoporosis Canada, Toronto, Ontario, Canada
| | - J E M Sale
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
22
|
Arafa A, Eshak ES, Iso H. Oxalates, urinary stones and risk of cardiovascular diseases. Med Hypotheses 2020; 137:109570. [PMID: 31972450 DOI: 10.1016/j.mehy.2020.109570] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/31/2019] [Accepted: 01/12/2020] [Indexed: 12/20/2022]
Abstract
Increased level of oxalates in urine and plasma can be attributed to endogenous overproduction, increased ingestion or excessive intestinal absorption. When a supersaturation status is reached, oxalates combine with calcium and crystallize to form 80% of the urinary stones. Several cardiovascular diseases such as coronary heart disease and stroke are thought to be associated with the formation of urinary stones via sharing the same pathogenesis and/or risk factors. This review investigated the evidence linking oxalates/urinary stones to cardiovascular diseases. Eventually, two theories can explain the possible association between urinary stones and cardiovascular diseases: the theory of common origin and the theory of common risk factors. While the first theory is based on the common vascular pathophysiology of urinary stones and cardiac events, the later suggests that metabolic syndrome traits increase the risk of urinary stones and cardiovascular diseases independently. A few cohort studies showed a higher risk of coronary heart disease and stroke among people with history of urinary stones than people without it while other cohort studies did not. These studies had different definitions for cardiovascular diseases, used various methods to assess urinary stones, and some of them did not control for potential confounders. When they were pooled together in meta-analyses, a significant heterogeneity across studies was observed. In conclusion, although there is some evidence indicating that urinary stones could increase the risk of cardiovascular diseases, a substantial causal relationship cannot be settled.
Collapse
Affiliation(s)
- Ahmed Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ehab S Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| |
Collapse
|
23
|
Kopiczko A. Bone mineral density in old age: the influence of age at menarche, menopause status and habitual past and present physical activity. Arch Med Sci 2020; 16:657-665. [PMID: 32399115 PMCID: PMC7212225 DOI: 10.5114/aoms.2019.81314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/09/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In this study, the hypothesis that bone mineral density (BMD) of peri-, pre- and postmenopausal women is associated with the current level of habitual physical activity, as well as past physical activity, at the age of building peak bone mass, was tested. MATERIAL AND METHODS The study involved 500 Polish women aged 40 to 70. For the assessment of BMD and bone mineral content (BMC) the densitometry method (dual-energy X-ray absorptiometry, DXA) of the forearm bone was used. The International Physical Activity Questionnaire (IPAQ) was used to assess the present level of physical activity. The assessment of past physical activity was related to adolescence. RESULTS There was a significant, strong influence on the norm BMD in the distal forearm sections values in the distal forearm sections of such variables as: older age of the first menstruation (OR = 1.37; p = 0.002), sufficient present physical activity (OR = 1.57; p = 0.001), and particularly high past physical activity (OR = 6.77; p = 0.003). Significantly lower chances for the norm BMD dis were found in women with the oldest hormonal status (OR = 0.09; p < 0.001). In the proximal segment, the analogous conditions of the norm BMD, and in addition the chances for good mineralization, were increased by higher body mass index (OR = 1.11; p < 0.001). Sufficient present activity increased the chances of good forearm mineralization in the proximal part more than four times (OR = 4.2; p < 0.001), and a high level of past physical activity increased these chances several dozen times (OR = 69.9; p < 0.001). CONCLUSIONS Physical activity proved to be one of the most important factors determining the statistically significant correct mineralization of bone tissue of women.
Collapse
Affiliation(s)
- Anna Kopiczko
- Department of Anthropology and Health Promotion, Faculty of Biomedical Sciences, Józef Piłsudski University of Physical Education, Warsaw, Poland
| |
Collapse
|
24
|
Liu Z, Sun X, Liang T, Luo Y, Chen X, Li T, Chen L, Wang J, Lin Y, Ye Y, Zhong Z. Preparation and Characterization of the Biological Compound Effervescent Granule of Calcium Acetate. Curr Pharm Biotechnol 2019; 20:934-944. [PMID: 31264545 DOI: 10.2174/1389201020666190628144637] [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] [Received: 03/17/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Calcium acetate (Ca(CH3COO)2) is commonly used in calcium supplement for medicine, which is used as an auxiliary agent to treat osteoporosis. An effervescent granule is widely used in medical industry due to its palatability. The purpose of this study is to develop a new preparation of compound effervescent granule of the biological calcium acetate (Ca(CH3COO)2 effervescent granule), overcoming the disadvantages of the previous other dosage forms of calcium and thus enhancing the therapeutic efficacy. METHODS The biological Ca(CH3COO)2 effervescent granule was prepared by the wet granulation method. The formulation was optimized by the orthogonal experiment. The effervescent base was comprised of various amounts of citric acid and sodium bicarbonate. Other ingredients were added for optimal performance of effervescent granule. The performed Ca(CH3COO)2 effervescent granule was evaluated for the particle size, repose angle, pH value of solution, calcium acetate content and effervescence time. The in vivo effects of Ca(CH3COO)2 effervescent granule on the bone microarchitecture were investigated via Micro-CT detection, and the serum calcium level was also investigated. RESULTS The optimized formulation of the biological Ca(CH3COO)2 effervescent granules was composed of calcium acetate, citric acid, sodium bicarbonate, PEG6000, aspartame, PVP ethanol solution, lactose and vitamin D. Our findings reveal that this biological Ca(CH3COO)2 effervescent granule exhibited prominent effect on preventing the bone-mass loss and did better in enhancing the bone microarchitecture compared to the other calcium preparations. CONCLUSION The biological Ca(CH3COO)2 effervescent granule is a novel dosage form among so many kinds of calcium preparations. It may perform better functions in the dairy calcium supplement.
