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Sakai T, Oishi T, Takashina Y, Hirao M. Serum 25(OH)D and vitamin K 1 levels in patients with severe motor and intellectual disability: A Japanese single-center experience. Brain Dev 2024; 46:268-273. [PMID: 38876823 DOI: 10.1016/j.braindev.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/29/2024] [Accepted: 06/09/2024] [Indexed: 06/16/2024]
Abstract
PURPOSE To investigate whether patients with severe motor and intellectual disability (SMID) have nutritional vitamin D and K insufficiencies and clarify the required vitamin supplementation. METHODS This prospective observational study enrolled Japanese adults with SMID receiving institutionalized care who underwent blood sampling between February 2020 and February 2022 during annual medical checkups. Serum vitamin K1 and 25-hydroxy vitamin D (25(OH)D) levels were measured to determine their relationship with serum uncarboxylated osteocalcin (ucOC) levels. Vitamin D and K intake was compared among tube-fed and oral-intake patients with SMID and control participants using corresponding serum levels. RESULTS The study included 124 patients with SMID (56 men and 68 women; mean age: 53.0 years) and 20 control participants. Serum 25(OH)D levels were significantly higher in the SMID group than in the control group and the oral intake SMID group than in the tube-fed SMID group. In the tube-fed SMID group, vitamin D intake was lower than the daily recommended intake and correlated with serum 25(OH)D levels. Daily vitamin K intake in the tube-fed group was lower than recommended but not correlated with serum vitamin K levels. Serum ucOC levels were significantly higher in the SMID group than in the control group. Tube feeding was significantly and positively correlated with serum 25(OH)D levels. Serum 25(OH)D levels were not correlated with serum vitamin K1 levels. CONCLUSIONS The SMID group had higher ucOC levels than the control group, possibly owing to daily vitamin K and D deficiencies. Vitamin D supplementation is recommended to decrease ucOC levels.
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Affiliation(s)
- Tomoko Sakai
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Tsutomu Oishi
- Department of Pediatrics, Akitsu Ryoiku-en, Tokyo, Japan
| | - Yusuke Takashina
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanobu Hirao
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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2
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Zhang Z, Xia K, Gong W, Mai R, Liu P, Lu Z. Efficacy of Recombinant Human Parathyroid Hormone 1-34 and Vitamin K2 Combination Therapy in Postmenopausal Osteoporosis. Horm Metab Res 2024. [PMID: 39197463 DOI: 10.1055/a-2371-1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2024]
Abstract
This study aimed to assess the efficacy and safety of a combined recombinant human parathyroid hormone 1-34 [rhPTH (1-34)] and vitamin K2 therapy versus vitamin K2 alone in the treatment of postmenopausal osteoporosis. A total of 77 postmenopausal osteoporosis patients were randomly divided into two groups. Patients in one group received vitamin K2 alone, while patients in the other group received a combination of rhPTH (1-34) and vitamin K2. Bone mineral density (BMD), electrolyte levels, pain scores, bone metabolism levels, and adverse drug reactions were compared pre- and post-treatment. Both two treatments improved BMD, blood calcium concentrations, pain scores, and increased osteocalcin and osteoprotegerin levels. Notably, the combined rhPTH (1-34) and vitamin K2 treatment demonstrated superior efficacy in improving BMD and bone metabolism markers. Furthermore, there was no significant difference in the incidence of adverse reactions between the two groups, indicating the safety of the combined treatment. In summary, the combined therapy of rhPTH (1-34) and vitamin K2 exhibited more potent efficacy in the treatment of postmenopausal osteoporosis, more effectively enhancing BMD and bone metabolism markers than vitamin K2 alone, without a significant increase in adverse reactions.
