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Li ZX, Zhuo JL, Yang N, Gao MB, Qu ZH, Han T. Effect of Lycium barbarum polysaccharide on osteoblast proliferation and differentiation in postmenopausal osteoporosis. Int J Biol Macromol 2024; 271:132415. [PMID: 38759858 DOI: 10.1016/j.ijbiomac.2024.132415] [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: 01/31/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE We aimed to investigate the effect of Lycium barbarum polysaccharide (LBP) on the proliferation and differentiation of osteoblasts in postmenopausal individuals with osteoporosis using in vitro cell experiments. METHODS We assessed the effect of long-term LBP consumption on the intestinal metabolites of individuals using a simulation of the human intestinal microbiota ecosystem. We also tested the capacity of LBP in proliferating MC3T3-E1 cells using the cell counting kit-8 (CCK-8) method and analyzed the effect of intestinal metabolites on the osteogenic differentiation of MC3T3-E1 cells by testing bone metabolism viability with relevant indicators. RESULTS The level of short-chain fatty acids (SCFAs) significantly increased (p < 0.05), and the concentrations of acetic acid, propionic acid, and butyric acid all showed an upward trend after the treatment using LBP. At appropriate concentrations, the fermentation supernatant can enhance osteoblast proliferation by significantly increasing the active expression of bone-alkaline phosphatase (B-ALP) and osteocalcin (OCN) in osteoblasts (p < 0.05). CONCLUSION By modulating the metabolites of intestinal microbiota, production of SCFAs, the prebiotic properties of LBP can enhance osteoblast differentiation through in vitro simulation experiment and cell-based assay.
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Affiliation(s)
- Zi-Xiang Li
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jia-Lu Zhuo
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ning Yang
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ming-Bo Gao
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Zhi-Hua Qu
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ting Han
- Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
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Torfadóttir JE, Uusi-Rasi K. Calcium - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10303. [PMID: 38187795 PMCID: PMC10770652 DOI: 10.29219/fnr.v67.10303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 04/13/2022] [Accepted: 10/18/2023] [Indexed: 01/09/2024] Open
Abstract
The aim of this scoping review was to conduct evidence-based documentations between calcium (Ca) intake and health outcomes for updating dietary reference values (DRVs) and food-based dietary guidelines (FBDGs) in the sixth edition of Nordic Nutrient Recommendations (NNR2023). The systematic literature search was limited to reviews on human data published between 2011 and June 2021. Systematic reviews (SRs) and original publications of relevance for this scoping review were included. A common practice of designing studies on health outcomes related to Ca supplement intake is to examine combined Ca and vitamin D, and therefore, a combination of Ca with vitamin D (CaD) was included in this review. In total, 27 studies addressing the association between dietary or supplemental Ca on bone health, bone mineral density (BMD), pregnancy-related outcomes, cardiovascular diseases (CVD), cancers, obesity, and mortality were reviewed. SRs showed that both dietary and supplemental Ca intakes were positively associated with BMD, but evidence did not support the benefit in fracture prevention. Current evidence did not support that Ca or CaD supplementation increases risk of coronary heart disease or all-cause mortality in older adults, but that Ca may be beneficial for hypertension, especially in young people. Increasing Ca intake may be beneficial during pregnancy, especially for those at high risk of pre-eclampsia due to ethnicity, age, high BMI, and those with low baseline Ca intake. The associations between high Ca intake and cancers were varied, with strong evidence that high consumption of dairy products is protective against colorectal cancer and limited-suggestive evidence that dairy products and diets high in Ca might also be protective against breast cancer. Moreover, there is limited-suggestive evidence that dairy products and diets high in Ca increase the risk of prostate cancer. Based on current evidence, Ca intake is beneficial or neutral in relation to most of the outcomes evaluated in this review. Data from the Nordic countries show that average Ca intake is around the same as previously recommended by NNR. However, the average Ca intake in the Baltic countries is below the recommendations.
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Affiliation(s)
- Jóhanna E. Torfadóttir
- Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
- Directorate of Health, Reykjavik, Iceland
| | - Kirsti Uusi-Rasi
- The UKK Institute for Health Promotion Research, Tampere, Finland
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Wang Y, Han X, Shi J, Liao Z, Zhang Y, Li Y, Jiang M, Liu M. Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4895. [PMID: 38068753 PMCID: PMC10708105 DOI: 10.3390/nu15234895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/04/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
Multiple studies have indicated that distinct metabolites are involved in the occurrence and development of osteopenia (ON) and osteoporosis (OP); however, these metabolites in OP and ON have not yet been classified and standardized. This systematic review and meta-analysis included 21 articles aiming to investigate the distinct metabolites in patients with ON and OP. The quality of the included articles was generally high; seventeen studies had >7 stars, and the remaining four received 6 stars. This systematic review showed that three metabolites (phosphatidylcholine (PC) (lipid metabolites), galactose (carbohydrate metabolites), and succinic acid (other metabolites)) increased, four (glycylglycine (gly-gly), cystine (amino acids), sphingomyelin (SM) (lipid metabolites) and glucose (carbohydrate metabolites)) decreased, and five (glutamine, hydroxyproline, taurine (amino acids), lysophosphatidylcholine (LPC) (lipid metabolites), and lactate (other metabolites)) had conflicting directions in OP/ON. The results of the meta-analysis show that gly-gly (MD = -0.77, 95%CI -1.43 to -0.11, p = 0.02) and cystine (MD = -5.52, 95%CI -7.35 to -3.68, p < 0.00001) decreased in the OP group compared with the healthy control group. Moreover, LPC (MD = 1.48, 95%CI 0.11 to 2.86, p = 0.03) increased in the OP group compared with the healthy control group. These results indicate that distinct metabolites were associated with ON and OP, which could be considered a predictor for OP.