Collapse
Affiliation(s)
- Zhongbing Liu
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Xuemei Sun
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Tiantian Liang
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yi Luo
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Xiaoyan Chen
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Ting Li
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Lin Chen
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Junjie Wang
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yan Lin
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yun Ye
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Zhirong Zhong
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| |
Collapse
|
25
|
Association between 25-Hydroxyvitamin D, Parathyroid Hormone, Vitamin D and Calcium Intake, and Bone Density in Healthy Adult Women: A Cross-Sectional Analysis from the D-SOL Study. Nutrients 2019; 11:nu11061267. [PMID: 31167443 PMCID: PMC6628165 DOI: 10.3390/nu11061267] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 11/17/2022] Open
Abstract
There is still limited data on the association between 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and bone health in healthy younger adults, particularly in Latin America. This cross-sectional analysis aimed to investigate the associations of 25(OH)D and plasma PTH concentrations with bone parameters, and potential confounders, in women living in a high (England) or low (Brazil) latitude country. Bone was assessed by either peripheral quantitative computed tomography (pQCT) (England) or dual-energy x-ray absorptiometry (DXA) scan (Brazil), serum 25(OH)D concentrations by high performance liquid chromatography tandem mass spectrometry (HPLC-MS) and PTH by the chemiluminescent method. In participants living in England, total volumetric bone mineral density (vBMD) was significantly higher in women <29 years compared to ≥30 years, and total and cortical vBMD values at the 66% site were negatively correlated with weight and body mass index (BMI). In participants living in Brazil, age was positively correlated with bone mineral density (BMD) at the femur and bone mineral content (BMC), and weight, BMI, and body fat were correlated with BMD (lumbar spine and femur) and BMC. PTH concentrations were negatively correlated with 25(OH)D concentrations, and the prevalence of secondary hyperparathyroidism was 28.6% (n = 14) in participants with concentrations <25 nmol/L and 12.2% (n = 41) with concentrations between 25 and 49.9 nmol/L, compared to 6.3% (n = 79) in those with concentrations ≥50 nmol/L. In conclusion, weight and BMI were significantly correlated with bone parameters in both groups and age was significantly correlated with BMD at the femoral neck for women living in Brazil only. Although 25(OH)D concentrations were not correlated to bone parameters at any sites, in either country, PTH concentrations showed a significant correlation with total vBMD at the 66% site for women living in England. Secondary hyperparathyroidism was more common amongst those with deficient and insufficient vitamin D status.
Collapse
|
26
|
Oura P, Auvinen J, Paananen M, Junno JA, Niinimäki J, Karppinen J, Nurkkala M. Dairy- and supplement-based calcium intake in adulthood and vertebral dimensions in midlife-the Northern Finland Birth Cohort 1966 Study. Osteoporos Int 2019; 30:985-994. [PMID: 30656368 PMCID: PMC6502777 DOI: 10.1007/s00198-019-04843-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022]
Abstract
UNLABELLED Among a representative sample of 1064 Northern Finns, we studied the association of dairy- and supplement-based calcium intake in adulthood with vertebral size in midlife. Inadequate calcium intake (< 800 mg/day) from age 31 to 46 predicted small vertebral size and thus decreased spinal resilience among women but not men. INTRODUCTION Small vertebral size predisposes individuals to fractures, which are common among aging populations. Although previous studies have associated calcium (Ca) intake with enhanced bone geometry in the appendicular skeleton, few reports have addressed the axial skeleton or the vertebrae in particular. We aimed to investigate the association of dairy- and supplement-based Ca intake in adulthood with vertebral cross-sectional area (CSA) in midlife. METHODS A sample of 1064 individuals from the Northern Finland Birth Cohort 1966 had undergone lumbar magnetic resonance imaging at the age of 46, and provided self-reported data on diet and Ca intake (dairy consumption and use of Ca supplements) at the ages of 31 and 46. We assessed the association between Ca intake (both continuous and categorized according to local recommended daily intake) and vertebral CSA, using generalized estimating equation and linear regression models with adjustments for body mass index, diet, vitamin D intake, education, leisure-time physical activity, and smoking. RESULTS Women with inadequate Ca intake (< 800 mg/day) over the follow-up had 3.8% smaller midlife vertebral CSA than women with adequate Ca intake (p = 0.009). Ca intake among men showed no association with vertebral CSA. CONCLUSIONS Inadequate Ca intake (< 800 mg/day) from the age of 31 to 46 predicts small vertebral size and thus decreased spinal resilience among middle-aged women. Future studies should confirm these findings and investigate the factors underlying the association of low Ca intake in women but not in men with smaller vertebral size.