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Affiliation(s)
- Zhuo Zhang
- Surgery of Spine and Bone Tumors, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Kun Xia
- Surgery of Spine and Bone Tumors, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Wentao Gong
- Surgery of Spine and Bone Tumors, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Ruopeng Mai
- Surgery of Spine and Bone Tumors, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Peng Liu
- Surgery of Spine and Bone Tumors, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Zhaogang Lu
- Department of Clinical Pharmacy, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
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3
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Aaseth JO, Finnes TE, Askim M, Alexander J. The Importance of Vitamin K and the Combination of Vitamins K and D for Calcium Metabolism and Bone Health: A Review. Nutrients 2024; 16:2420. [PMID: 39125301 PMCID: PMC11313760 DOI: 10.3390/nu16152420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
The aim of the present review is to discuss the roles of vitamin K (phylloquinone or menaquinones) and vitamin K-dependent proteins, and the combined action of the vitamins K and D, for the maintenance of bone health. The most relevant vitamin K-dependent proteins in this respect are osteocalcin and matrix Gla-protein (MGP). When carboxylated, these proteins appear to have the ability to chelate and import calcium from the blood to the bone, thereby reducing the risk of osteoporosis. Carboxylated osteocalcin appears to contribute directly to bone quality and strength. An adequate vitamin K status is required for the carboxylation of MGP and osteocalcin. In addition, vitamin K acts on bone metabolism by other mechanisms, such as menaquinone 4 acting as a ligand for the nuclear steroid and xenobiotic receptor (SXR). In this narrative review, we examine the evidence for increased bone mineralization through the dietary adequacy of vitamin K. Summarizing the evidence for a synergistic effect of vitamin K and vitamin D3, we find that an adequate supply of vitamin K, on top of an optimal vitamin D status, seems to add to the benefit of maintaining bone health. More research related to synergism and the possible mechanisms of vitamins D3 and K interaction in bone health is needed.
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Affiliation(s)
- Jan O. Aaseth
- Department of Research, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, N-2418 Elverum, Norway
| | - Trine Elisabeth Finnes
- Department of Medicine, Innlandet Hospital Hamar, P.O. Box 4453, N-2326 Hamar, Norway;
- Department of Endocrinology, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Merete Askim
- Independent Researcher, Bromstadvegen 43, N-7045 Trondheim, Norway;
| | - Jan Alexander
- Norwegian Institute of Public Health, P.O. Box 222 Skøyen, N-0213 Oslo, Norway;
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Rusu ME, Bigman G, Ryan AS, Popa DS. Investigating the Effects and Mechanisms of Combined Vitamin D and K Supplementation in Postmenopausal Women: An Up-to-Date Comprehensive Review of Clinical Studies. Nutrients 2024; 16:2356. [PMID: 39064799 PMCID: PMC11279569 DOI: 10.3390/nu16142356] [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: 06/13/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Aging is a complex process and a significant risk factor for chronic diseases. Menopause, a component of aging in women, is associated with several important cardiometabolic conditions including metabolic syndrome, osteoporosis, and cardiovascular diseases. Menopausal women could benefit from preventative strategies that may decrease morbidity and mortality and improve their quality of life. Vitamins D and K are essential nutrients required for bone health, immune function, and reducing cardiovascular risks, yet their synergistic effect is less understood in aging women. This is the first comprehensive review to summarize the evidence found in randomized clinical trials of the beneficial effects of vitamin D and K co-treatment in postmenopausal women. In our literature search across key electronic databases such as Cochrane, PubMed, and Ovid, we identified 31 pertinent studies. Overall, significant findings indicate that the combined intake of vitamins D and K may positively affect cardiovascular and bone health in postmenopausal women, emphasizing the importance of maintaining a healthy diet rich in vegetables and fermented dairy products. Given the challenges in obtaining all necessary nutrients solely through the diet, vitamin D and K supplements are recommended for postmenopausal women to promote healthy aging and well-being.
