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Luo Y, Zheng S, Jiang S, Yang G, Pavel V, Ji H, Zhou S, Bao Y, Xiao W, Li Y. B vitamins and bone health: a meta-analysis with trial sequential analysis of randomized controlled trials. Osteoporos Int 2024:10.1007/s00198-024-07150-0. [PMID: 38953947 DOI: 10.1007/s00198-024-07150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
Our study showed that B vitamins did not have significant effect on fracture incidence, bone mineral density, and bone turnover markers. However, the research data of B vitamins on bone mineral density and bone turnover markers are limited, and more clinical trials are needed to draw sufficient conclusions. PURPOSE The objective of this study was to identify the efficacy of B vitamin (VB) (folate, B6, and B12) supplements on fracture incidence, bone mineral density (BMD), and bone turnover markers (BTMs). METHODS A comprehensive search was performed in PubMed, MEDLINE, EMBASE, Cochrane databases, and ClinicalTrials.gov up to September 4, 2023. The risk of bias was assessed according to Cochrane Handbook and the quality of evidence was assessed according to the GRADE system. We used trial sequential analysis (TSA) to assess risk of random errors and Stata 14 to conduct sensitivity and publication bias analyses. RESULTS Data from 14 RCTs with 34,700 patients were extracted and analyzed. The results showed that VBs did not significantly reduce the fracture incidence (RR, 1.06; 95% CI, 0.95 - 1.18; p = 0.33; I2 = 40%) and did not affect BMD in lumbar spine and femur neck. VBs had no significant effect on bone specific alkaline phase (a biomarker for bone formation), but could increase the serum carboxy-terminal peptide (a biomarker for bone resorption) (p = 0.009; I2 = 0%). The TSA showed the results of VBs on BMD and BTMs may not be enough to draw sufficient conclusions due to the small number of sample data included and needed to be demonstrated in more clinical trials. The inability of VBs to reduce fracture incidence has been verified by TSA as sufficient. Sensitivity analysis and publication bias assessment proved that our meta-analysis results were stable and reliable, with no significant publication bias. CONCLUSIONS Available evidence from RCTs does not support VBs can effectively influence osteoporotic fracture risk, BMD, and BTMs. TRIAL REGISTRATION PROSPERO registration number: CRD42023427508.
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Affiliation(s)
- Yan Luo
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Shengyuan Zheng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Shide Jiang
- The Central Hospital of Yongzhou, Yongzhou, 425000, China
| | - Guang Yang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Volotovski Pavel
- Republican Scientific and Practical Center of Traumatology and Orthopedics, 220024, Minsk, Belarus
| | - Haoran Ji
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shujie Zhou
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunong Bao
- Xiangya Medicine School, Central South University, Changsha, Hunan, China
| | - Wenfeng Xiao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yusheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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2
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Maus U. [Exercise therapy and basic treatment for osteoporosis]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:793-798. [PMID: 37658239 DOI: 10.1007/s00132-023-04432-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/03/2023]
Abstract
Physical training is an important component in the prophylaxis of osteoporosis and the prevention of fractures. Physical training not only has a direct effect on muscle strength and muscular performance, but also on the risk of falling and the fear of falling. Therefore, physical training is also an integral part of the basic treatment for osteoporosis. The recommendations for basic treatment are an adequate intake of nutrients, including protein in particular. The intake of calcium and vitamin D in sufficient quantities is also important and, in the case of specific drug therapy, also to avoid side effects and to ensure the therapeutic effect. This article summarizes the recommendations of the updated S3 guideline on the diagnosis and treatment of osteoporosis and explains the background for the recommendations included.