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Affiliation(s)
- Yuhe Wang
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
| | - Xu Han
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China;
| | - Jingru Shi
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
| | - Zeqi Liao
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
| | - Yuanyue Zhang
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
| | - Yuanyuan Li
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
| | - Miao Jiang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China;
| | - Meijie Liu
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; (Y.W.); (J.S.); (Z.L.); (Y.Z.); (Y.L.)
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Suliburska J, Wawrzyniak N, Gramza-Michałowska A, Kurzawa P. Calcium-Deficit Diet Improves Iron Content in Ovariectomized Rats. Biol Trace Elem Res 2023; 201:4806-4811. [PMID: 36624332 PMCID: PMC10415432 DOI: 10.1007/s12011-023-03556-9] [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: 11/18/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
In women, menopause is associated with disorders related to calcium and iron content, which may increase the risk of osteoporosis. This study aimed to determine the effect of calcium deficiency on the iron content in ovariectomized rats. This study included 30 3-month-old female rats, which were divided into three groups: group C (n = 10)-control group fed the standard diet; group O-ovariectomized rats fed the standard diet; and group D-ovariectomized rats fed the calcium-deficit diet. After 3 months of experimental intervention, the weight of the rats was measured, and blood and tissue samples were collected. Morphological parameters were analyzed in whole blood, and serum levels of leptin, estrogen and C-reactive protein, and total antioxidant status were determined. The iron content was measured in tissues, and histological analysis was performed in the femur. The results obtained demonstrated that ovariectomy significantly decreased the iron content in bones, hair, spleen, liver, and kidneys. The calcium-deficit diet increased the iron content in tissues and the hemoglobin level in ovariectomized rats and also enhanced the number of osteoblasts in bones compared with the O group. In conclusion, calcium deficiency improved the iron content in ovariectomized rats in this 12-week study.
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Affiliation(s)
- Joanna Suliburska
- Department of Human Nutrition and Dietetics, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland.
| | - Natalia Wawrzyniak
- Department of Human Nutrition and Dietetics, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland
| | - Anna Gramza-Michałowska
- Department of Gastronomy Science and Functional Foods, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland
| | - Paweł Kurzawa
- Department of Clinical Pathology, Poznań University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznań, Poland
- Department of Oncological Pathology, University Hospital of Lord's Transfiguration, Partner of Karol Marcinkowski University of Medical Sciences, Szamarzewskiego 84, 60-569, Poznań, Poland
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Manoj P, Derwin R, George S. What is the impact of daily oral supplementation of vitamin D3 (cholecalciferol) plus calcium on the incidence of hip fracture in older people? A systematic review and meta-analysis. Int J Older People Nurs 2023; 18:e12492. [PMID: 35842938 PMCID: PMC10078370 DOI: 10.1111/opn.12492] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Hip fractures have a huge impact in reducing the quality of life and increasing mortality. This review aims to assess the impact of daily oral supplementation of vitamin D3 plus calcium on the incidence of hip fracture in people over 65 years. METHODS PRISMA guidelines were followed and RCTs that evaluated the effectiveness of daily oral supplementation of vitamin D3 plus calcium in preventing hip fracture in adults over 65 years were included in the study. The databases such as Cochrane Library, Embase, Medline, PubMed, CINAHL, Web of Science and Scopus were searched from October 2019- January 2020.The Cochrane risk of bias tool was used to check the quality of the included studies. A meta-analysis with fixed effect model using Review Manager (Revman 5.3) was used to analyse the data. RESULTS The meta-analysis of seven RCTs on vitamin D3 plus calcium supplementation and hip fracture (n = 12,620) identified odds ratio (OR) of 0.75; 95% Confidence interval (CI): 0.64, 0.87; p = .0003. Daily oral supplementation of 800 IU of Vitamin D3 plus 1200 mg of calcium was found more effective (n = 5676 participants; OR = 0.69; 95% CI: 0.58, 0.82; p < .0001) than daily oral supplementation of 800 IU of Vitamin D3 plus 1000 mg of calcium (n = 6555,OR = 1.08; 95% CI: 0.74, 1.56; p = .70) in reducing hip fracture. A meta-analysis of the seven RCTs to identify the incidence of non-vertebral fracture gave the OR of 0.80; 95% CI: 0.72, 0.89; p < .0001. A meta-analysis of three RCTs on femoral neck bone mineral density (BMD) (n = 483) gave a mean difference of 1.21; 95% CI: -0.79, 3.20; p = .24. CONCLUSION Daily oral supplementation 800 IU of vitamin D3 plus 1200 mg of calcium reduces hip fracture and non-vertebral fracture in older people. Administering vitamin D3 and calcium supplements had no effect in increasing the femoral neck BMD. IMPLICATIONS FOR PRACTICE Even though it is evident from the review that optimal daily intake of vitamin D3 plus calcium supplementation help in the prevention of fracture, it is only one essential element in fracture prevention. Also, people who are on dietary supplements should be compliant with same for better result. Efforts to prevent bone loss and osteoporosis should begin from an early age. It includes maintaining a healthy lifestyle, optimal intake of calcium and vitamin D3, proper nutrition, adequate exposure to sunlight, exercise etc. Proper education on healthy lifestyle, avoiding risk factors like smoking, caffeine, alcohol and awareness of bone health should continue throughout life with emphasis during menopause when increased bone loss is expected.