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Affiliation(s)
- Marius Emil Rusu
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Galya Bigman
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Alice S. Ryan
- Baltimore Veterans Affairs Medical Center, Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Baltimore Geriatric Research, Education and Clinical Center, Veterans Affairs Maryland Health Care System, Baltimore, MD 21201, USA
| | - Daniela-Saveta Popa
- Department of Toxicology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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Marinari M, Marini F, Giusti F, Brandi ML. Role of Nutrition in the Management of Patients with Multiple Endocrine Neoplasia Type 1. Nutrients 2024; 16:1576. [PMID: 38892509 PMCID: PMC11174418 DOI: 10.3390/nu16111576] [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: 04/15/2024] [Revised: 05/18/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome caused by inactivating mutations in the MEN1 tumor suppressor gene. The three main clinical manifestations of MEN1 are primary hyperparathyroidism (PHPT), duodenal-pancreatic neuroendocrine tumors (DP-NETs) and anterior pituitary tumors. Endocrine tumors in patients with MEN1 differ from sporadic tumors because of their younger age at onset, common multiple presentations and the different clinical course. MEN1 is characterized by a complex clinical phenotype; thus, patients should be followed by a multidisciplinary team of experts that includes an endocrinologist, a surgeon, a oncologist, a radiotherapist, and not least, a nutritionist. It is important to remember the fundamental role that diet plays as a primary prevention tool, together with a healthy and active lifestyle in preventing osteoporosis/osteopenia and reducing the risk of developing kidney stones due to hypercalciuria, two frequent clinical complications in MEN1 patients. Is very important for MEN1 patients to have an adequate intake of calcium, vitamin D, magnesium and phosphate to maintain good bone health. The intake of foods containing oxalates must also be kept under control because in combination with calcium they concur to form calcium oxalate crystals, increasing the risk of nephrolithiasis. Another aspect to consider is the management of patients with pancreatic neuroendocrine tumors undergoing major surgical resections of the pancreas that can lead to alterations in digestion and absorption mechanisms due to partial or total reduction in pancreatic enzymes such as amylase, lipase, and protease, resulting in malabsorption and malnutrition. Therefore, the nutritionist's aim should be to devise a dietary plan that takes into consideration each single patient, educating them about a healthy and active lifestyle, and accompanying them through various life stages by implementing strategies that can enhance their quality of life.
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Affiliation(s)
- Monica Marinari
- Department of Pharmacy, University of Pisa, 56120 Pisa, Italy;
| | - Francesca Marini
- Fondazione Italiana Ricerca Sulle Malattie dell’Osso (FIRMO Onlus), 50129 Florence, Italy;
| | - Francesca Giusti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50139 Florence, Italy;
| | - Maria Luisa Brandi
- Fondazione Italiana Ricerca Sulle Malattie dell’Osso (FIRMO Onlus), 50129 Florence, Italy;
- Donatello Bone Clinic, Villa Donatello Hospital, 50019 Sesto Fiorentino, Italy
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6
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Xu R, Chen Y, Yao Z, Wu W, Cui J, Wang R, Diao Y, Jin C, Hong Z, Li X. Application of machine learning algorithms to identify people with low bone density. Front Public Health 2024; 12:1347219. [PMID: 38726233 PMCID: PMC11080984 DOI: 10.3389/fpubh.2024.1347219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/29/2024] [Indexed: 05/12/2024] Open
Abstract
Background Osteoporosis is becoming more common worldwide, imposing a substantial burden on individuals and society. The onset of osteoporosis is subtle, early detection is challenging, and population-wide screening is infeasible. Thus, there is a need to develop a method to identify those at high risk for osteoporosis. Objective This study aimed to develop a machine learning algorithm to effectively identify people with low bone density, using readily available demographic and blood biochemical data. Methods Using NHANES 2017-2020 data, participants over 50 years old with complete femoral neck BMD data were selected. This cohort was randomly divided into training (70%) and test (30%) sets. Lasso regression selected variables for inclusion in six machine learning models built on the training data: logistic regression (LR), support vector machine (SVM), gradient boosting machine (GBM), naive Bayes (NB), artificial neural network (ANN) and random forest (RF). NHANES data from the 2013-2014 cycle was used as an external validation set input into the models to verify their generalizability. Model discrimination was assessed via AUC, accuracy, sensitivity, specificity, precision and F1 score. Calibration curves evaluated goodness-of-fit. Decision curves determined clinical utility. The SHAP framework analyzed variable importance. Results A total of 3,545 participants were included in the internal validation set of this study, of whom 1870 had normal bone density and 1,675 had low bone density Lasso regression selected 19 variables. In the test set, AUC was 0.785 (LR), 0.780 (SVM), 0.775 (GBM), 0.729 (NB), 0.771 (ANN), and 0.768 (RF). The LR model has the best discrimination and a better calibration curve fit, the best clinical net benefit for the decision curve, and it also reflects good predictive power in the external validation dataset The top variables in the LR model were: age, BMI, gender, creatine phosphokinase, total cholesterol and alkaline phosphatase. Conclusion The machine learning model demonstrated effective classification of low BMD using blood biomarkers. This could aid clinical decision making for osteoporosis prevention and management.