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Affiliation(s)
- Uwe Maus
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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Thomasius F, Pesta D, Rittweger J. Adjuvant pharmacological strategies for the musculoskeletal system during long-term space missions. Br J Clin Pharmacol 2023. [PMID: 37559171 DOI: 10.1111/bcp.15877] [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: 05/02/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
Despite 2 h of daily exercise training, muscle wasting and bone loss are still present after 6-month missions to the international space station. Some crew members lose bone much faster than others. In preparation for missions to the Moon and Mars, space agencies are therefore reviewing their countermeasure portfolios. Here, we discuss the potential of current pharmacological strategies. Bone loss in space is fuelled by bone resorption. Alendronate, an oral bisphosphonate, reduced bone losses in experimental bed rest and space. However, gastrointestinal side effects precluded its further utilization in space. Zoledronate (a potent bisphosphonate), denosumab (RANKL antagonist) and romosozumab (sclerostin antagonist) are all administered via injection. They effectively suppress bone resorption and are routinely prescribed against osteoporosis. Their serious adverse effects, namely, osteonecrosis of the jaw and atypical femur fractures occur very rarely when the usage is limited to 1 or 2 years. Hence, utilization of one of these compounds may outweigh the bone risks of space travelling, in particular in those with high bone resorption rates. Muscle wasting in space is likely due to hampered muscle protein synthesis. Even though this might theoretically be countered by the synthesis-boosting effects of anabolic steroids, the practical grounds for such recommendation are currently weak. Moreover, they reveal their full potential only when combined with an anabolic exercise stimulus, for example, via strength training. It therefore seems that a combination of exercise and pharmacological countermeasures should be considered for musculoskeletal health on the way to the Moon and Mars and back.
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Affiliation(s)
| | - Dominik Pesta
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Centre for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University Hospital Cologne, Cologne, Germany
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4
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Welan R. Effect of Vitamin B6 on Osteoporosis Fracture. J Bone Metab 2023; 30:141-147. [PMID: 37449347 PMCID: PMC10346000 DOI: 10.11005/jbm.2023.30.2.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/24/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023] Open
Abstract
Osteoporosis is a medical condition that causes bones to become weak and brittle, making them more likely to break or fracture. This condition occurs when the body loses too much bone, makes too little bone, or both. Bones are living tissues that are constantly being broken down and rebuilt. However, as we age, this process slows down, and our bodies may be unable to replace bone as quickly as it is broken down. This can lead to a loss of bone density, making bones weaker and more prone to fracture. Unfortunately, osteoporosis often has no symptoms until a bone is broken, so taking steps to prevent this condition is essential. This may include getting enough calcium and vitamin D, engaging in weight-bearing exercise, quitting smoking, limiting alcohol intake, and taking medication if prescribed by a doctor. Vitamin B6, also known as pyridoxine, is a water-soluble vitamin that plays a vital role in various bodily functions. It is part of the B-vitamin complex and is essential for metabolizing proteins, carbohydrates, and fats. Vitamin B6 produces neurotransmitters such as serotonin, which helps regulate mood, and dopamine, which is involved in motivation and reward. Several previous studies have found that women with higher intakes of vitamin B6 have higher bone mineral density (BMD) of the hips and spine than women with lower intakes. Another study found that men and women with higher blood levels of vitamin B6 had higher BMD in the hips and spine.