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Affiliation(s)
- Preethy Manoj
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin 2, Ireland.,Connolly Hospital, Blanchardstown, Dublin 15, Ireland
| | - Rosemarie Derwin
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Sherly George
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin 2, Ireland
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Cui Y, Sun K, Xiao Y, Li X, Mo S, Yuan Y, Wang P, Yang L, Zhang R, Zhu X. High-salt diet accelerates bone loss accompanied by activation of ion channels related to kidney and bone tissue in ovariectomized rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114024. [PMID: 36057202 DOI: 10.1016/j.ecoenv.2022.114024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Excessive salt intake can induce a variety of diseases, such as hypertension, cardiovascular disease, kidney disease and so on,it is also one of the factors promoting bone resorption. The mechanism of osteoporosis-induced exacerbations of high salt diet is not well-defined. In this study, we used ovariectomized 6-month-old Sprague Dawley rats to construct a high bone turnover model, and then administrated with high sodium chloride diet (2.0% w/w NaCl, 8.0% w/w NaCl) for 12 weeks to observe the effect of high salt diet on bone metabolism. The results showed that high salt diet could lead to the destruction of bone microstructure, promote the excretion of urinary calcium and phosphorus and accelerate the bone turnover, as well as cause the pathologic structural abnormalities in renal tubular. At the same time, it was accompanied by the up-regulated expression of the epithelial sodium channel (ENaCα), voltage-gated chloride channels (ClC)- 3 and the down-regulated expression of Na-Cl cotransporter (NCC), sodium calcium exchanger (NCX1) in femoral tissue and renal tubules. These findings confirm that high salt diet can destroy the microstructure of bone by increasing bone resorption and affect some ion channels of bone tissue and renal tubule in ovariectomized rats.
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Affiliation(s)
- Yan Cui
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Kehuan Sun
- The First Affiliated Hospital of Shenzhen University,Shenzhen Second People's Hospital, Shenzhen, Guangdong 518020, PR China
| | - Yawen Xiao
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Xiaoyun Li
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Shu Mo
- Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong 518000, PR China
| | - Yihan Yuan
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Panpan Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; Cancer research Institution, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Li Yang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Ronghua Zhang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China; Cancer research Institution, Jinan University, Guangzhou, Guangdong 510630, PR China; Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, Guangdong 510630, PR China.
| | - Xiaofeng Zhu
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China.
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Shaikhomar OA, Abdelghnay AH, Qutob HMH. Diagnosis of Low Bone Mass Density: Serological versus Radiological Methods. Int J Gen Med 2022; 15:5937-5945. [PMID: 35799999 PMCID: PMC9255419 DOI: 10.2147/ijgm.s357417] [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: 01/20/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
Context Bone remodeling comprises balanced coupling of bone formation and resorption, and low bone mineral density (BMD) demonstrates high rates of bone resorption. Osteoporosis is a chronic asymptomatic disease with fragile bones and impending risk of fractures mediated by minor trauma. Whereas bone mineralization and integrity are determined by calcium and vitamin D, specific serum markers such as bone specific alkaline phosphatase (ALP) and osteocalcin (OC) play a vital role in bone formation. Materials and Methods Serum calcium, vitamin D, ALP, and OC levels were measured in 2,145 Saudi students aged 18–22 years at Umm Al-Qura University. The BMD was measured by dual-energy X-ray absorptiometry (DEXA), and the findings were statistically evaluated. The following statistics were utilized in the analysis: the SPSS software was used to record, tabulate, and statistically evaluate the results. Results Low BMD cases accounted for 27.46% of all cases investigated, with considerably higher serum calcium, bone-specific ALP, and OC levels compared to control cases, but significantly lower serum vitamin D levels. In low BMD instances, there was no association between serum markers and DEXA findings. Conclusion Serum indicators by themselves may be useful for screening and predicting patients at risk of osteoporosis, as well as assessing treatment response. The combination of serum markers and DEXA measures is more effective in detecting low BMD.
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Affiliation(s)
- Osama A Shaikhomar
- Physiology Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Correspondence: Osama A Shaikhomar, Tel +966 555568569, Email
| | - Abdelghnay H Abdelghnay
- Faculty of Medicine, University of Alexandria, Alexandria, Egypt
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Haitham M H Qutob
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences-Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Trollfors B. Ethnicity, gender and seasonal variations all play a role in vitamin D deficiency. Acta Paediatr 2022; 111:1596-1602. [PMID: 35472253 DOI: 10.1111/apa.16372] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022]
Abstract
AIM (1) To explore the adherence of recommendations of vitamin D supplementation to children aged 0-4 years. (2) To compare serum levels of vitamin D in children and adolescents aged 0-17 years originating from different parts of the world. (3) To compare levels between boys and girls and (4) To determine seasonal variation. METHODS A review of vitamin D levels in children with parents from different parts of the world was conducted. 2502 children aged 0-17 years were included between 22 January 2004 and 17 May 2021. RESULTS Fifty-nine of 363 children aged 0-4 years received the recommended vitamin D supplementation. Children from all parts of the world had lower levels of serum 25(OH)D than Swedish children. Girls from the Indian subcontinent, Middle East and Africa had the lowest levels of s-25(OH)D. Seasonal variation with higher levels during the summer was seen in children from Sweden, the rest of Europe, Russia and Latin America. Overall prevalence of vitamin D deficiency (≤25 nmol/L) was 928/2198 (42%) in children not receiving supplementation. Seven children had clinical rickets. CONCLUSION Adherence of giving children aged 0-4 years the recommended vitamin D supplementation was very low. Vitamin D deficiency is common in immigrant children of all ages in Sweden.