Collapse
Affiliation(s)
- P Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
| | - J Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - M Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J-A Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Finnish Institute of Occupational Health, Aapistie 1, FI-90220, Oulu, Finland
| | - M Nurkkala
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. Box 365, FI-90101, Oulu, Finland
| |
Collapse
|
27
|
Hong AR, Lee JH, Kim JH, Kim SW, Shin CS. Effect of Endogenous Parathyroid Hormone on Bone Geometry and Skeletal Microarchitecture. Calcif Tissue Int 2019; 104:382-389. [PMID: 30659307 DOI: 10.1007/s00223-019-00517-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/03/2019] [Indexed: 02/05/2023]
Abstract
Parathyroid hormone (PTH) has anabolic or catabolic effects on bones; however, the skeletal effect of endogenous PTH on cortical and trabecular bones is not yet clear. Therefore, we aimed to examine the effects of an excess and a deficiency of endogenous PTH on the lumbar spine trabecular bone score (TBS) and bone geometry using dual-energy X-ray absorptiometry. We retrospectively included 70 patients with primary hyperparathyroidism (PHPT), 26 patients with idiopathic or postoperative hypoparathyroidism (HypoPT), and 96 normal controls matched by age, sex, and body mass index. The bone mineral density (BMD) at the lumbar spine, femur neck, and total hip was higher in the HypoPT, followed by the controls and PHPT group (all P < 0.001). The TBS was significantly decreased in the PHPT group compared to the controls (P = 0.021); however, statistical significance disappeared after adjusting for the lumbar BMD (P = 0.653). There were no significant differences in the TBS between the HypoPT group and controls as well as the PHPT and HypoPT group. As for bone geometry parameters, the cross-sectional area, cross-sectional moment of inertia, and section modulus were higher in the HypoPT, followed by the controls and PHPT group (all P < 0.001); statistical significance remained after adjusting for the total hip BMD. We also observed a significantly increased cortical neck width in the HypoPT group compared to the PHPT group (P = 0.009). The buckling ratio was higher in the PHPT than the HypoPT group and controls (P = 0.018 and P = 0.013, respectively). The present study demonstrated that an excess of endogenous PTH had catabolic effects on both cortical and trabecular bones. Under conditions of endogenous PTH deficiency, the effect on cortical bone was pronounced, but that on trabecular bone was modest.
Collapse
Affiliation(s)
- A Ram Hong
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
28
|
|
29
|
Binu AJ, Cherian KE, Kapoor N, Jebasingh FK, Asha HS, Paul TV. Bone Health after Fifth Decade in Rural Ambulatory South Indian Postmenopausal Women. Indian J Community Med 2019; 44:205-208. [PMID: 31602103 PMCID: PMC6776936 DOI: 10.4103/ijcm.ijcm_161_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: The incidence of postmenopausal osteoporosis continues to rise, as population ages. The morbidity and mortality associated with osteoporotic fractures have a significant negative impact on the economy and quality of life of the affected individual and the community, at large. Objectives: We aimed to study the prevalence of osteoporosis in ambulant rural postmenopausal women, and to look at their dietary calcium intake (DCI) and Vitamin D status. Subjects and Methods: This was a cross-sectional study conducted in 1565 ambulant South Indian rural postmenopausal women. Bone mineral density was estimated by a dual-energy X-ray absorptiometry scan at the femoral neck (FN) and lumbar spine (LS). DCI was calculated by recall for the previous week, and the blood bone biochemical profile was measured. Results: The mean standard deviation (SD) age and body mass index of this population were 60.7 (7.2) years and 26.2 (4.8) kg/m2, respectively. The prevalence of osteoporosis was 22% at the FN and 39% at the LS. An increase in the prevalence of osteoporosis was noted at both sites, in successive age categories. Mean (SD) DCI was 420 (282) mg/24 h. Fifty-four percent had Vitamin D deficiency (VDD) (<20 ng/ml) and 6% had severe VDD (<10 ng/ml). Conclusion: A significant proportion of this large cohort of south Indian healthy rural postmenopausal women had osteoporosis at either site with advancing age. Most of them had a suboptimal DCI, and over half of them had VDD.
Collapse
Affiliation(s)
- Aditya John Binu
- Department of Internal Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Kripa Elizabeth Cherian
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Felix K Jebasingh
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Hesarghatta Shyamasunder Asha
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Thomas Vizhalil Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| |
Collapse
|
30
|
Méndez-Gallegos E, Caire-Juvera G, Astiazarán-García H, Méndez-Estrada RO. Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables. Nutrients 2018; 10:nu10111669. [PMID: 30400559 PMCID: PMC6265878 DOI: 10.3390/nu10111669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 12/03/2022] Open
Abstract
The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.
Collapse
Affiliation(s)
- Eloy Méndez-Gallegos
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Graciela Caire-Juvera
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Humberto Astiazarán-García
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Rosa O Méndez-Estrada
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| |
Collapse
|
31
|
Styburski D, Janda K, Baranowska-Bosiacka I, Łukomska A, Dec K, Goschorska M, Michalkiewicz B, Ziętek P, Gutowska I. Beer as a potential source of macroelements in a diet: the analysis of calcium, chlorine, potassium, and phosphorus content in a popular low-alcoholic drink. Eur Food Res Technol 2018. [DOI: 10.1007/s00217-018-3098-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
32
|
Chiodini I, Bolland MJ. Calcium supplementation in osteoporosis: useful or harmful? Eur J Endocrinol 2018; 178:D13-D25. [PMID: 29440373 DOI: 10.1530/eje-18-0113] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 01/01/2023]
Abstract
Osteoporosis and fragility fractures are important social and economic problems worldwide and are due to both the loss of bone mineral density and sarcopenia. Indeed, fragility fractures are associated with increased disability, morbidity and mortality. It is known that a normal calcium balance together with a normal vitamin D status is important for maintaining well-balanced bone metabolism, and for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, recently, the usefulness of calcium supplementation (alone or with concomitant vitamin D) has been questioned, since some studies reported only weak efficacy of these supplementations in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This debate article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.