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Affiliation(s)
- Rahmani Welan
- Department of Nutritional Science, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
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5
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Ilesanmi-Oyelere BL, Kruger MC. B-vitamins and homocysteine as determinants of bone health: a literature review of human studies. J Hum Nutr Diet 2022; 36:1031-1044. [PMID: 36056551 DOI: 10.1111/jhn.13080] [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: 05/01/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
Although there are several factors related to bone diseases such as physical activity, gender (oestrogen), race/ethnicity, smoking and alcohol habits, nutrition is a modifiable risk factor that could be employed to prevent or manage the onset of bone health diseases such as osteoporosis in humans. Aside from calcium and vitamin D, B-vitamins are a group of water-soluble vitamins that play a vital role in cell metabolism. In this review, current evidence on B-vitamins and bone health was assessed. Clinical trials (interventions) indicated that treatment with B-vitamins impact the concentrations of total plasma/serum homocysteine concentrations (tHcy), however, most studies reported a lack of an effect of low homocysteine concentrations on bone turnover markers, bone mineral density (BMD) or fracture risks. Current studies have been inconsistent in their reports on the role of B-vitamins and homocysteine in bone health. More data are therefore required to show the mechanism and effect of tHcy and B-vitamins on BMD, bone metabolism and fracture risk. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bolaji L Ilesanmi-Oyelere
- School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North, 4442, New Zealand
| | - Marlena C Kruger
- School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North, 4442, New Zealand
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Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I. Does Folic Acid Protect Patients with Inflammatory Bowel Disease from Complications? Nutrients 2021; 13:nu13114036. [PMID: 34836291 PMCID: PMC8618862 DOI: 10.3390/nu13114036] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 01/12/2023] Open
Abstract
Folic acid, referred to as vitamin B9, is a water-soluble substance, which participates in the synthesis of nucleic acids, amino acids, and proteins. Similarly to B12 and B6, vitamin B9 is involved in the metabolism of homocysteine, which is associated with the MTHFR gene. The human body is not able to synthesize folic acid; thus, it must be supplemented with diet. The most common consequence of folic acid deficiency is anemia; however, some studies have also demonstrated the correlation between low bone mineral density, hyperhomocysteinemia, and folic acid deficiency. Patients with inflammatory bowel disease (IBD) frequently suffer from malabsorption and avoid certain products, such as fresh fruits and vegetables, which constitute the main sources of vitamin B9. Additionally, the use of sulfasalazine by patients may result in folic acid deficiency. Therefore, IBD patients present a higher risk of folic acid deficiency and require particular supervision with regard to anemia and osteoporosis prevention, which are common consequences of IBD.
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Affiliation(s)
- Alicja Ewa Ratajczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
| | | | | | | | | | - Iwona Krela-Kaźmierczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
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7
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Webster J, Rycroft CE, Greenwood DC, Cade JE. Dietary risk factors for hip fracture in adults: An umbrella review of meta-analyses of prospective cohort studies. PLoS One 2021; 16:e0259144. [PMID: 34758048 PMCID: PMC8580223 DOI: 10.1371/journal.pone.0259144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
AIM To summarise the totality of evidence regarding dietary risk factors for hip fracture in adults, evaluating the quality of evidence, to provide recommendations for practice and further research. DESIGN Systematic review of meta-analyses of prospective cohort studies. ELIGIBILITY CRITERIA Systematic reviews with meta-analyses reporting summary risk estimates for associations between hip fracture incidence and dietary exposures including oral intake of a food, food group, beverage, or nutrient, or adherence to dietary patterns. INFORMATION SOURCES Medline, Embase, Web of Science, and the Cochrane Library from inception until November 2020. DATA SYNTHESIS The methodological quality of systematic reviews and meta-analyses was assessed using AMSTAR-2, and the quality of evidence for each association was assessed using GRADE. Results were synthesised descriptively. RESULTS Sixteen systematic reviews were identified, covering thirty-four exposures, including dietary patterns (n = 2 meta-analyses), foods, food groups, or beverages (n = 16), macronutrients (n = 3), and micronutrients (n = 13). Identified meta-analyses included 6,282 to 3,730,424 participants with between 322 and 26,168 hip fractures. The methodological quality (AMSTAR-2) of all systematic reviews was low or critically low. The quality of evidence (GRADE) was low for an inverse association between hip fracture incidence and intake of fruits and vegetables combined (adjusted summary relative risk for higher vs lower intakes: 0.92 [95% confidence interval: 0.87 to 0.98]), and very low for the remaining thirty-three exposures. CONCLUSION Dietary factors may play a role in the primary prevention of hip fracture, but the methodological quality of systematic reviews and meta-analyses was below international standards, and there was a lack of high-quality evidence. More long-term cohort studies reporting absolute risks and robust, well-conducted meta-analyses with dose-response information are needed before policy guidelines can be formed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020226190.