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Affiliation(s)
- Birger Trollfors
- Department of Paediatrics Sahlgrenska University Hospital Gothenburg Sweden
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Zhang YW, Cao MM, Li YJ, Dai GC, Lu PP, Zhang M, Bai LY, Chen XX, Zhang C, Shi L, Rui YF. The regulative effect and repercussion of probiotics and prebiotics on osteoporosis: involvement of brain-gut-bone axis. Crit Rev Food Sci Nutr 2022; 63:7510-7528. [PMID: 35234534 DOI: 10.1080/10408398.2022.2047005] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis (OP) is a systemic disease characterized by decreased bone mass and degeneration of bone microstructure. In recent years, more and more researches have focused on the close relationship between gut microbiota (GM) and the occurrence and progression of OP, and the regulation of probiotics and prebiotics on bone metabolism has gradually become a research hotspot. Based on the influence of brain-gut-bone axis on bone metabolism, this review expounds the potential mechanisms of probiotics and prebiotics on OP from next perspectives: regulation of intestinal metabolites, regulation of intestinal epithelial barrier function, involvement of neuromodulation, involvement of immune regulation and involvement of endocrine regulation, so as to provide a novel and promising idea for the prevention and treatment of OP in the future.
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Affiliation(s)
- Yuan-Wei Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Mu-Min Cao
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Ying-Juan Li
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Guang-Chun Dai
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Pan-Pan Lu
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Ming Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Li-Yong Bai
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Xiang-Xu Chen
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Cheng Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Liu Shi
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Yun-Feng Rui
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, P.R. China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, P.R. China
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10
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Song K, Kwon A, Chae HW, Suh J, Choi HS, Choi Y, Oh JS, Kim HS. Vitamin D status is associated with bone mineral density in adolescents: Findings from the Korea National Health and Nutrition Examination Survey. Nutr Res 2021; 87:13-21. [DOI: 10.1016/j.nutres.2020.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/10/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022]
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11
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Li XL, Xu F, Lin FH, Ai LZ, Zhao YJ, Bi XL, Sui L, Zhang Y. A Naringin- and Icariin-Contained Herbal Formula, Gushukang, Ameliorated Aged Osteoporosis of Aged Mice with High Calcium Intake. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2021; 48:1671-1691. [PMID: 33249854 DOI: 10.1142/s0192415x20500834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Traditional herbal formula Gushukang (GSK) was clinically applied to treat primary osteoporosis and showed osteoprotective effect in ovariectomized rodent animals and regulatory action on calcium transporters. This study aimed to determine if GSK could ameliorate aged osteoporosis by modulating serum level of calciotropic hormones and improving calcium balance. 18-month-old male mice were orally administered with either GSK (0.38[Formula: see text]g/kg body weight) or calcitriol (1[Formula: see text][Formula: see text]g/kg body weight) combined with high calcium diet (HCD, 1.2% Ca) for 60 days. The aged mice fed with normal calcium diet (NCD, 0.6% Ca) were a negative control. Trabecular bone and cortical bone properties as well as calcium balance were determined. Treatment with GSK significantly increased 25(OH)D and 1,25-(OH)2D levels in serum, moreover, it markedly attenuated trabecular bone micro-architectural deteriorations and elevated trabecular bone mass as well as strengthened cortical bone mechanical properties shown by the increase in maximal bending load and elastic modulus. Calcium balance, including urinary Ca excretion, fecal Ca level and net calcium retention, was remarkably improved by GSK, which up-regulated TRPV6 expression in duodenum and TRPV5 expression in kidney and down-regulated claudin-14 expression in duodenum and kidney. Additionally, 1-OHase and 24-OHase expression was significantly decreased (vs. NCD group) and increased (vs. HCD group), respectively, in kidney of GSK- and calcitriol-treated mice. Taken together, this study demonstrated the ameliorative effects of Gushukang on aged osteoporosis by effectively stimulating vitamin D production and improving calcium balance of aged mice with high dietary calcium supplement.