Collapse
Affiliation(s)
- Iacopo Chiodini
- Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
- Unit of Endocrinology, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Mark J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand
| |
Collapse
|
33
|
Oh JM, Woo HW, Kim MK, Lee YH, Shin DH, Shin MH, Choi BY. Dietary total, animal, vegetable calcium and type 2 diabetes incidence among Korean adults: The Korean Multi-Rural Communities Cohort (MRCohort). Nutr Metab Cardiovasc Dis 2017; 27:1152-1164. [PMID: 29167059 DOI: 10.1016/j.numecd.2017.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/26/2017] [Accepted: 10/05/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Although a possible mechanism for developing type 2 diabetes in relation to calcium intake has been suggested, there is currently little epidemiological evidence on the association between dietary calcium and type 2 diabetes (T2D). This study aimed to evaluate the prospective association between dietary calcium and T2D incidence among adults 40 years of age or over, from the Multi-rural Communities Cohort (MRCohort), South Korea. METHODS AND RESULTS In total, 8313 participants (3033 men and 5280 women) who did not have diabetes at baseline were recruited between 2005 and 2013. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator. During follow-up (31,570 person-years), 322 T2D cases were newly diagnosed. Dietary calcium (total and vegetable calcium) were inversely associated with the risk of T2D incidence among women (IRR = 0.61, 95% CI = 0.43-0.86, P for trend = 0.007 in third tertile of baseline total calcium intake comparing to the first tertile; IRR = 0.57, 95% CI = 0.39-0.84, P for trend = 0.006 for baseline vegetable calcium intake), not for men. The tendency of those inverse associations remained in both the normal fasting blood glucose group and the impaired fasting blood glucose group and were independent of obesity, smoking, and magnesium intake. CONCLUSIONS Total and vegetable calcium may be inversely associated with T2D incidence among women, regardless of impaired fasting blood glucose group or normal group. The associations may be potentially dose-responsive. Moderate dietary calcium may be related to lower risk of T2D incidence comparing to low intake group among women.
Collapse
Affiliation(s)
- J M Oh
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - H W Woo
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - M K Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea.
| | - Y-H Lee
- Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, South Korea
| | - D H Shin
- Department of Occupational and Environmental Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - M-H Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - B Y Choi
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea
| |
Collapse
|
34
|
Li SKY, Wan MMP, Siu FPL, Chung S, Pang MYC. Relationship Between Nutritional Factors and Hip Bone Density in Individuals with Chronic Stroke. Calcif Tissue Int 2017; 101:259-270. [PMID: 28417148 DOI: 10.1007/s00223-017-0276-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/30/2017] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the relationship between dietary habits and hip bone health in community-dwelling individuals with chronic stroke. The usual dietary intake of 94 individuals with chronic stroke (30 women, mean age: 59.0 years) was assessed by a 3-day food record within a single week. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) at both hips. The results showed that low hip bone mass was found in 59 and 50 of the participants on the affected and unaffected side, respectively. The mean hip BMD was also significantly lower on the affected side than the unaffected side (P < 0.001). The intake of total fat, carbohydrates, calcium, magnesium, iron, zinc, fiber, folic acid, vitamin B1, B2, B3, B6, C, and K was significantly lower than the respective recommended daily intake values (P < 0.05). Multiple regression analyses revealed that after adjusting for the effects of age, sex, body mass index, post-stroke duration, side of paresis, motor impairment, physical activity level, walking endurance, total calories intake, and total number of medications, intake of protein, fiber, and magnesium remained significantly associated with hip T score on the affected side, accounting for 4.2, 4.4, and 3.2% of the variance, respectively. On the other hand, intake of protein and fiber was independently associated with hip T score on the unaffected side, explaining 2.7 and 5.2% of the variance, respectively. The results highlighted the potential relevance of diet modification in maintaining bone health post stroke, which would require further study.
Collapse
Affiliation(s)
- Samuel K Y Li
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Mabel M P Wan
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Frankie P L Siu
- Sport Nutrition Monitoring Centre, Hong Kong Sports Institute, Sha Tin, Hong Kong
| | - Susan Chung
- Sport Nutrition Monitoring Centre, Hong Kong Sports Institute, Sha Tin, Hong Kong
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| |
Collapse
|
35
|
Kong SH, Kim JH, Hong AR, Cho NH, Shin CS. Dietary calcium intake and risk of cardiovascular disease, stroke, and fracture in a population with low calcium intake. Am J Clin Nutr 2017; 106:27-34. [PMID: 28615253 DOI: 10.3945/ajcn.116.148171] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 04/06/2017] [Indexed: 11/14/2022] Open
Abstract
Background: The role of dietary calcium intake in cardiovascular disease (CVD), stroke, and fracture is controversial. Most previous reports have evaluated populations with high calcium intake.Objective: We aimed to evaluate whether high dietary calcium intake was associated with the risk of CVD, stroke, and fracture in a population with low calcium intake.Design: In a prospective cohort study beginning in 2001 in Ansung-Ansan, Korea, 2158 men and 2153 women aged >50 y were evaluated for all-cause mortality, CVD, stroke, and fractures over a median 9-y follow-up.Results: During follow-up, 242 and 100 deaths, 149 and 150 CVD events, 58 and 82 stroke events, and 211 and 292 incident fractures occurred in men and women, respectively. The first quartiles of energy-adjusted dietary calcium intake were 249 mg/d (IQR: 169 mg/d) in men and 209 mg/d (IQR: 161 mg/d) in women. Both men and women with higher dietary calcium intake tended to have higher fat, protein, sodium, phosphorus, fruit, and vegetable intakes. In men, outcomes were not significantly associated with dietary calcium intake with or without adjustments, and CVD risk tended to increase with increasing energy-adjusted dietary calcium intake, but this was not statistically significant (P = 0.078 and P = 0.093 with and without adjustment, respectively). In women, CVD risk and dietary calcium intake showed a U-shaped association; the HRs (95% CIs) without adjustment relative to the first quartile were 0.71 (0.47, 1.07), 0.57 (0.36, 0.88), and 0.52 (0.33, 0.83) for quartiles 2, 3, and 4, respectively, and the values after adjustment were 0.70 (0.45, 1.07), 0.51 (0.31, 0.81), and 0.49 (0.29, 0.83) for quartiles 2, 3, and 4, respectively.Conclusion: In Korean women, increased dietary calcium intake was associated with a decreased CVD risk, but it did not influence the risk of stroke or fracture.