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Affiliation(s)
- James Webster
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Catherine E. Rycroft
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | | | - Janet E. Cade
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
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8
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Li Z, Zhang S, Wan L, Song X, Yuan D, Zhang S, Wu D, Jiang J. Vitamin B6 as a novel risk biomarker of fractured ankles. Medicine (Baltimore) 2021; 100:e27442. [PMID: 34622861 PMCID: PMC8500643 DOI: 10.1097/md.0000000000027442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Ankle fractures are the most common intra-articular fractures. Osteoporosis is a common and frequent disease among the elderly with a poor prognosis and high risk of fractured ankles. However, the relationship between vitamin B6 and the incidence of fractured ankles in patients with osteoporosis is unclear.A total of 101 patients with osteoporosis were recruited. Clinical and followed-up information was recorded. And the vitamin B6, albumin, globulin, and hemoglobin in the blood were tested. Pearson's chi-squared and spearman test were performed to analyze the correlation between fractured ankles and relative parameters. Univariate and multivariate logistic regression, receiver operating characteristic curve analysis, univariate and multivariate Cox proportional hazards regression analysis, and Kaplan-Meier method were also performed.There exist strong relation between the expression level of vitamin B6 and fractured ankle (P < .001). The expression of vitamin B6 [Odd ratio (OR) = 12.071, 95% confidence interval (CI): 4.69-31.143, P < .001] has a clear correlation with whether the patients have fractured ankles via the univariate logistic regression analysis. In terms of multivariate logistic regression level, vitamin B6 (OR = 15.384, 95% CI:5.195-45.556, P < .001) was significantly associated with fractured ankle. In addition, expression level of vitamin B6 [hazard ratio (HR) = 11.684, 95% CI: 6.419-21.267, P < .001] was significantly associated with Maintenance time from recovery to recurrence (MRTT) of patients with osteoporosis.Enhanced vitamin B6 is significantly correlated with the poor prognosis of patients with osteoporosis and the increasing incidence of fractured ankles.
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Affiliation(s)
- Zhihao Li
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Shaoan Zhang
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Lei Wan
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Xiaoyan Song
- Department of Obstetrics and Gynecology ultrasound Department, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Dongtao Yuan
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Shikui Zhang
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Dalong Wu
- Department of Orthopaedic Trauma, The Second Affiliated Hospital of Luohe Medical College, Henan Province, China
| | - Jiankui Jiang
- Hand Surgery & Foot and Ankle Surgery Department, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
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9
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Vitamin K Nutrition and Bone Health. Nutrients 2020; 12:nu12071909. [PMID: 32605143 PMCID: PMC7399911 DOI: 10.3390/nu12071909] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 01/22/2023] Open
Abstract
Vitamin K is essential for blood coagulation and plays an important role in extrahepatic metabolism, such as in bone and blood vessels, and in energy metabolism. This review discusses the assessment of vitamin K sufficiency and the role of vitamin K in bone health. To elucidate the exact role of vitamin K in other organs, accurate tools for assessing vitamin K deficiency or insufficiency are crucial. Undercarboxylated vitamin K-dependent protein levels can be measured to evaluate tissue-specific vitamin K deficiency/insufficiency. Vitamin K has genomic action through steroid and xenobiotic receptor (SXR); however, the importance of this action requires further study. Recent studies have revealed that the bone-specific, vitamin K-dependent protein osteocalcin has a close relationship with energy metabolism through insulin sensitivity. Among the organs that produce vitamin K-dependent proteins, bone has attracted the most attention, as vitamin K deficiency has been consistently associated with bone fractures. Although vitamin K treatment addresses vitamin K deficiency and is believed to promote bone health, the corresponding findings on fracture risk reduction are conflicting. We also discuss the similarity of other vitamin supplementations on fracture risk. Future clinical studies are needed to further elucidate the effect of vitamin K on fracture risk.