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Affiliation(s)
- Xiao-Li Li
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China
| | - Fei Xu
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China
| | - Fu-Hui Lin
- Department of Orthopaedic, Shenzhen Pingle Orthopaedic Hospital, Shenzhen 518000, P. R. China
| | - Lian-Zhong Ai
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China
| | - Yong-Jian Zhao
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional, Chinese Medicine, Shanghai 200032, P. R. China
| | - Xiao-Lei Bi
- Liaoning Konruns Pharmaceutical Co., Ltd, Dandong 118301, P. R. China
| | - Li Sui
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China
| | - Yan Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional, Chinese Medicine, Shanghai 200032, P. R. China
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12
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Tian Y, Gong Z, Zhao R, Zhu Y. Melatonin inhibits RANKL‑induced osteoclastogenesis through the miR‑882/Rev‑erbα axis in Raw264.7 cells. Int J Mol Med 2020; 47:633-642. [PMID: 33416111 PMCID: PMC7797465 DOI: 10.3892/ijmm.2020.4820] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
Melatonin, secreted in a typical diurnal rhythm pattern, has been reported to prevent osteoporosis; however, its role in osteoclastogenesis remains unclear. In the present study, the ability of melatonin to inhibit receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis and the associated mechanism were investigated. Raw264.7 cells were cultured with RANKL (100 ng/ml) and macrophage colony-stimulating factor (M-CSF; 30 ng/ml) for 7 days, and tartrate-resistant acid phosphatase (TRAP) staining was used to detect osteoclastogenesis following treatment with melatonin. In addition, the effect of melatonin on cathepsin K and microRNA (miR)-882 expression was investigated via western blotting and reverse transcription-quantitative PCR. Melatonin significantly inhibited RANKL-induced osteoclastogenesis in Raw264.7 cells. From bioinformatics analysis, it was inferred that nuclear receptor subfamily 1 group D member 1 (NR1D1/Rev-erbα) may be a target of miR-882. In vitro, melatonin upregulated Rev-erbα expression and downregulated miR-882 expression in the osteoclastogenesis model. Rev-erbα overexpression boosted the anti-osteoclastogenesis effects of melatonin, whereas miR-882 partially diminished these effects. The present results indicated that the miR-882/Rev-erbα axis may serve a vital role in inhibiting osteoclastogenesis following RANKL and M-CSF treatment, indicating that Rev-erbα agonism or miR-882 inhibition may represent mechanisms through which melatonin prevents osteoporosis.
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Affiliation(s)
- Yihao Tian
- Department of Orthopaedics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Zunlei Gong
- Department of Orthopaedics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Rui Zhao
- Department of Orthopaedics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yue Zhu
- Department of Orthopaedics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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13
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Liu C, Kuang X, Li K, Guo X, Deng Q, Li D. Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Food Funct 2020; 11:10817-10827. [PMID: 33237064 DOI: 10.1039/d0fo00787k] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of the present study was to explore whether combined calcium and vitamin D supplementation is beneficial for osteoporosis in postmenopausal women. METHODS We searched the PubMed, Cochrane library, Web of science and Embase databases and reference lists of eligible articles up to Feb, 2020. Randomized controlled trials (RCTs) evaluating the effect of combined calcium and vitamin D on osteoporosis in postmenopausal women were included in the present study. RESULTS Combined calcium and vitamin D significantly increased total bone mineral density (BMD) (standard mean differences (SMD) = 0.537; 95% confidence interval (CI): 0.227 to 0.847), lumbar spine BMD (SMD = 0.233; 95% CI: 0.073 to 0.392; P < 0.001), arms BMD (SMD = 0.464; 95% CI: 0.186 to 0.741) and femoral neck BMD (SMD = 0.187; 95% CI: 0.010 to 0.364). It also significantly reduced the incidence of hip fracture (RR = 0.864; 95% CI: 0.763 to 0.979). Subgroup analysis showed that combined calcium and vitamin D significantly increased femoral neck BMD only when the dose of the vitamin D intake was no more than 400 IU d-1 (SMD = 0.335; 95% CI: 0.113 to 0.558), but not for a dose more than 400 IU d-1 (SMD = -0.098; 95% CI: -0.109 to 0.305), and calcium had no effect on the femoral neck BMD. Subgroup analysis also showed only dairy products fortified with calcium and vitamin D had a significant influence on total BMD (SMD = 0.784; 95% CI: 0.322 to 1.247) and lumbar spine BMD (SMD = 0.320; 95% CI: 0.146 to 0.494), but not for combined calcium and vitamin D supplement. CONCLUSION Dairy products fortified with calcium and vitamin D have a favorable effect on bone mineral density. Combined calcium and vitamin D supplementation could prevent osteoporosis hip fracture in postmenopausal women.
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Affiliation(s)
- Chunxiao Liu
- Institute of Nutrition and Health, Qingdao University, Qingdao 266021, China.
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14
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Abstract
With increasing longevity of the population globally, the prevalence of osteoporosis will rise, associated with significant morbidity, disability and increased mortality. Adequate intake of calcium, vitamin D, increasing physical activity, a strategy of avoiding falls, cessation of smoking and avoiding excessive alcohol intake are pivotal in maintaining healthy bones in all age groups. Oral bisphosphonates remain the most cost-effective first line of treatment. Better methods of identifying patients with high fracture risk is needed as there is adequate effective treatment for osteoporosis.
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15
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Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients 2020; 12:nu12071986. [PMID: 32635394 PMCID: PMC7400143 DOI: 10.3390/nu12071986] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.
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Affiliation(s)
- Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de las Nieves Hospital, 18014 Granada, Spain
- Correspondence: (A.M.-G.); (M.M.-T.)
| | - Beatriz García-Fontana
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), 18014 Granada, Spain;
- CIBERFES, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), 18014 Granada, Spain;
- CIBERFES, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad de Gestión Clínica Endocrinología y Nutrición, Hospital Universitario San Cecilio de Granada, 18016 Granada, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
- Correspondence: (A.M.-G.); (M.M.-T.)
