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Chen YJ, Jia LH, Han TH, Zhao ZH, Yang J, Xiao JP, Yang HJ, Yang K. Osteoporosis treatment: current drugs and future developments. Front Pharmacol 2024; 15:1456796. [PMID: 39188952 PMCID: PMC11345277 DOI: 10.3389/fphar.2024.1456796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 07/31/2024] [Indexed: 08/28/2024] Open
Abstract
Osteoporosis is a common systemic metabolic disease characterized by a decrease in bone density and bone mass, destruction of bone tissue microstructure, and increased bone fragility leading to fracture susceptibility. Pharmacological treatment of osteoporosis is the focus of current research, and anti-osteoporosis drugs usually play a role in inhibiting bone resorption, promoting bone formation, and having a dual role. However, most of the drugs have the disadvantages of single target and high toxic and side effects. There are many types of traditional Chinese medicines (TCM), from a wide range of sources and mostly plants. Herbal plants have unique advantages in regulating the relationship between osteoporosis and the immune system, acupuncture therapy has significant therapeutic effects in combination with medicine for osteoporosis. The target cells and specific molecular mechanisms of TCM in preventing and treating osteoporosis have not been fully elucidated. At present, there is a lack of comprehensive understanding of the pathological mechanism of the disease. Therefore, a better understanding of the pathological signaling pathways and key molecules involved in the pathogenesis of osteoporosis is crucial for the design of therapeutic targets and drug development. In this paper, we review the development and current status of anti-osteoporosis drugs currently in clinical application and under development to provide relevant basis and reference for drug prevention and treatment of osteoporosis, with the aim of promoting pharmacological research and new drug development.
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Affiliation(s)
- Ya-jing Chen
- 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, China
- Department of Urology, Jinhua Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Jinhua, China
- Zhejiang Provincial Key Laboratory of Biometrology and Inspection and Quarantine, College of Life Science, China Jiliang University, Hangzhou, China
| | - Li-hua Jia
- Department of Urology, Jinhua Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Jinhua, China
| | - Tao-hong Han
- Zhejiang Provincial Key Laboratory of Biometrology and Inspection and Quarantine, College of Life Science, China Jiliang University, Hangzhou, China
| | - Zhi-hui Zhao
- Zhejiang Provincial Key Laboratory of Biometrology and Inspection and Quarantine, College of Life Science, China Jiliang University, Hangzhou, China
| | - Jian Yang
- State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
- Dexing Research and Training Center of Chinese Medical Sciences, Dexing, China
| | - Jun-ping Xiao
- Jiangxi Prozin Pharmaceutical Co., Ltd., Jiangxi, China
| | - Hong-Jun Yang
- 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, China
| | - Ke Yang
- 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, China
- Zhejiang Provincial Key Laboratory of Biometrology and Inspection and Quarantine, College of Life Science, China Jiliang University, Hangzhou, China
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Abbasi B, Hajinasab MM, Mohammadi Zadeh Z, Ahmadi P. Diversity of the diet is correlated with osteoporosis in post-menopausal women: an Iranian case-control study. Front Public Health 2024; 12:1431181. [PMID: 39185118 PMCID: PMC11342058 DOI: 10.3389/fpubh.2024.1431181] [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: 05/11/2024] [Accepted: 07/30/2024] [Indexed: 08/27/2024] Open
Abstract
Background Proper nutrition is a crucial factor in preventing osteoporosis, a significant pathological cause linked to skeletal weakness; this study investigated the relationship between dietary diversity score and food group diversity score with osteoporosis in postmenopausal women. Methods This case-control study was conducted on 378 menopausal women aged 45-85 in Tehran, Iran. The age-matching method to control the confounding effect of age was used. The method of dual-energy X-ray absorptiometry (DXA) was used for assessing the bone mineral density of lumbar vertebrae and femoral neck. The bone mass status was evaluated with WHO criteria. All subjects were divided into the osteoporosis group and the non-osteoporosis group according to their T-score. A convenience sampling method was utilized to select the participants, which included two groups: case (n = 189) and control (n = 189). Data was collected using demographic and anthropometric information questionnaires, a valid 147 item food frequency questionnaire, and a physical activity questionnaire. Statistical analyses were conducted using SPSS-26, and p-values less than 0.05 were deemed to be statistically significant. Results The results indicated significant differences in weight, body mass index, physical activity, smoking, and alcohol use between the two groups. The mean ± standard deviation of dietary diversity score (DDS) was lower in participants with osteoporosis (case) (3.31 ± 1.26) than in control (4.64 ± 1.33) (p < 0.001). The mean ± standard deviation of diversity score of cereals, fruits, and vegetables in the osteoporosis group (respectively: 0.71 ± 0.21, 0.94 ± 0.76, and 0.45 ± 0.44) was less than the control group (respectively: 0.80 ± 0.21, 1.64 ± 0.55 and 0.87 ± 0.42) (p < 0.001). After adjusting the confounding variables, the risk of osteoporosis had an inverse relationship with the diversity score of vegetable (OR = 0.16; 95%CI: 0.07-0.35), bread and cereal (OR = 0.21; 95% CI: 0.05-0.87) and fruit (OR = 0.35; 95%CI: 0.22-0.56) (p < 0.05). Nevertheless, no discernible correlation was seen between the tertiles of DDS, dairy and meat diversity score, and osteoporosis. Conclusion We found a correlation between the diversity score of fruits, vegetables, and grains and osteoporosis. However, there is no significant correlation between the DDS triads and the diversity score of dairy products and meats with osteoporosis.