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Kuroda T, Uenishi K, Ohta H, Shiraki M. Multiple vitamin deficiencies additively increase the risk of incident fractures in Japanese postmenopausal women. Osteoporos Int 2019; 30:593-599. [PMID: 30483849 DOI: 10.1007/s00198-018-4784-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/15/2018] [Indexed: 12/21/2022]
Abstract
UNLABELLED The associations of multiple vitamin deficiencies on incident fractures were uncertain, the relationships between serum vitamin markers and incident bone fractures were investigated in Japanese postmenopausal women. The number of deficiencies was additively associated with incident fracture after adjustment for possible confounding factors including the treatment of osteoporosis. INTRODUCTION To evaluate the associations of multiple vitamin deficiencies on incident fractures, the relationships between serum vitamin markers and incident bone fractures were investigated in Japanese postmenopausal women. METHODS This analysis used a subset of the ongoing cohort maintained by a primary care institution. Inclusion criteria of the present study were postmenopausal women aged ≥ 50 years, without vitamin supplementation and secondary osteoporosis. Baseline serum concentrations of 25-hydroxyvitamin D (25(OH)D), undercarboxylated osteocalcin (ucOC), and homocysteine (Hcy) were measured to assess vitamin D, vitamin K, and vitamin B, respectively. Since 25(OH) D positively relates to vitamin D, ucOC and Hcy negatively relate to vitamin K and vitamin B nutrients, respectively, the subjects with lower (25(OH)D) or higher (ucOC or Hcy) values than each median value was defined as subjects with the corresponding vitamin deficiency. Subjects were divided into four groups according to the number of deficiency: no deficiency, single deficiency, double deficiencies, and triple deficiencies. Relationships between the vitamin deficiencies and incident fractures were evaluated by Cox regression analysis. RESULTS A total of 889 subjects were included in this analysis; their mean and SD age was 68.3 ± 9.5 years, and the follow-up period was 6.3 ± 5.1 years. The numbers of subjects in the four groups were 139 (15.6%), 304 (34.2%), 316 (35.5%), and 130 (14.6%) for the groups with no, single, double, and triple deficiencies, respectively. Incident fractures were observed in 264 subjects (29.7%) during the observation period. The number of deficiencies was significantly associated with incident fracture (hazard ratio 1.25, 95% confidence interval 1.04-1.50, P = 0.018) after adjustment for possible confounding factors including the treatment of osteoporosis. CONCLUSION Accumulation of vitamin deficiencies was related to incident fractures.
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Affiliation(s)
- T Kuroda
- Public Health Research Foundation, 1-1-7 Nishiwaseda, Shinjuku-ku, Tokyo, 169-0051, Japan.
| | - K Uenishi
- Division of Nutritional Physiology, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado City, Saitama, 350-0288, Japan
| | - H Ohta
- Clinical Medical Research Center, Women's Medical Center, Sanno Medical Center, International University of Health and Welfare, 8-5-35 Akasaka, Minato-ku, Tokyo, 107-0052, Japan
| | - M Shiraki
- Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano, 399-8101, Japan
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11
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Allen LH, Miller JW, de Groot L, Rosenberg IH, Smith AD, Refsum H, Raiten DJ. Biomarkers of Nutrition for Development (BOND): Vitamin B-12 Review. J Nutr 2018; 148:1995S-2027S. [PMID: 30500928 PMCID: PMC6297555 DOI: 10.1093/jn/nxy201] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/06/2017] [Accepted: 08/02/2018] [Indexed: 12/31/2022] Open
Abstract
This report on vitamin B-12 (B12) is part of the Biomarkers of Nutrition for Development (BOND) Project, which provides state-of-the art information and advice on the selection, use, and interpretation of biomarkers of nutrient exposure, status, and function. As with the other 5 reports in this series, which focused on iodine, folate, zinc, iron, and vitamin A, this B12 report was developed with the assistance of an expert panel (BOND B12 EP) and other experts who provided information during a consultation. The experts reviewed the existing literature in depth in order to consolidate existing relevant information on the biology of B12, including known and possible effects of insufficiency, and available and potential biomarkers of status. Unlike the situation for the other 5 nutrients reviewed during the BOND project, there has been relatively little previous attention paid to B12 status and its biomarkers, so this report is a landmark in terms of the consolidation and interpretation of the available information on B12 nutrition. Historically, most focus has been on diagnosis and treatment of clinical symptoms of B12 deficiency, which result primarily from pernicious anemia or strict vegetarianism. More recently, we have become aware of the high prevalence of B12 insufficiency in populations consuming low amounts of animal-source foods, which can be detected with ≥1 serum biomarker but presents the new challenge of identifying functional consequences that may require public health interventions.