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16
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Holford N. Treatment response and disease progression. Transl Clin Pharmacol 2020; 27:123-126. [PMID: 32095479 PMCID: PMC7032964 DOI: 10.12793/tcp.2019.27.4.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 11/19/2022] Open
Abstract
This tutorial defines the concepts of disease progression in the context of clinical pharmacology. Disease progression describes the natural history of disease, such as pain, or biomarker of drug response, such as blood pressure. The action of a drug, such as inhibiting an enzyme or activating a receptor, leads to a change in disease status over time. Two main types of drug response can be defined based on the pattern of the time course of disease status. The most common is a symptomatic effect equivalent to a shift up or down of the natural history curve. Less common but quite clinically important is a disease-modifying effect equivalent to a change in the rate of disease progression.
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Affiliation(s)
- Nick Holford
- Department of Pharmacology & Clinical Pharmacology, University of Auckland, Auckland, New Zealand
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17
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Föger-Samwald U, Dovjak P, Azizi-Semrad U, Kerschan-Schindl K, Pietschmann P. Osteoporosis: Pathophysiology and therapeutic options. EXCLI JOURNAL 2020; 19:1017-1037. [PMID: 32788914 PMCID: PMC7415937 DOI: 10.17179/excli2020-2591] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022]
Abstract
Osteoporosis is a metabolic bone disease that, on a cellular level, results from osteoclastic bone resorption not compensated by osteoblastic bone formation. This causes bones to become weak and fragile, thus increasing the risk of fractures. Traditional pathophysiological concepts of osteoporosis focused on endocrine mechanisms such as estrogen or vitamin D deficiency as well as secondary hyperparathyroidism. However, research over the last decades provided exiting new insights into mechanisms contributing to the onset of osteoporosis, which go far beyond this. Selected mechanisms such as interactions between bone and the immune system, the gut microbiome, and cellular senescence are reviewed in this article. Furthermore, an overview on currently available osteoporosis medications including antiresorptive and bone forming drugs is provided and an outlook on potential future treatment options is given.
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Affiliation(s)
- Ursula Föger-Samwald
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- *To whom correspondence should be addressed: Ursula Föger-Samwald, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Tel: +43 (1) 40400-56940 or 51270, Fax: +43 (1) 40400-51300, E-mail:
| | - Peter Dovjak
- Department of Acute Geriatrics, Salzkammergut Klinikum Gmunden, Gmunden, Austria
| | - Ursula Azizi-Semrad
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Katharina Kerschan-Schindl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Pietschmann
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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18
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Te Karu L, Bryant L, Harwood M, Arroll B. Pounamu: Achieving health equity in Aotearoa New Zealand: the contribution of medicines optimisation. J Prim Health Care 2019; 10:11-15. [PMID: 30068445 DOI: 10.1071/hc17067] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This paper aims to consider the various parts of what is required to achieve the best possible health outcomes from medicines in partnership with the person for whom they are prescribed. Specifically, it looks to highlight the process from an Indigenous view with respect to Māori in Aotearoa New Zealand, and claims a multi-dimensional approach is imperative. Attaining optimal use of medicines is necessary to help achieve health equity. There is an urgent need to understand and investigate models of care that achieve this optimal state.
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Affiliation(s)
- Leanne Te Karu
- Department of General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
| | - Linda Bryant
- Department of General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- Te Kupenga Hauora M?ori, Faculty of Medical and Health Sciences University of Auckland, Auckland, New Zealand
| | - Bruce Arroll
- Department of General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
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19
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Wang Y, Ding H, Wang X, Wei Z, Feng S. Associated Factors for Osteoporosis and Fracture in Chinese Elderly. Med Sci Monit 2019; 25:5580-5588. [PMID: 31350990 PMCID: PMC6681684 DOI: 10.12659/msm.914182] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background The factors associated with osteoporosis are poorly understood in the Chinese population. This study aimed to examine the factors associated with osteoporosis and with fractures in a Chinese elderly population. Material/Methods This was a cross-sectional study of elderly people living in Tianjin between 2012 and 2014. Bone mineral density was measured by dual X-ray absorptiometry. The subjects completed a questionnaire about lifestyle habits, personal and family medical history, calcium intake, and exercising. Data were gathered on occurrence of fracture at 5 years or August 2018, whichever occurred first. Results There were 298 individuals with osteoporosis (18.5% male, median age 67 years) and 397 without (46.3% male, median age 62 years). Male sex (OR=0.051, 95% CI: 0.021–0.126), age (OR=1.049, 95% CI: 1.099–1.202), being divorced/widowed (OR=2.445, 95% CI: 1.219-4.904), digestive ulcer history (OR=3.805, 95% CI: 1.539–9.405), family history of hunchback (OR=2.659, 95% CI: 1.145–6.175), family history of osteoarthropathy (OR=4.222, 95% CI: 2.128–8.375), fracture history (OR=2.138, 95% CI: 1.307–3.496), drinking green tea (OR=0.352, 95% CI: 0.217–0.574), and exercising (OR=0.303, 95% CI: 0.193–0.475) were independently associated with osteoporosis. Digestive ulcer history (OR=3.183, 95% CI: 1.178–8.5992), exercising (OR=0.354, 95% CI: 0.139–0.903), and taking calcium supplements during follow-up (OR=0.262, 95% CI: 0.112–0.611) were independently associated with fractures in patients with osteoporosis. Conclusions Female sex, age, marital status, history of digestive ulcer and fracture, and family history of hunchback and osteoarthropathy are associated with osteoporosis among elderly subjects, while drinking green tea and exercising are inversely associated. Among the patients with osteoporosis, a history of digestive ulcer is associated with fractures, while exercising and taking calcium supplements are inversely associated.