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Affiliation(s)
- Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Mahdi Hajinasab
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Mohammadi Zadeh
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Paniz Ahmadi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
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He L, Chhantyal K, Chen Z, Zhu R, Zhang L. The association of combined vitamin C and D deficiency with bone mineral density and vertebral fracture. J Orthop Surg Res 2024; 19:460. [PMID: 39095815 PMCID: PMC11297575 DOI: 10.1186/s13018-024-04953-z] [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: 05/10/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024] Open
Abstract
PURPOSE Both vitamin C and D deficiencies are extremely common in clinical practice, especially in elderly population. Unfortunately, the role of vitamin C deficiency in osteoporosis related consequences is often neglected. The aim of the present study is to analyse if combined vitamin C and D deficiency would have an association with bone mineral density (BMD) and osteoporotic vertebral fracture (OVF). METHODS Ninety-nine post-menopausal female patients admitted in the department of spine surgery of third affiliated hospital of Sun Yat-sen University were enrolled in the study. The participants were divided into four groups; vitamin D deficiency alone (comparator group), vitamin C deficiency alone and combined vitamin C and D deficiency as experimental group. The levels of vitamin C, vitamin D, calcium, phosphorous, BMD and condition of OVF were analysed. RESULTS There were statistically significant differences between the groups in terms of vitamin C and D levels. In terms of lumbar BMD, significant differences were observed between vitamin D deficiency alone and combined vitamin C and D deficiency. Only the combined vitamin C and D deficiency had a significant negative association with lumbar BMD and T-score. Similarly, combined vitamin C and D deficiency had a significant positive association with lumbar osteoporosis. None of the groups had any significant association with OVF. Combined vitamin C and D deficiency was found to be significantly associated with lower lumbar BMD and osteoporosis. CONCLUSION Combined vitamin C and D deficiency results in lower bone mineral density and higher risk of osteoporosis. We believe that existence of deficiencies of both vitamins could have a synergistic effect. Therefore, we recommend that vitamin C and D should be routinely measured in clinical practice.
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Affiliation(s)
- Lei He
- Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
| | - Kishor Chhantyal
- Emergency department, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, England
| | - Zihao Chen
- Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
| | - Ruijue Zhu
- Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China
| | - Liangming Zhang
- Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, China.
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China.
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, No. 600 Tianhe Road, Guangzhou, 510630, China.
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Athanasiou A, Charalambous M, Anastasiou T, Aggeli K, Soteriades ES. Preoperative and postoperative administration of vitamin C in cardiac surgery patients - settings, dosages, duration, and clinical outcomes: a narrative review. Ann Med Surg (Lond) 2024; 86:3591-3607. [PMID: 38846824 PMCID: PMC11152825 DOI: 10.1097/ms9.0000000000002112] [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: 01/30/2024] [Accepted: 04/16/2024] [Indexed: 06/09/2024] Open
Abstract
Vitamin C or ascorbic acid is a water-soluble vitamin capable of directly donating electrons to reactive oxygen species, attenuating electrical remodeling, and cardiac dysfunction in patients undergoing cardiac surgery (CS), considered one of the most effective defenses against free radicals in the blood, thus being one of the first antioxidants consumed during oxidative stress. The aim of this review is to assess the effects of perioperative administration of vitamin C in CS patients. A comprehensive literature search was conducted in order to identify prospective cohort studies and/or randomized controlled trials reporting on the perioperative effects of vitamin C among adult patients undergoing CS. Studies published between January 1980 to December 2022 were included in our search, resulting in a total of 31 articles that met all our inclusion criteria. There seems to be a beneficial effect of vitamin C supplementation in arrhythmias such as in postoperative atrial fibrillation, reduction of ICU length of stay, and hospital length of stay, reduction in postoperative ventilation time, in inotropic demand, and in postoperative fatigue. Vitamin C can act as a scavenger of free radicals to decrease the peroxidation of the lipids present in the cell membrane, and to protect the myocardium postoperatively from ischemia/reperfusion injury, thus attenuating oxidative stress and inflammation. It represents a readily available and cost-effective strategy that could improve the outcome of patients undergoing CS, by reducing the risk of serious cardiovascular adverse events, both perioperatively and postoperatively.