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Affiliation(s)
- Rongxuan Xu
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Zhihan Yao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Wei Wu
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Zhijun Hong
- The Health Management Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
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7
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Alabadi B, Civera M, Moreno-Errasquin B, Cruz-Jentoft AJ. Nutrition-Based Support for Osteoporosis in Postmenopausal Women: A Review of Recent Evidence. Int J Womens Health 2024; 16:693-705. [PMID: 38650834 PMCID: PMC11034565 DOI: 10.2147/ijwh.s409897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Postmenopausal osteoporosis stands as the predominant bone disorder in the developed world, posing a significant public health challenge. Nutritional factors play a crucial role in bone health and may contribute to its prevention or treatment. Calcium and vitamin D, extensively studied with robust scientific evidence, are integral components of the non-pharmacological treatment for this disorder. Nevertheless, other less-explored nutritional elements appear to influence bone metabolism. This review provides a comprehensive summary of the latest evidence concerning the relationship between various nutrients, such as phosphorus, magnesium, vitamins, phytate, and phytoestrogens; specific foods like dairy or soy, and dietary patterns such as the Mediterranean diet with bone health and osteoporosis.
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Affiliation(s)
- Blanca Alabadi
- Service of Endocrinology and Nutrition, Hospital Clinico Universitario of Valencia, Valencia, 46010, Spain
- INCLIVA Biomedical Research Institute, Valencia, 46010, Spain
| | - Miguel Civera
- Service of Endocrinology and Nutrition, Hospital Clinico Universitario of Valencia, Valencia, 46010, Spain
- Department of Medicine, University of Valencia, Valencia, 46010, Spain
| | | | - Alfonso J Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, 28034, Spain
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8
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Chen S, Zhang Z, Liu S, Chen T, Lu Z, Zhao W, Mou X, Liu S. Consistent signatures in the human gut microbiome of longevous populations. Gut Microbes 2024; 16:2393756. [PMID: 39197040 PMCID: PMC11364081 DOI: 10.1080/19490976.2024.2393756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 08/30/2024] Open
Abstract
Gut microbiota of centenarians has garnered significant attention in recent years, with most studies concentrating on the analysis of microbial composition. However, there is still limited knowledge regarding the consistent signatures of specific species and their biological functions, as well as the potential causal relationship between gut microbiota and longevity. To address this, we performed the fecal metagenomic analysis of eight longevous populations at the species and functional level, and employed the Mendelian randomization (MR) analysis to infer the causal associations between microbial taxa and longevity-related traits. We observed that several species including Eisenbergiella tayi, Methanobrevibacter smithii, Hungatella hathewayi, and Desulfovibrio fairfieldensis were consistently enriched in the gut microbiota of long-lived individuals compared to younger elderly and young adults across multiple cohorts. Analysis of microbial pathways and enzymes indicated that E. tayi plays a role in the protein N-glycosylation, while M. smithii is involved in the 3-dehydroquinate and chorismate biosynthesis. Furthermore, H. hathewayi makes a distinct contribution to the purine nucleobase degradation I pathway, potentially assisting the elderly in maintaining purine homeostasis. D. fairfieldensis contributes to the menaquinone (vitamin K2) biosynthesis, which may help prevent age-related diseases such as osteoporosis-induced fractures. According to MR results, Hungatella was significantly positively correlated with parental longevity, and Desulfovibrio also exhibited positive associations with lifespan and multiple traits related to parental longevity. Additionally, Alistipes and Akkermansia muciniphila were consistently enriched in the gut microbiota of the three largest cohorts of long-lived individuals, and MR analysis also suggests their potential causal relationships with longevity. Our findings reveal longevity-associated gut microbial signatures, which are informative for understanding the role of microbiota in regulating longevity and aging.