Collapse
Affiliation(s)
- Sung Hye Kong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - A Ram Hong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| |
Collapse
|
36
|
Aguilar CM, Sant'Ana CT, Costa AGV, Silva PI, Costa NMB. Comparative effects of brown and golden flaxseeds on body composition, inflammation and bone remodelling biomarkers in perimenopausal overweight women. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.03.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
37
|
Kim SJ, Lee YK, Oh J, Cho AJ, Noh JW. Effects of low calcium dialysate on the progression of coronary artery calcification in hemodialysis patients: An open-label 12-month randomized clinical trial. Int J Cardiol 2017; 243:431-436. [PMID: 28502735 DOI: 10.1016/j.ijcard.2017.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/27/2017] [Accepted: 05/03/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The association between the dialysate calcium level and coronary artery calcification (CAC) has not yet been evaluated in hemodialysis patients. The objective of this study was to determine whether lowering the dialysate calcium levels would decrease the progression of coronary artery calcification (CAC) compared to using standard calcium dialysate. METHODS We conducted an open-label randomized trial with parallel groups. The patients were randomly assigned to either 12-month treatment with low calcium dialysate (LCD; 1.25mmol/L, n=36) or standard calcium dialysate (SCD; 1.5mmol/L, n=40). The primary outcome was the change in the CAC scores assessed by 64-slice multidetector computed tomography after 12months. RESULTS During the treatment period, CAC scores increased in both groups, especially significant in LCD group (402.5±776.8, 580.5±1011.9, P=0.004). When we defined progressors as patients at second and third tertiles of CAC changes, progressor group had a higher proportion of LCD-treated patients than SCD-treated patients (P=0.0229). In multivariate analysis, LCD treatment is a significant risk factor for increase in CAC scores (odds ratio=5.720, 95% CI: 1.219-26.843, P=0.027). CONCLUSIONS Use of LCD may accelerate the progression of CAC in patients with chronic hemodialysis over a 12-month period. TRIAL REGISTRATION Clinical Research Information Service [Internet]; Osong (Chungcheongbuk-do): Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare (Republic of Korea), 2010: KCT0000942. Available from: https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=3572&sLeft=2&type=my.
Collapse
Affiliation(s)
- Soo Jin Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University Kidney Research Institute, Seoul, Republic of Korea
| | - Young-Ki Lee
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University Kidney Research Institute, Seoul, Republic of Korea.
| | - Jieun Oh
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University Kidney Research Institute, Seoul, Republic of Korea
| | - AJin Cho
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University Kidney Research Institute, Seoul, Republic of Korea
| | - Jung Woo Noh
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University Kidney Research Institute, Seoul, Republic of Korea
| |
Collapse
|
38
|
Kong SH, Kim JH, Hong AR, Lee JH, Kim SW, Shin CS. Dietary potassium intake is beneficial to bone health in a low calcium intake population: the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2011). Osteoporos Int 2017; 28:1577-1585. [PMID: 28093633 DOI: 10.1007/s00198-017-3908-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
Abstract
UNLABELLED Dietary potassium may neutralize acid load and reduce calcium loss from the bone, leading to beneficial effect on bone mineral density. In this nationwide Korean population study, dietary potassium intake was associated with improved bone mineral density in older men and postmenopausal women. INTRODUCTION Nutrition is a major modifiable factor that affects bone health. The accompanying anion in dietary potassium may act as an alkaline source by neutralizing the acid load and reducing calcium loss from the bone. We aimed to evaluate the association between dietary potassium intake and bone mineral density (BMD) in the Korean population. METHODS We analyzed a total of 3135 men aged >50 years and 4052 postmenopausal women from the Korean National Health and Nutrition Examination Survey (KNHANES). Lumbar spine, total hip, and femur neck BMD were measured using dual energy X-ray absorptiometry. The daily food intake was assessed using a food frequency questionnaire. RESULTS When we divided the participants into tertiles based on the intake of potassium intake, the highest potassium intake tertile group showed a significantly higher total hip and femur neck BMD as compared to lower tertile groups (0.914 ± 0.004, 0.928 ± 0.003, 0.925 ± 0.004 mg/day across the tertiles, P = .014 for total hip; 0.736 ± 0.003, 0.748 ± 0.003, 0.750 ± 0.004 mg/day, P = .012 for femur neck). Postmenopausal women in the highest potassium intake tertile group showed significantly higher lumbar, total hip, and femur neck BMD as compared to those in lower potassium intake tertile groups (0.793 ± 0.004, 0.793 ± 0.003, 0.805 ± 0.004 mg/day across the tertiles, P = .029 for lumbar spine; 0.766 ± 0.003, 0.770 ± 0.002, 0.780 ± 0.003 mg/day, P = .002 for total hip; 0.615 ± 0.003, 0.619 ± 0.002, 0.628 ± 0.003 mg/day, P = .002 for femur neck). CONCLUSIONS Dietary potassium intake was positively associated with BMD in men aged >50 years and postmenopausal women, indicating the beneficial effects of dietary potassium intake on bone health.