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Affiliation(s)
- Lindsay H Allen
- USDA, Agricultural Research Service Western Human Nutrition Research Center, University of California, Davis, CA
| | - Joshua W Miller
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ
| | - Lisette de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Irwin H Rosenberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda, MD
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12
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Garcia Lopez M, Baron JA, Omsland TK, Søgaard AJ, Meyer HE. Homocysteine-Lowering Treatment and the Risk of Fracture: Secondary Analysis of a Randomized Controlled Trial and an Updated Meta-Analysis. JBMR Plus 2018; 2:295-303. [PMID: 30283911 PMCID: PMC6139704 DOI: 10.1002/jbm4.10045] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/05/2018] [Accepted: 02/21/2018] [Indexed: 01/21/2023] Open
Abstract
High plasma homocysteine is a risk factor for osteoporotic fractures. Several studies have assessed the possible preventive effect of homocysteine-lowering B-vitamin treatment on the risk of fracture with inconclusive results. In the current study, we include new results from the Aspirin Folate Polyp Prevention Study (AFPPS) together with an updated meta-analysis of randomized controlled trials (RCTs). Our objective was to determine whether there is an association between homocysteine-lowering B-vitamin treatment and the risk of fracture. The AFPPS trial was performed between 1994 and 2004 in nine clinical centers in the United States, and 1021 participants were randomized to a daily folic acid dose of 1 mg (n = 516) or placebo (n = 505). The main outcome was fracture of any type. In addition, we analyzed the risk of hip fracture. In the meta-analysis, studies were identified following a search strategy in electronic database and by hand searching. Risk ratio with 95% confidence interval (CI) was chosen for pooled analyses. In the AFPPS, no statistically significant association was found between folic acid treatment and fractures of any type (risk ratio [RR] = 0.95; 95% CI 0.61-1.48) or hip fracture (RR = 0.98; 95% CI 0.25-3.89). In the meta-analysis, six RCTs were included with a total of 36,527 participants. For interventions including folic acid and/or vitamin B12, the pooled RR for treatment was 0.97 (95% CI 0.87-1.09) for fractures of any type (n = 1199) and 1.00 (95% CI 0.81-1.23) for hip fractures (n = 335). In conclusion, no association was found between homocysteine-lowering treatment with B vitamins (folic acid and vitamin B12) and the risk of fracture. © 2018 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Maria Garcia Lopez
- Department of Clinical EndocrinologyMorbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
- Department of Community Medicine and Global HealthInstitute of Health and SocietyUniversity of OsloOsloNorway
| | - John A Baron
- Department of EpidemiologyGeisel School of Medicine at DartmouthLebanonNHUSA
- Department of MedicineUniversity of North Carolina School of MedicineChapel HillNCUSA
| | - Tone K Omsland
- Department of Community Medicine and Global HealthInstitute of Health and SocietyUniversity of OsloOsloNorway
| | - Anne Johanne Søgaard
- Division of Mental and Physical HealthNorwegian Institute of Public HealthOsloNorway
| | - Haakon E Meyer
- Department of Community Medicine and Global HealthInstitute of Health and SocietyUniversity of OsloOsloNorway
- Division of Mental and Physical HealthNorwegian Institute of Public HealthOsloNorway
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Xia YH, Chen F, Zhang L, Li G, Tang ZY, Feng B, Xu K. Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two-year follow-up. Exp Ther Med 2018; 16:3617-3622. [PMID: 30233717 DOI: 10.3892/etm.2018.6628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/06/2018] [Indexed: 11/06/2022] Open
Abstract
Percutaneous kyphoplasty (PKP) has been used in Kümmell disease treatment for years. The objective of the current study was to evaluate the efficacy and safety of PKP in the treatment of patients with Kümmell disease and to explore the association between cement injection volume and pain relief. A total of 50 patients were enrolled in the present study and follow-up was 2 years. Efficacy was evaluated using the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI) and the kyphotic angle (Cobb's angle). VAS and ODI were determined at the initial evaluation (prior to surgery), at 3 days, 3 months, and 1 and 2 years post surgery. Cobb's angle was measured prior to and 3 months, 1 year and 2 years following surgery. PKP safety was assessed by evaluating complications, including cement leakage and spinal cord compression. In the follow-ups, VAS significantly decreased from 7.00±0.78 pre-PKP to 3.14±0.67 at 2 years post-PKP (P<0.05). ODI significantly decreased from 73.88±8.60 prior to surgery to 22.84±8.85 at 1 year following surgery (P<0.05) and did not significantly change at the following 2-year measurement (26.44±8.63). The Cobb's angle, measured at 17.73±2.43° preoperatively, significantly decreased to 8.32±2.21° at 3 months following surgery (P<0.05). On subsequent follow-ups at 1 and 2 years, the Cobb's angle increased to 9.55±2.82 and 10.27±3.22°, respectively. A total of 8 patients exhibited signs of cement leakage during the PKP procedure. No patients experienced severe neurological deficits or complications. Spearman analysis demonstrated a positive correlation between cement injection volume and pain relief. The current study indicated that PKP was a safe and effective treatment for patients with Kümmell disease and that there was a positive correlation between cement injection volume and pain relief. The current study may be used a reference in cement dosing for the treatment of PKP.