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Affiliation(s)
- Shu Chen
- Shenzhen Key Laboratory of Systems Medicine for Inflammatory Diseases, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China
- Department of Pathology, the Seven Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Zhao Zhang
- Research and Development Center, Center of Human Microecology Engineering and Technology of Guangdong Province, Guangzhou, Guangdong, China
| | - Sanxin Liu
- Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tao Chen
- Research and Development Center, Center of Human Microecology Engineering and Technology of Guangdong Province, Guangzhou, Guangdong, China
| | - Zhengqi Lu
- Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenjing Zhao
- Shenzhen Key Laboratory of Systems Medicine for Inflammatory Diseases, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Xiangyu Mou
- Shenzhen Key Laboratory of Systems Medicine for Inflammatory Diseases, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Sheng Liu
- Shenzhen Key Laboratory of Systems Medicine for Inflammatory Diseases, School of Medicine, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China
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Skalny AV, Aschner M, Tsatsakis A, Rocha JB, Santamaria A, Spandidos DA, Martins AC, Lu R, Korobeinikova TV, Chen W, Chang JS, Chao JC, Li C, Tinkov AA. Role of vitamins beyond vitamin D 3 in bone health and osteoporosis (Review). Int J Mol Med 2024; 53:9. [PMID: 38063255 PMCID: PMC10712697 DOI: 10.3892/ijmm.2023.5333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
The objective of the present review was to summarize the molecular mechanisms associated with the effects of the vitamins A, C, E and K, and group B vitamins on bone and their potential roles in the development of osteoporosis. Epidemiological findings have demonstrated an association between vitamin deficiency and a higher risk of developing osteoporosis; vitamins are positively related to bone health upon their intake at the physiological range. Excessive vitamin intake can also adversely affect bone formation, as clearly demonstrated for vitamin A. Vitamins E (tocopherols and tocotrienols), K2 (menaquinones 4 and 7) and C have also been shown to promote osteoblast development through bone morphogenetic protein (BMP)/Smad and Wnt/β‑catenin signaling, as well as the TGFβ/Smad pathway (α‑tocopherol). Vitamin A metabolite (all‑trans retinoic acid) exerts both inhibitory and stimulatory effects on BMP‑ and Wnt/β‑catenin‑mediated osteogenesis at the nanomolar and micromolar range, respectively. Certain vitamins significantly reduce receptor activator of nuclear factor kappa‑B ligand (RANKL) production and RANKL/RANK signaling, while increasing the level of osteoprotegerin (OPG), thus reducing the RANKL/OPG ratio and exerting anti‑osteoclastogenic effects. Ascorbic acid can both promote and inhibit RANKL signaling, being essential for osteoclastogenesis. Vitamin K2 has also been shown to prevent vascular calcification by activating matrix Gla protein through its carboxylation. Therefore, the maintenance of a physiological intake of vitamins should be considered as a nutritional strategy for the prevention of osteoporosis.
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Affiliation(s)
- Anatoly V. Skalny
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Aristidis Tsatsakis
- Laboratory of Toxicology and Forensic Sciences, Division of Morphology, Medical School, University of Crete, 70013 Heraklion, Greece
| | - Joao B.T. Rocha
- Department of Biochemistry and Molecular Biology, CCNE, Federal University of Santa Maria, Santa Maria, RS 97105-900, Brazil
| | - Abel Santamaria
- Faculty of Science, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 70013 Heraklion, Greece
| | - Airton C. Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Rongzhu Lu
- Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Tatiana V. Korobeinikova
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
| | - Wen Chen
- Department of Toxicology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jung-Su Chang
- College of Nutrition, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Jane C.J. Chao
- College of Nutrition, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu 215300, P.R. China
| | - Alexey A. Tinkov
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
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10
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Andrian T, Stefan A, Nistor I, Covic A. Vitamin K supplementation impact in dialysis patients: a systematic review and meta-analysis of randomized trials. Clin Kidney J 2023; 16:2738-2749. [PMID: 38046003 PMCID: PMC10689161 DOI: 10.1093/ckj/sfad255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Indexed: 12/05/2023] Open
Abstract
Vitamin K supplementation has been considered recently as a potential treatment for addressing vascular calcification in chronic kidney disease patients. We conducted a systematic review and meta-analysis to summarize the impact of vitamin K supplementation in dialysis patients. Electronic databases were searched for clinical randomized trials among patients treated with vitamin K. Random effects models were performed and risk of bias was evaluated with Cochrane tools and the search was conducted until 15 of September 2023. Eleven trials comprising 830 patients (both adult and pediatric, mainly hemodialysis) compared vitamin K with different controls: lower doses of vitamin K, standard care or placebo. Vitamin K supplementation had no effect on mortality. Vitamin K administration improved vitamin K levels and led to lower levels of dp-uc-MGP and moderately increased calcium levels [0.18 (0.04-0.32)]. Vitamin K1 proved more potency in reducing dp-uc-MGP [SMD -1.64 (-2.05, -1.23) vs. -0.56 (-0.82, -0.31)] and also raised serum vitamin K levels in comparison with vitamin K2 [5.69 (3.43, 7.94) vs. 2.25 (-2.36, 6.87)]. While it did not have a proved benefit in changing calcification scores [-0.14 (-0.37 ± 0.09)], vitamin K proved to be a safe product. There was some concern with bias. Vitamin K supplementation has no impact on mortality and did not show significant benefit in reversing calcification scores. Vitamin K1 improved vitamin K deposits and lowered dp-uc-MGP, which is a calcification biomarker more than vitamin K2. As it proved to be a safe product, additional randomized well-powered studies with improved treatment regimens are needed to establish the true impact of vitamin K in dialysis patients.