Collapse
Affiliation(s)
- S H Kong
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - J H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
| | - A R Hong
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - J H Lee
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - S W Kim
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - C S Shin
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| |
Collapse
|
39
|
Song YS, Oh TJ, Kim KM, Moon JH, Choi SH, Jang HC, Park KS, Lim S. Application of the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline to the Korean National Health and Nutrition Examination Surveys from 1998 to 2012. Diabetes Metab J 2017; 41:38-50. [PMID: 28029013 PMCID: PMC5328695 DOI: 10.4093/dmj.2017.41.1.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/22/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline for the treatment of blood cholesterol recommends statin therapy for individuals at high risk of atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to investigate serial trends in the percentages of Korean adults considered eligible for statin therapy according to the new ACC/AHA cholesterol guideline. METHODS Data from the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998, n=7,698), II (2001, n=5,654), III (2005, n=5,269), IV (2007 to 2009, n=15,727), and V (2010 to 2012, n=16,304), which used a stratified, multistage, probability sampling design, were used as representative of the entire Korean population. RESULTS The percentage of adults eligible for statin therapy according to the ACC/AHA cholesterol guideline increased with time: 17.0%, 19.0%, 20.8%, 20.2%, and 22.0% in KNHANES I, II, III, IV, and V, respectively (P=0.022). The prevalence of ASCVD was 1.4% in KNHANES I and increased to 3.3% in KNHANES V. The percentage of diabetic patients aged 40 to 75 years with a low density lipoprotein cholesterol levels of 70 to 189 mg/dL increased from 4.8% in KNHANES I to 6.1% in KNHANES V. People with an estimated 10-year ASCVD risk ≥7.5% and aged 40 to 75 years accounted for the largest percentage among the four statin benefit groups: 9.1% in KNHANES I and 11.0% in KNHANES V. CONCLUSION Application of the 2013 ACC/AHA guideline has found that the percentage of Korean adults in the statin benefit groups has increased over the past 15 years.
Collapse
Affiliation(s)
- Young Shin Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
40
|
Affiliation(s)
- Jae Hyuk Lee
- Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| |
Collapse
|
41
|
Lima GAC, Lima PDA, de Barros MDGCRM, Vardiero LP, de Melo EF, Paranhos FDP, Madeira M, de Farias MLF. Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:252-63. [PMID: 27355855 PMCID: PMC10522307 DOI: 10.1590/2359-3997000000173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/10/2016] [Indexed: 11/22/2022]
Abstract
The proper dietary calcium intake and calcium supplementation, when indicated, are important factors in the acquisition of peak bone mass during youth and in the prevention of fractures in old age. In addition to its deposition in bone, calcium confers an increase in its resistance and exhibits important activities in different enzymatic pathways in the body (e.g., neural, hormonal, muscle-related and blood clotting pathways). Thus, calcium supplementation can directly or indirectly affect important functions in the body, such as the control of blood pressure, plasma glucose, body weight, lipid profile and endothelial function. Since one publication reported increased cardiovascular risk due to calcium supplementation, many researchers have studied whether this risk actually exists; the results are conflicting, and the involved mechanisms are uncertain. However, studies that have evaluated the influence of the consumption of foods rich in calcium have reported no increase in the cardiovascular risk, which suggests that nutritional intake should be prioritized as a method for supplementation and that the use of calcium supplements should be reserved for patients who truly need supplementation and are unable to achieve the recommended daily nutritional intake of calcium.
Collapse
Affiliation(s)
- Guilherme Alcantara Cunha Lima
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Faculdade de Medicina de CamposCampos dos GoytacazesRJBrasil Serviço de Clínica Médica da Faculdade de Medicina de Campos (FMC), Campos dos Goytacazes, RJ, Brasil
| | - Priscilla Damião Araújo Lima
- Faculdade de Medicina de CamposCampos dos GoytacazesRJBrasil Serviço de Clínica Médica da Faculdade de Medicina de Campos (FMC), Campos dos Goytacazes, RJ, Brasil
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Maria da Glória Costa Reis Monteiro de Barros
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Centro Universitário Serra dos ÓrgãosTeresópolisRJBrasil Serviço de Clínica Médica do Centro Universitário Serra dos Órgãos (Unifeso), Teresópolis, RJ, Brasil
| | - Lívia Paiva Vardiero
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Elisa Fernandes de Melo
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Francisco de Paula Paranhos
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Miguel Madeira
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Universidade do Grande RioRio de JaneiroRJBrasil Serviço de Clínica Médica da Universidade do Grande Rio (Unigranrio), Rio de Janeiro, RJ, Brasil
| | - Maria Lucia Fleiuss de Farias
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| |
Collapse
|
42
|
Yoon DS, Lee YK, Ha YC, Kim HY. Inadequate Dietary Calcium and Vitamin D Intake in Patients with Osteoporotic Fracture. J Bone Metab 2016; 23:55-61. [PMID: 27294077 PMCID: PMC4900961 DOI: 10.11005/jbm.2016.23.2.55] [Citation(s) in RCA: 10] [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: 03/21/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background Inadequate calcium and vitamin D intake is a possible risk factor of osteoporosis. Our purposes were to estimate calcium and vitamin D intake in women with osteoporotic fractures, to determine associated factors for low calcium and vitamin D intake, and to evaluate the effects of calcium and vitamin D intake on bone mineral density (BMD). Methods This is a multicenter, hospital-based, and cross-sectional study involving 277 women with osteoporotic fractures. Dietary calcium and vitamin D intake were evaluated using the Korean Calcium Assessment Tool (KCAT) self-reported questionnaire. BMD was measured by dual energy X-ray absorptiometry (DXA) in the lumbar spine and femoral neck. Results Average daily calcium and vitamin D intake was 503.7±274.7 mg and 7.5±12.6 µg, respectively. Patients with low calcium intake had less family history of osteoporosis and were older. There was a negative correlation between age and calcium intake (r=-0.14; P=0.019). In multivariate analysis, calcium intake showed a positive correlation with BMD of femoral neck (β=0.0005, P=0.021). Conclusions About 80% of patients with osteoporotic fracture had calcium and vitamin D intake below the recommended dietary intake. Low calcium intake was associated with no family history of osteoporosis and older age. Dietary calcium intake showed positive effect on BMD.