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Affiliation(s)
| | | | | | - Konstantina Aggeli
- Department of Cardiology, ‘Hippocrates’ General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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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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Wang K, Wu J, Deng M, Tao F, Li Q, Luo X, Xia F. Associations of healthy eating index-2015 with osteoporosis and low bone mass density in postmenopausal women: a population-based study from NHANES 2007-2018. Front Nutr 2024; 11:1388647. [PMID: 38694220 PMCID: PMC11061362 DOI: 10.3389/fnut.2024.1388647] [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: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024] Open
Abstract
Purpose The current study aimed to explore the associations of diet quality assessed by healthy eating index-2015 (HEI-2015) with risks of osteoporosis and low bone mineral density (BMD) among American postmenopausal women aged 50 years and older. Methods Postmenopausal women aged 50 years and older in the National Health and Nutrition Examination Survey from 2007 through 2018 were included in the final sample. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across tertiles of HEI-2015. Univariate and multivariate weighted logistic regression models were employed to explore the associations of HEI-2015 tertiles and continuous HEI-2015 with the risks of osteoporosis and low BMD. Nonlinear dose-response associations were evaluated using weighted restricted cubic spline analyses, and the contributions of various HEI-2015 components were assessed using weighted quantile sum regression models. Results The final sample included 3,421 postmenopausal women aged 50 years and older representative for approximately 28.38 million non-institutionalized U.S. postmenopausal women. Osteoporosis prevalence decreased with HEI-2015 tertiles while the prevalence of low BMD showed no significant decrease. Compared with postmenopausal women in the first tertile of HEI-2015, those with the second (OR: 0.57, 95%CI: 0.38-0.84) and third (OR: 0.48, 95%CI: 0.29-0.78) HEI-2015 tertiles were associated with reduced osteoporosis risk after multivariate adjustments, but no significant association of HEI-2015 with the risk of BMD was identified. Furthermore, similar effects were confirmed in the sensitivity analyses and subgroup analyses and interaction effects. Moreover, significant nonlinear associations were observed between HEI-2015 with osteoporosis risk, and total vegetables, refined grains and greens and beans demonstrated the strongest protective effect among HEI-2015 components against osteoporosis. Conclusions This study strongly suggests the significant negative associations of HEI-2015 with osteoporosis risk in American postmenopausal women. These findings highlight the importance of adherence to the dietary guidelines for Americans in reducing the risk of osteoporosis.
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Affiliation(s)
- Kai Wang
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Jinyi Wu
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Minggang Deng
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Fengxi Tao
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Qingwen Li
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Xin Luo
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Fang Xia
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
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Lang H, Li H, Zhang A, Li N. Joint effects between cadmium exposure and dietary antioxidant quality score on osteoporosis and bone mineral density. Br J Nutr 2024; 131:956-963. [PMID: 37905696 DOI: 10.1017/s0007114523002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
To explore the relationship between dietary antioxidant quality score (DAQS) and Cd exposure both alone and in combination with osteoporosis and bone mineral density (BMD) among postmenopausal women. In total, 4920 postmenopausal women from the National Health and Nutrition Examination Survey were included in this cross-sectional study. Weighted univariate and multivariate logistic regression analyses to assess the association between DAQS and Cd exposure with femur neck BMD, total femur BMD, osteoporosis among postmenopausal women, respectively, and the coexistence effect of DAQS and Cd exposure. Four hundred and ninety-nine had osteoporosis. DAQS (OR = 0·86, 95 % CI 0·77, 0·97) and high DAQS (OR = 0·60, 95 % CI 0·36, 0·99) were found to be associated with decreased odds of osteoporosis, while Cd exposure (OR = 1·34, 95 % CI 1·04, 1·72) and high Cd exposure (OR = 1·45, 95 % CI 1·02, 2·06) were related to increased odds of osteoporosis. A positive correlation was observed between high DAQS and both total femur BMD and femur neck BMD. Conversely, Cd exposure was found to be negatively correlated with total femur BMD and femur neck BMD. Additionally, taking low-Cd and high-quality DAQS group as reference, the joint effect of Cd exposure and DAQS showed greater increased odds of osteoporosis and decreased total femur BMD and femur neck BMD as Cd level and DAQS combinations worsened. There may be an interaction between Cd exposure and DAQS for femur neck BMD, total femur BMD, and osteoporosis in postmenopausal women.