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Affiliation(s)
- Titus Andrian
- Internal Medicine, Nephrology, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iasi, Romania
- Nephrology, Dialysis, Transplantation, Spitalul Clinic Dr C I Parhon, Iasi, Romania
| | - Anca Stefan
- Nephrology, Dialysis, Transplantation, Spitalul Clinic Dr C I Parhon, Iasi, Romania
| | - Ionut Nistor
- Internal Medicine, Nephrology, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iasi, Romania
- Nephrology, Dialysis, Transplantation, Spitalul Clinic Dr C I Parhon, Iasi, Romania
| | - Adrian Covic
- Internal Medicine, Nephrology, Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iasi, Romania
- Nephrology, Dialysis, Transplantation, Spitalul Clinic Dr C I Parhon, Iasi, Romania
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11
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Wang H, Ma Y. The Potential of Vitamin K as a Regulatory Factor of Bone Metabolism-A Review. Nutrients 2023; 15:4935. [PMID: 38068793 PMCID: PMC10708186 DOI: 10.3390/nu15234935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
Vitamin K (VK), a fat-soluble vitamin, is essential for the clotting of blood because of its role in the production of clotting factors in the liver. Moreover, researchers continue to explore the role of VK as an emerging novel bioactive molecule with the potential function of improving bone health. This review focuses on the effects of VK on bone health and related mechanisms, covering VK research history, homologous analogs, dietary sources, bioavailability, recommended intake, and deficiency. The information summarized here could contribute to the basic and clinical research on VK as a natural dietary additive and drug candidate for bone health. Future research is needed to extend the dietary VK database and explore the pharmacological safety of VK and factors affecting VK bioavailability to provide more support for the bone health benefits of VK through more clinical trials.
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Affiliation(s)
- Huakai Wang
- Department of Animal Nutrition and Feed Science, State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China;
- Institute of Animal Husbandry and Veterinary Medicine, Anhui Academy of Agricultural Sciences, Nongkenan Road No. 40, Hefei 230031, China
| | - Yongxi Ma
- Department of Animal Nutrition and Feed Science, State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China;
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Yoshida S, Shiraishi R, Nakayama Y, Taira Y. Can Nutrition Contribute to a Reduction in Sarcopenia, Frailty, and Comorbidities in a Super-Aged Society? Nutrients 2023; 15:2991. [PMID: 37447315 DOI: 10.3390/nu15132991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Many countries are facing the advent of super-aging societies, where sarcopenia and frailty will become pertinent problems. The prevalence of comorbidities is a major problem in countries with aged populations as elderly people suffer from various diseases, such as diabetes, heart failure, chronic kidney disease and dementia. All of these diseases are associated with sarcopenia and frailty, and they frequently cause falls, fractures, and a decline in activities of daily living. Fractures in the elderly people are associated with bone fragility, which is influenced by diabetes and chronic kidney disease. Nutritional support for chronic disease patients and sarcopenic individuals with adequate energy and protein intake, vitamin D supplementation, blood glucose level management for individuals with diabetes, obesity prevention, nutritional education for healthy individuals, and the enlightenment of society could be crucial to solve the health-related problems in super-aging societies.