Collapse
Affiliation(s)
- Dong Sik Yoon
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ha-Young Kim
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| |
Collapse
|
43
|
Affiliation(s)
- Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
44
|
Kim TH, Joung JY, Kang M, Choi SK, Kim K, Jang JY, Cho YY, Min YK, Chung JH, Kim SW. A Modest Protective Effect of Thyrotropin against Bone Loss Is Associated with Plasma Triiodothyronine Levels. PLoS One 2015; 10:e0145292. [PMID: 26679692 PMCID: PMC4682993 DOI: 10.1371/journal.pone.0145292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/02/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The independent skeletal effect of thyrotropin (thyroid stimulating hormone, TSH) has been suggested in animal studies. However, clinical data on the association between bone loss and variations in TSH levels is inconsistent. This study aimed to investigate the relationship between TSH levels and bone mineral density (BMD). METHODS We conducted a cross-sectional study with 37,431 subjects (33,052 cases with euthyroidism and 4,379 cases with subclinical thyroid dysfunction) aged over 35 years. We performed thyroid function tests and measured BMD at the lumbar spine, femur neck, and total hip. RESULTS Levels of TSH and T3 were positively correlated in women (r = 0.076, P = 0.001) and uncorrelated in men. In both men and women, TSH levels correlated positively and T3 levels correlated negatively with BMD at all skeletal sites in age and body mass index adjusted analyses. BMD increased steadily with TSH levels from the subclinical hyperthyroid to subclinical hypothyroid range in subjects with T3 levels in the highest tertile (119.5-200.0 ng/dL), but was no longer significant in subjects with lower plasma T3 levels. CONCLUSIONS The variations in TSH levels within the euthyroid and subclinical range were positively correlated with BMD in healthy men and women. The negative effect of T3 on BMD appears to be compensated for by increased TSH in subjects with plasma T3 levels in the upper normal range.
Collapse
Affiliation(s)
- Tae Hyuk Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Young Joung
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mira Kang
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea
| | - Sun Kyu Choi
- Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ju Young Jang
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Young Cho
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|
45
|
Kim KM, Choi HS, Choi MJ, Chung HY. Calcium and Vitamin D Supplementations: 2015 Position Statement of the Korean Society for Bone and Mineral Research. J Bone Metab 2015; 22:143-9. [PMID: 26713305 PMCID: PMC4691588 DOI: 10.11005/jbm.2015.22.4.143] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 11/16/2022] Open
Abstract
Calcium and vitamin D are essential components for bone health, thus calcium and vitamin D supplementation is an important strategy in the management of osteoporosis. However, the benefit of calcium and vitamin D supplementation on bone health is still controversial. Moreover, potentially harmful effects of excessive calcium supplementation on cardiovascular health are recently suggested. Too high a level of vitamin D has been also reported to have several, possibly related, harmful events. Korea is well known for low dietary calcium intake and vitamin D deficiency in its population. This position statement developed the following recommendation for adequate levels of calcium and vitamin D intake in Korean, postmenopausal women and men older than 50 years: Adequate calcium intake and optimal vitamin D level are essential for preventing and treating osteoporosis in postmenopausal women and men older than 50 years. We recommend a daily calcium intake of 800 to 1,000 mg/day. Food remains the best source of calcium; however calcium supplements should be considered when dietary intake of calcium is inadequate. We recommend dietary vitamin D intake of more than 800 IU per day, a level which appears to reduce the risk of fractures. When vitamin D deficiency is suspected, serum 25-hydroxy-vitamin D (25-[OH]D) level should be tested. We suggest that a serum 25-(OH)D level greater than 20 ng/mL is generally appropriate for prevention of osteoporosis. However, a serum 25-(OH)D level greater than 30 ng/mL is probably helpful for management of osteoporosis and prevention of fractures.
Collapse
Affiliation(s)
- Kyoung Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongman, Korea
| | - Han Seok Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Mi-Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu, Korea
| | - Ho Yeon Chung
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| |
Collapse
|
46
|
Dietary and pharmacological compounds altering intestinal calcium absorption in humans and animals. Nutr Res Rev 2015; 28:83-99. [PMID: 26466525 DOI: 10.1017/s0954422415000050] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The intestine is the only gate for the entry of Ca to the body in humans and mammals. The entrance of Ca occurs via paracellular and intracellular pathways. All steps of the latter pathway are regulated by calcitriol and by other hormones. Dietary and pharmacological compounds also modulate the intestinal Ca absorption process. Among them, dietary Ca and P are known to alter the lipid and protein composition of the brush-border and basolateral membranes and, consequently, Ca transport. Ca intakes are below the requirements recommended by health professionals in most countries, triggering important health problems. Chronic low Ca intake has been related to illness conditions such as osteoporosis, hypertension, renal lithiasis and incidences of human cancer. Carbohydrates, mainly lactose, and prebiotics have been described as positive modulators of intestinal Ca absorption. Apparently, high meat proteins increase intestinal Ca absorption while the effect of dietary lipids remains unclear. Pharmacological compounds such as menadione, dl-butionine-S,R-sulfoximine and ursodeoxycholic acid also modify intestinal Ca absorption as a consequence of altering the redox state of the epithelial cells. The paracellular pathway of intestinal Ca absorption is poorly known and is under present study in some laboratories. Another field that needs to be explored more intensively is the influence of the gene × diet interaction on intestinal Ca absorption. Health professionals should be aware of this knowledge in order to develop nutritional or medical strategies to stimulate the efficiency of intestinal Ca absorption and to prevent diseases.