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Affiliation(s)
- Yong-Hui Xia
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Feng Chen
- Department of Interventional Radiology, Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China
| | - Liang Zhang
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Gang Li
- Department of Interventional Radiology, Jinhua Central Hospital, Jinhua, Zhejiang 321000, P.R. China
| | - Zhi-Yu Tang
- Department of Interventional Radiology, Nanchong Central Hospital, Nanchong, Sichuan 637900, P.R. China
| | - Bo Feng
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Ke Xu
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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14
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Effect of Energy Drink on Bone Formation in the Expanded Inter-Premaxillary Suture. J Craniofac Surg 2017; 28:285-289. [PMID: 27922952 DOI: 10.1097/scs.0000000000003244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Maxillary expansion of the median palatal suture is a common procedure in orthodontics. Even after retention, there is a strong tendency to relapse in the expanded suture. The authors' objectives are to accelerate the bone formation process in the expanded suture and to reduce the required retention time by using an energy drink (ED). Twenty rats were divided into 2 groups (n = 20). The expansion-only group was defined as the control group (Group C). The other group was defined as the expansion-plus-energy drink group (Group ED). In Group ED, ED was administered systemically through oro-gastric tubes after the expansion period. After 5 days of expansion, the springs were removed and replaced with short lengths of rectangular retaining wire. Tooth separation was maintained for 12 days. Histomorphometric analysis showed significant differences between the 2 groups in terms of newly formed bone (P = 0.018) and the bone area (P = 0.007). For the parameters that were investigated, Group ED had better results than Group C. These results show that systemic administration of an ED during the early stages of the orthopedic expansion of the inter-maxillary suture areas can stimulate bone formation and decrease the time required for retention.
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15
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Yang DL, Yang SD, Chen Q, Shen Y, Ding WY. The Treatment Evaluation for Osteoporotic Kummell Disease by Modified Posterior Vertebral Column Resection: Minimum of One-Year Follow-Up. Med Sci Monit 2017; 23:606-612. [PMID: 28148908 PMCID: PMC5301956 DOI: 10.12659/msm.902669] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background The aim of this study was to evaluate the clinical efficacy of modified posterior vertebral column resection (MPVCR) in treating osteoporotic Kummell disease. Material/Methods Between January 2013 and January 2015, 10 patients who were diagnosed with Kummell disease underwent MPVCR treatment, and their medical records were retrospectively collected. Every patient had follow-up for at least one year, with an average of 15 months. Clinical efficacy of MPVCR treatment was evaluated by kyphotic Cobb’s angle, Oswestry disability index (ODI) and visual analogue scale (VAS) score. Results Data analyses showed that operation time was 188.39±30.8 minutes, and blood loss was 860±130 mL with 600±200 mL of blood transfusions. VAS score decreased significantly after MPVCR surgery (p<0.001, Mann-Whitney U test). In addition, data analyses showed that postoperative ODI was less than preoperative ODI, which was a statistically significant difference (p<0.001, Mann-Whitney U test). X-ray radiograph showed that kyphotic Cobb’s angle was 45°±12° preoperatively, 10°±4° two weeks after surgery, and 15°±6° at last follow-up, indicating that Cobb’s angle after MPVCR surgery was significantly improved, compared to the preoperative scores (p<0.05, SNK-q test). Conclusions MPVCR surgery was an effective and safe surgical method to treat Kummell disease, especially for patients with kyphotic deformity and obvious nerve-oppressed symptoms. However, the long-term clinical effect still needs further studies.