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Affiliation(s)
- Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
- Department of Health and Nutrition, Okinawa University, 555 Kokuba, Naha 902-8521, Okinawa, Japan
- Faculty of Health Sciences, Kinjo University, 1200 Kasama-machi, Hakusan 924-8511, Ishikawa, Japan
| | - Ryo Shiraishi
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
| | - Yuki Nakayama
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
| | - Yasuko Taira
- Faculty of Nutrition, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
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Lecomte M, Tomassi D, Rizzoli R, Tenon M, Berton T, Harney S, Fança-Berthon P. Effect of a Hop Extract Standardized in 8-Prenylnaringenin on Bone Health and Gut Microbiome in Postmenopausal Women with Osteopenia: A One-Year Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2023; 15:2688. [PMID: 37375599 DOI: 10.3390/nu15122688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Estrogen deficiency increases the risk of osteoporosis and fracture. The aim of this study was to investigate whether a hop extract standardized in 8-prenylnaringenin (8-PN), a potent phytoestrogen, could improve bone status of osteopenic women and to explore the gut microbiome roles in this effect. In this double-blind, placebo-controlled, randomized trial, 100 postmenopausal, osteopenic women were supplemented with calcium and vitamin D3 (CaD) tablets and either a hop extract (HE) standardized in 8-PN (n = 50) or a placebo (n = 50) for 48 weeks. Bone mineral density (BMD) and bone metabolism were assessed by DXA measurements and plasma bone biomarkers, respectively. Participant's quality of life (SF-36), gut microbiome composition, and short-chain fatty acid (SCFA) levels were also investigated. In addition to the CaD supplements, 48 weeks of HE supplementation increased total body BMD (1.8 ± 0.4% vs. baseline, p < 0.0001; 1.0 ± 0.6% vs. placebo, p = 0.08), with a higher proportion of women experiencing an increase ≥1% compared to placebo (odds ratio: 2.41 ± 1.07, p < 0.05). An increase in the SF-36 physical functioning score was observed with HE versus placebo (p = 0.05). Gut microbiome α-diversity and SCFA levels did not differ between groups. However, a higher abundance of genera Turicibacter and Shigella was observed in the HE group; both genera have been previously identified as associated with total body BMD. These results suggest that an 8-PN standardized hop extract could beneficially impact bone health of postmenopausal women with osteopenia.
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Affiliation(s)
| | | | - René Rizzoli
- Service of Bone Disease, Geneva University Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland
| | | | | | - Sinead Harney
- Rheumatology Department, Cork University Hospital, T12 DFK4 Cork, Ireland
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Wang H, Luo Y, Wang H, Li F, Yu F, Ye L. Mechanistic advances in osteoporosis and anti-osteoporosis therapies. MedComm (Beijing) 2023; 4:e244. [PMID: 37188325 PMCID: PMC10175743 DOI: 10.1002/mco2.244] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/15/2023] [Accepted: 03/06/2023] [Indexed: 05/17/2023] Open
Abstract
Osteoporosis is a type of bone loss disease characterized by a reduction in bone mass and microarchitectural deterioration of bone tissue. With the intensification of global aging, this disease is now regarded as one of the major public health problems that often leads to unbearable pain, risk of bone fractures, and even death, causing an enormous burden at both the human and socioeconomic layers. Classic anti-osteoporosis pharmacological options include anti-resorptive and anabolic agents, whose ability to improve bone mineral density and resist bone fracture is being gradually confirmed. However, long-term or high-frequency use of these drugs may bring some side effects and adverse reactions. Therefore, an increasing number of studies are devoted to finding new pathogenesis or potential therapeutic targets of osteoporosis, and it is of great importance to comprehensively recognize osteoporosis and develop viable and efficient therapeutic approaches. In this study, we systematically reviewed literatures and clinical evidences to both mechanistically and clinically demonstrate the state-of-art advances in osteoporosis. This work will endow readers with the mechanistical advances and clinical knowledge of osteoporosis and furthermore present the most updated anti-osteoporosis therapies.