Collapse
|
47
|
Shin CS, Kim KM. Calcium, Is It Better to Have Less?-Global Health Perspectives. J Cell Biochem 2015; 116:1513-21. [DOI: 10.1002/jcb.25119] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 01/23/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Chan Soo Shin
- Department of Internal Medicine; Seoul National University College of Medicine and Seoul National University Hospital; Seoul 110-744 Korea
| | - Kyoung Min Kim
- Department of Internal Medicine; Seoul National University Bundang Hospital; Seongnam 137-761 Korea
| |
Collapse
|
48
|
Sato Y, Iki M, Fujita Y, Tamaki J, Kouda K, Yura A, Moon JS, Winzenrieth R, Iwaki H, Ishizuka R, Amano N, Tomioka K, Okamoto N, Kurumatani N. Greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in a population of elderly Japanese men with relatively low dietary calcium intake: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study. Osteoporos Int 2015; 26:1585-94. [PMID: 25627112 DOI: 10.1007/s00198-015-3032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 01/06/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED The effects of milk intake on bone health are not clear in elderly Asian men with low dietary calcium intake. This study showed that greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in community-dwelling elderly Japanese men. INTRODUCTION The consumption of milk or dairy products is widely recommended for maintaining bone health regardless of gender or age. However, little evidence exists on the beneficial effects of milk intake on bone health in elderly Japanese men characterized with relatively low dietary calcium intake. Here we examined whether or not greater milk intake was associated with lower bone turnover, higher bone density, and stronger bone microarchitecture in community-dwelling elderly Japanese men. METHODS Interviews were conducted to obtain information on medical history and lifestyle, including the amount of habitual milk intake, nutrient intake calculations based on a 1-week food diary, and measurements of areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy x-ray absorptiometry (DXA), trabecular bone score (TBS) using DXA images at LS, and biochemical markers of bone turnover in sera. Participants with a history of diseases or medications that affect bone metabolism, or with missing data, were excluded from the analysis. RESULTS The median intake of milk in the 1479 participants (mean age, 73.0 ± 5.1 years) was one glass of milk per day. Bone turnover markers showed a decreasing trend (p < 0.05) and aBMD at TH (p = 0.0019) and FN (p = 0.0057) and TBS (p = 0.0017) showed increasing trends with greater milk intake after adjusting for demographic and behavioral confounding factors. This association was attenuated after further adjusting for nutrient intake, in particular, calcium intake. CONCLUSIONS Greater milk intake was associated with lower bone turnover, higher aBMD, and higher TBS in community-dwelling elderly Japanese men.
Collapse
Affiliation(s)
- Y Sato
- Department of Health and Nutrition, Faculty of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui, 915-8586, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Park JS, Choi SB, Rhee Y, Chung JW, Choi EY, Kim DW. Parathyroid hormone, calcium, and sodium bridging between osteoporosis and hypertension in postmenopausal Korean women. Calcif Tissue Int 2015; 96:417-29. [PMID: 25707344 DOI: 10.1007/s00223-015-9972-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/12/2015] [Indexed: 01/14/2023]
Abstract
The coexistence of osteoporosis and hypertension, which are considered distinct diseases, has been widely reported. In addition, daily intake of calcium and sodium, as well as parathyroid hormone levels (PTH), is known to be associated with osteoporosis and hypertension. This study aimed to determine the association of low calcium intake, high sodium intake, and PTH levels with osteoporosis and hypertension in postmenopausal Korean women. Data for postmenopausal Korean women aged 50 years or older were obtained from the Korea National Health and Nutrition Examination Survey 2008-2011. Osteoporosis was diagnosed using dual energy X-ray absorptiometry, while hypertension was diagnosed using blood pressure data. The odds ratios for osteoporosis and hypertension were calculated using logistic regression analysis for quartiles of the daily calcium intake, daily sodium intake, and PTH levels. Women with hypertension had a high coexistence of osteoporosis (43.6 vs. 36.5 %; P = 0.022), and vice versa (21.1 vs. 16.6 %; P = 0.022). PTH was significantly associated with osteoporosis and hypertension, and a high intake of calcium was strongly correlated with a low incidence of osteoporosis. This is the first study to report the characteristics of postmenopausal Korean women who have high dietary sodium intake and low dietary calcium intake, in association with the incidence of osteoporosis and hypertension. Osteoporosis and hypertension were strongly associated with each other, and PTH appears to be a key mediator of both diseases, suggesting a possible pathogenic link.
Collapse
Affiliation(s)
- Jee Soo Park
- Department of Medical Engineering, Yonsei University College of Medicine, CPO Box 8044, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
The association between calcium supplementation and adverse cardiovascular events has recently become a topic of debate due to the publication of two epidemiological studies and one meta-analysis of randomized controlled clinical trials. The reports indicate that there is a significant increase in adverse cardiovascular events following supplementation with calcium; however, a number of experts have raised several issues with these reports such as inconsistencies in attempts to reproduce the findings in other populations and questions concerning the validity of the data due to low compliance, biases in case ascertainment, and/or a lack of adjustment. Additionally, the Auckland Calcium Study, the Women's Health Initiative, and many other studies included in the meta-analysis obtained data from calcium-replete subjects and it is not clear whether the same risk profile would be observed in populations with low calcium intakes. Dietary calcium intake varies widely throughout the world and it is especially low in East Asia, although the risk of cardiovascular events is less prominent in this region. Therefore, clarification is necessary regarding the occurrence of adverse cardiovascular events following calcium supplementation and whether this relationship can be generalized to populations with low calcium intakes. Additionally, the skeletal benefits from calcium supplementation are greater in subjects with low calcium intakes and, therefore, the risk-benefit ratio of calcium supplementation is likely to differ based on the dietary calcium intake and risks of osteoporosis and cardiovascular diseases of various populations. Further studies investigating the risk-benefit profiles of calcium supplementation in various populations are required to develop population-specific guidelines for individuals of different genders, ages, ethnicities, and risk profiles around the world.
Collapse
Affiliation(s)
- Chan Soo Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|