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Affiliation(s)
- Yuqiang Wang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland).,Department of Orthopedic Surgery, Affiliated Hospital of Logistics, University of Chinese Armed Police Force, Tianjin, China (mainland)
| | - Han Ding
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Xiaohua Wang
- Department of Neurological, Intensive Care Unit, Tianjin Huanhu Hospital, Tianjin, China (mainland)
| | - Zhijian Wei
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Shiqing Feng
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
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20
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Anti-Obesity Effects of Dietary Calcium: The Evidence and Possible Mechanisms. Int J Mol Sci 2019; 20:ijms20123072. [PMID: 31234600 PMCID: PMC6627166 DOI: 10.3390/ijms20123072] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/07/2023] Open
Abstract
Obesity is a serious health challenge worldwide and is associated with various comorbidities, including dyslipidemia, type 2 diabetes, and cardiovascular disease. Developing effective strategies to prevent obesity is therefore of paramount importance. One potential strategy to reduce obesity is to consume calcium, which has been implicated to be involved in reducing body weight/fat. In this review, we compile the evidence for the anti-obesity roles of calcium in cells, animals, and humans. In addition, we summarize the possible anti-obesity mechanisms of calcium, including regulation of (a) adipogenesis, (b) fat metabolism, (c) adipocyte (precursor) proliferation and apoptosis, (d) thermogenesis, (e) fat absorption and excretion, and (f) gut microbiota. Although the exact anti-obesity roles of calcium in different subjects and how calcium induces the proposed anti-obesity mechanisms need to be further investigated, the current evidence demonstrates the anti-obesity effects of calcium and suggests the potential application of dietary calcium for prevention of obesity.
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21
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Molecular-Based Treatment Strategies for Osteoporosis: A Literature Review. Int J Mol Sci 2019; 20:ijms20102557. [PMID: 31137666 PMCID: PMC6567245 DOI: 10.3390/ijms20102557] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is an unavoidable public health problem in an aging or aged society. Anti-resorptive agents (calcitonin, estrogen, and selective estrogen-receptor modulators, bisphosphonates, anti-receptor activator of nuclear factor κB ligand antibody along with calcium and vitamin D supplementations) and anabolic agents (parathyroid hormone and related peptide analogs, sclerostin inhibitors) have major roles in current treatment regimens and are used alone or in combination based on the pathological condition. Recent advancements in the molecular understanding of bone metabolism and in bioengineering will open the door to future treatment paradigms for osteoporosis, including antibody agents, stem cells, and gene therapies. This review provides an overview of the molecular mechanisms, clinical evidence, and potential adverse effects of drugs that are currently used or under development for the treatment of osteoporosis to aid clinicians in deciding how to select the best treatment option.
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22
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Dovjak P. [Diagnostics and treatment of osteoporosis in patients over 65 years old : Current status and future perspectives]. Z Gerontol Geriatr 2019; 52:421-427. [PMID: 31087159 DOI: 10.1007/s00391-019-01548-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/20/2019] [Accepted: 04/04/2019] [Indexed: 12/31/2022]
Abstract
Only one third of all women with osteoporosis over the age of 65 years are adequately treated; therefore, many experience fractures. For men the data are insufficient. Using a newly developed algorithm and based on the current guidelines, the diagnosis and specific treatment of osteoporosis can be easily set up. The differential treatment should be selected in an individualized approach based on the side effect profile of the specific medication. No statistically significant differences were found between most specific osteoporotic drugs in head-to-head comparisons. This article presents an overview of the currently available pharmaceutical and non-pharmaceutical forms of treatment as well as approaches with novel medications and interventions for a better control of osteoporosis.
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Affiliation(s)
- Peter Dovjak
- Akutgeriatrie, Salzkammergutklinikum Gmunden, Miller-von-Aichholzstr. 49, 4810, Gmunden, Österreich.
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23
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Secondary fracture prevention: Drug treatment, fall prevention and nutrition requirements. Best Pract Res Clin Rheumatol 2019; 33:290-300. [PMID: 31547984 DOI: 10.1016/j.berh.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements. Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparatide should be considered. Adequate calcium and vitamin D are needed in all patients, together with appropriate nutrition, including adequate protein intake.
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24
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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: 40] [Impact Index Per Article: 6.7] [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.