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Affiliation(s)
- Haiwei Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
- Department of EndodonticsWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Yuchuan Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
- Department of EndodonticsWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Haisheng Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Feifei Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Fanyuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
- Department of EndodonticsWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
- Department of EndodonticsWest China Hospital of StomatologySichuan UniversityChengduChina
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Hmamouchi I, Paruk F, Tabra S, Maatallah K, Bouziane A, Abouqal R, El Maidany Y, El Maghraoui A, Kalla AA. Prevalence of glucocorticoid-induced osteoporosis among rheumatology patients in Africa: a systematic review and meta-analysis. Arch Osteoporos 2023; 18:59. [PMID: 37129714 DOI: 10.1007/s11657-023-01246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
The prevalence of glucocorticosteroid-induced osteoporosis (GIOP) is well established in higher income countries. There are limited studies showing a wide prevalence of GIOP in Africa. Prospective studies are needed on GIOP in African rheumatology patients to implement appropriate management algorithms. PURPOSE The prevalence of glucocorticosteroid-induced osteoporosis (GIOP) is well established in developed countries, but little is known about GIOP in African adult patients with inflammatory rheumatic musculoskeletal diseases (RMDs). This study aimed to determine the prevalence of GIOP and osteoporotic fracture risk in African patients with inflammatory RMDs according to radiographic and bone mineral density (BMD) findings. METHODS PubMed, Google Scholar, Scopus, and African Index Medicus were searched up to 31 December 2020. Heterogeneity was assessed using I2 statistic across the included studies. A random-effects model was applied to estimate the pooled effect size across studies. All statistical analyses were performed using STATA™ version 14 software. The study was registered with PROSPERO, number CRD42021256252. RESULTS In this meta-analysis, a total of 7 studies with 780 participants, stratified by geographical region were included. The pooled prevalence of GIOP based on BMD data was 47.7% (95% CI 32.9-62.8) with 52.2% (95% CI 36.5-67.6) in North African countries and 15.4% (95% 1.9-45.4%) in South Africa with a high heterogeneity (I2 = 93.3%, p = 0.018). There was no data from the rest of African countries. We were unable to complete the meta-analysis of osteoporotic fractures due to the lack of available data. CONCLUSION This study revealed that the prevalence of GIOP varies significantly in Africa. There is no information, however, for most of Africa, and further prospective studies are needed to develop context-specific GIOP preventive strategies in patients with RMDs.
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Affiliation(s)
- Ihsane Hmamouchi
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University Rabat, Rabat, Morocco.
- Health Sciences College, International University of Rabat (UIR), Rabat, Morocco.
| | - Farhanah Paruk
- Department of Rheumatology, Inkosi Albert Luthuli Central Hospital, School of Clinical Medicine, College of Health Science, University of Kwa-Zulu Natal, Durban, South Africa
| | - Samar Tabra
- Lecturer of Rheumatology, Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Kaouther Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Amal Bouziane
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University Rabat, Rabat, Morocco
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University Rabat, Rabat, Morocco
- Acute Medical Unit, Ibn Sina University Hospital, Rabat, Morocco
| | - Yasser El Maidany
- Rheumatology Department, Canterbury Christ Church University, Canterbury, UK
| | - Abdellah El Maghraoui
- Private Medical Office, Rabat, Morocco
- Mohammed V University in Rabat, Rabat, Morocco
| | - Asgar Ali Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Piscaer I, Janssen R, Franssen FME, Schurgers LJ, Wouters EFM. The Pleiotropic Role of Vitamin K in Multimorbidity of Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 12:1261. [PMID: 36835797 PMCID: PMC9964521 DOI: 10.3390/jcm12041261] [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: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Although defined by the presence of airflow obstruction and respiratory symptoms, patients with chronic obstructive pulmonary disease (COPD) are characterized by multimorbidity. Numerous co-occurring conditions and systemic manifestations contribute to the clinical presentation and progression of COPD; however, underlying mechanisms for multimorbidity are currently not fully elucidated. Vitamin A and vitamin D have been related to COPD pathogenesis. Another fat-soluble vitamin, vitamin K, has been put forward to exert protective roles in COPD. Vitamin K is an unequivocal cofactor for the carboxylation of coagulation factors, but also for extra-hepatic proteins including the soft tissue calcification inhibitor matrix Gla-protein and the bone protein osteocalcin. Additionally, vitamin K has been shown to have anti-oxidant and anti-ferroptosis properties. In this review, we discuss the potential role of vitamin K in the systemic manifestations of COPD. We will elaborate on the effect of vitamin K on prevalent co-occurring chronic conditions in COPD including cardiovascular disorders, chronic kidney disease, osteoporosis, and sarcopenia. Finally, we link these conditions to COPD with vitamin K as a connecting factor and provide recommendations for future clinical studies.
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Affiliation(s)
- Ianthe Piscaer
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6200 MD Maastricht, The Netherlands
| | - Rob Janssen
- Department of Respiratory Medicine, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Frits M. E. Franssen
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6200 MD Maastricht, The Netherlands
- Department of Research and Development, CIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands
| | - Leon J. Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200 MD Maastricht, The Netherlands
| | - Emiel F. M. Wouters
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6200 MD Maastricht, The Netherlands
- Department of Research and Development, CIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria
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