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Affiliation(s)
- Da-Long Yang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Si-Dong Yang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Qian Chen
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China (mainland)
| | - Yong Shen
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wen-Yuan Ding
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).,Hebei Provincial Key Laboratory of Orthopedic Biomechanics, Shijiazhuang, Hebei, China (mainland)
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16
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One carbon metabolism and bone homeostasis and remodeling: A review of experimental research and population studies. Biochimie 2016; 126:115-23. [DOI: 10.1016/j.biochi.2016.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/08/2016] [Indexed: 01/22/2023]
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17
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Bailey RL, Looker AC, Lu Z, Fan R, Eicher-Miller HA, Fakhouri TH, Gahche JJ, Weaver CM, Mills JL. B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States. Am J Clin Nutr 2015; 102:687-94. [PMID: 26224297 PMCID: PMC4548174 DOI: 10.3945/ajcn.115.108787] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 07/02/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous data suggest that elevated serum total homocysteine (tHcy) may be a risk factor for bone fracture and osteoporosis. Nutritional causes of elevated tHcy are suboptimal B-vitamin status. To our knowledge, this is the first nationally representative report on the relation of B vitamins and bone health from a population with folic acid fortification. OBJECTIVE The purpose of this analysis was to examine the relation between B-vitamin status biomarkers and bone mineral density (BMD), risk of osteoporosis, and biomarkers of bone turnover. DESIGN We examined the relation of tHcy, methylmalonic acid (MMA), and serum/red blood cell folate and total-body and lumbar spine BMD in women aged ≥50 y participating in the NHANES 1999-2004 (n = 2806), a nationally representative cross-sectional survey. These are the only years with concurrent measurement of tHcy and whole-body dual-energy X-ray absorptiometry. We also examined B-vitamin biomarkers relative to bone turnover markers, bone alkaline phosphatase, and urinary N-terminal cross-linked telopeptide of type I collagen in a 1999-2002 subset with available data (n = 1813). RESULTS In comparison with optimal concentrations, women with elevated tHcy were older with lower serum vitamin B-12, red blood cell folate, and dietary micronutrient intakes and had significantly higher mean ± SE markers of bone turnover (bone alkaline phosphatase: 15.8 ± 0.59 compared with 14.0 ± 0.25 μg/L; urinary N-terminal cross-linked telopeptide of type I collagen: 48.2 ± 2.9 compared with 38.9 ± 0.90 nmol bone collagen equivalents per mmol creatinine/L). Elevated MMA (OR: 1.88; 95% CI: 1.10, 3.18) and tHcy (OR: 2.17; 95% CI: 1.14, 4.15) were related to increased risk of lumbar osteoporosis. When examined as a continuous variable, tHcy was negatively associated, serum folates were positively associated, and MMA and vitamin B-12 were not significantly associated with lumbar and total-body BMD. CONCLUSION In this nationally representative population of older US women with high exposure to B vitamins through food fortification and dietary supplements, only elevated tHcy and MMA were independently associated with risk of lumbar spine osteoporosis.
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Affiliation(s)
- Regan L Bailey
- Office of Dietary Supplements and Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Anne C Looker
- National Center for Health Statistics, CDC, Hyattsville, MD
| | - Zhaohui Lu
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
| | - Ruzong Fan
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
| | | | | | - Jaime J Gahche
- National Center for Health Statistics, CDC, Hyattsville, MD
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - James L Mills
- Eunice Kennedy Shriver National Institute of Child and Human Development, NIH, Bethesda, MD
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