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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
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25
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Franic D, Verdenik I. Risk Factors for Osteoporosis in Postmenopausal Women - from The Point of View of Primary Care Gynecologist. Zdr Varst 2018; 57:33-38. [PMID: 29651313 PMCID: PMC5894367 DOI: 10.2478/sjph-2018-0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 11/27/2017] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Osteoporosis is a highly prevalent public health problem with osteoporosis-related fractures that account for high morbidity and mortality. Therefore, prevention strategies and early detection of osteoporosis should be carried out in primary gynaecological care units, so as to substantially reduce the risk of fractures and allow the best treatment option for a particular woman. METHODS From 2002 to 2011, we recruited 2956 women. Of the total number of women, we additionally extrapolated 1274 women aged 60-75 years, assumingly, the group of women at higher risk of osteoporosis. Demographic and anthropometrical data as well as the information regarding risk factors for osteoporosis were collected using a questionnaire. RESULTS The odds ratio for osteoporosis increased by 8% (p=0.001) with each additional year of life. The OP prevalence increased with age from 24.9% in 60-64 years to 37.4% in 70-75 years. In non-smokers the odds ratio for osteoporosis was 0.424, which was statistically significant (p<0.05). BMI <18.5 increased the odds ratio for osteoporosis by 2 times, which was not statistically significant. In women 60-75 years old (N=1274), the risk of fractures increased with increasing age, considering previous fractures in the last 5 years (p<0.001), hip fracture (p=0.001), wrist fracture (p=0.002) and observed height loss (p<0.001). Hormone therapy (HT) use decreased the prevalence of OP by 25% in comparison with non-users. CONCLUSION Primary care gynaecologist with a DXA centre has every opportunity for a holistic approach to the management of postmenopausal women, including the prevention and treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Damir Franic
- Outpatient Clinic for Obstetrics and Gynecology, Celjska cesta 10, 3250Rogaska Slatina, Slovenia
| | - Ivan Verdenik
- University Clinical Center Ljubljana, Department for Obstetrics and Gynecology, Zaloska cesta 7, 1000Ljubljana, Slovenia
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Abstract
This article summarizes presentations of a symposium on bone health-related hot topics of the 2016 Basic Science Focus Forum. Taken together, these topics emphasize the critical importance of bone health in fracture management, the systemic factors that influence fracture healing, and the need to focus on issues other than simply the technical aspects of fracture repair.
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Franic D, Verdenik I. Risk factors for osteoporosis in postmenopausal women – from the point of view of primary care gynecologist. Zdr Varst 2018. [DOI: 10.1515/sjph-2018-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractIntroductionOsteoporosis is a highly prevalent public health problem with osteoporosis-related fractures that account for high morbidity and mortality. Therefore, prevention strategies and early detection of osteoporosis should be carried out in primary gynaecological care units, so as to substantially reduce the risk of fractures and allow the best treatment option for a particular woman.MethodsFrom 2002 to 2011, we recruited 2956 women. Of the total number of women, we additionally extrapolated 1274 women aged 60-75 years, assumingly, the group of women at higher risk of osteoporosis. Demographic and anthropometrical data as well as the information regarding risk factors for osteoporosis were collected using a questionnaire.ResultsThe odds ratio for osteoporosis increased by 8% (p=0.001) with each additional year of life. The OP prevalence increased with age from 24.9% in 60-64 years to 37.4% in 70-75 years. In non-smokers the odds ratio for osteoporosis was 0.424, which was statistically significant (p<0.05). BMI <18.5 increased the odds ratio for osteoporosis by 2 times, which was not statistically significant. In women 60-75 years old (N=1274), the risk of fractures increased with increasing age, considering previous fractures in the last 5 years (p<0.001), hip fracture (p=0.001), wrist fracture (p=0.002) and observed height loss (p<0.001). Hormone therapy (HT) use decreased the prevalence of OP by 25% in comparison with non-users.ConclusionPrimary care gynaecologist with a DXA centre has every opportunity for a holistic approach to the management of postmenopausal women, including the prevention and treatment of postmenopausal osteoporosis.
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Sprague S, Slobogean GP, Bogoch E, Petrisor B, Garibaldi A, O'Hara N, Bhandari M. Vitamin D Use and Health Outcomes After Surgery for Hip Fracture. Orthopedics 2017; 40:e868-e875. [PMID: 29039872 DOI: 10.3928/01477447-20170907-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/24/2017] [Indexed: 02/03/2023]
Abstract
Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation. The current study asked a subset of patients included in the FAITH study about vitamin D supplementation and categorized them as consistent users, inconsistent users, or nonusers. This study also evaluated whether supplementation was associated with improved quality of life and reduced reoperation rates. The final analysis included 573 patients (mean age, 74.1 years; female, 66.3%; nondis-placed fractures, 72.4%). A total of 18.7% of participants reported no use of vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use. Adjusted analysis found that consistent supplementation was associated with a 2.42 increase of the Short Form-12 physical component score 12 months postoperatively (P=.033). However, supplementation was not associated with reduced reoperation rates (P=.386). Despite guidelines recommending vitamin D supplementation, a low proportion of elderly patients with hip fracture use vitamin D consistently, suggesting a need for additional strategies to promote compliance. This study found that the use of vitamin D was associated with a statistically significant but not clinically significant improvement in health-related quality of life after hip fracture. Further research is needed to confirm these findings. [Orthopedics. 2017; 40(5):e868-e875.].
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Morley JE. Nutrition and Aging Well. J Am Med Dir Assoc 2017; 18:91-94. [DOI: 10.1016/j.jamda.2016.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
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Sorpreso ICE, Soares Júnior JM, Fonseca AMD, Baracat EC. Female aging. Rev Assoc Med Bras (1992) 2016; 61:553-6. [PMID: 26841166 DOI: 10.1590/1806-9282.61.06.553] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 10/23/2015] [Indexed: 12/21/2022] Open
Abstract
Female aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.
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Affiliation(s)
- Isabel Cristina Esposito Sorpreso
- Division of Gynecology, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Edmund Chada Baracat
- Division of Gynecology, Department of Obstetrics and Gynecology, FM, USP, São Paulo, SP, Brazil
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Grey A. Osteoporosis and Fracture Risk in Men with Prostate Cancer. Eur Urol 2016; 69:1026-7. [PMID: 26749094 DOI: 10.1016/j.eururo.2015.12.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand.
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