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Affiliation(s)
- Huifang Lang
- Department of Endocrine, The First Hospital of Tsinghua University, Beijing, People's Republic of China
| | - Hongmei Li
- Department of Endocrine, The First Hospital of Tsinghua University, Beijing, People's Republic of China
| | - Aixian Zhang
- Department of General Practice Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People's Republic of China
| | - Na Li
- Department of Endocrine, The First Hospital of Tsinghua University, Beijing, People's Republic of China
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Vaishya R, Iyengar KP, Jain VK, Vaish A. Demystifying the Risk Factors and Preventive Measures for Osteoporosis. Indian J Orthop 2023; 57:94-104. [PMID: 38107819 PMCID: PMC10721752 DOI: 10.1007/s43465-023-00998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 12/19/2023]
Abstract
Background Osteoporosis is a major health problem, globally. It is characterized by structural bone weakness leading to an increased risk of fragility fractures. These fractures commonly affect the spine, hip and wrist bones. Consequently, Osteoporosis related proximal femur and vertebral fractures represent a substantial, growing social and economic burden on healthcare systems worldwide. Indentification of the risk factors, clinical risk assessment, utilization of risk assessment tools and appropriate management that play a crucial role in reducing the burden of Osteoporosis by tackling modifiable risk factors. Methods This chapter explores various risk factors that are associated with Osteoporosis and provides an overview of various clinical and diagnostic risk assessment tools with a particular emphasis on evidence-based strategies for their prevention. Conclusion The role of emerging technologies such as Artificial Intelligence (AI) and perspectives such as newer diagnostic modalities, monitoring and surveillance approaches in prevention of risk factors in the pathogenesis of Osteoporosis is highlighted.
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Affiliation(s)
- Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, 110076 India
| | | | - Vijay Kumar Jain
- Department of Orthopaedic Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, 110001 India
| | - Abhishek Vaish
- Department of Orthopaedics, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, 110076 India
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Nair P, Orford N, Kerschan-Schindl K. Micronutrient intake to protect against osteoporosis during and after critical illness. Curr Opin Clin Nutr Metab Care 2023; 26:557-563. [PMID: 37650707 DOI: 10.1097/mco.0000000000000979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE OF REVIEW Improved survival from critical illness has enhanced the focus on ways to augment functional outcomes following discharge from the Intensive Care Unit. An area that is gaining increased attention is the effect of critical illness on bone health and fragility fractures following the episode. This review discusses the micronutrients that may play a role in bone metabolism and the potential benefits of their supplementation to prevent osteoporosis. These include calcium, phosphorous, magnesium, vitamin D, vitamin C, vitamin K, and certain trace elements. FINDINGS Although there is sound physiological basis for the involvement of these micronutrients in bone health and fracture prevention, there are few clinically relevant publications in this area with calcium and vitamin D being the best studied to date. SUMMARY In the absence of high-quality evidence in critically ill populations, attention to measurement and supplementation of these micronutrients as per current guidelines outlining micronutrient requirements in enteral and parenteral nutrition might mitigate bone loss and its sequelae in the recovery phase from critical illness.
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Affiliation(s)
- Priya Nair
- Intensive Care Unit, St. Vincents Hospital
- University of New South Wales
- Critical Care and Trauma Division, The George Institute for Global Health, Sydney, Australia
| | - Neil Orford
- Intensive Care Unit, Geelong University Hospital
- Deakin University
- ANZICS Research Centre, Melbourne, Victoria, Australia
| | - Katharina Kerschan-Schindl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Austria
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Blouin S, Khani F, Messmer P, Roschger P, Hartmann MA, van Wijnen AJ, Thaler R, Misof BM. Vitamin C Deficiency Deteriorates Bone Microarchitecture and Mineralization in a Sex-Specific Manner in Adult Mice. J Bone Miner Res 2023; 38:1509-1520. [PMID: 37493605 PMCID: PMC10636228 DOI: 10.1002/jbmr.4889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/21/2023] [Indexed: 07/27/2023]
Abstract
Vitamin C (VitC) is essential for bone health, and low VitC serum levels increase the risk for skeletal fractures. If and how VitC affects bone mineralization is unclear. Using micro-computed tomography (μCT), histologic staining, as well as quantitative backscattered electron imaging (qBEI), we assessed the effects of VitC on femoral structure and microarchitecture, bone formation, and bone mineralization density distribution (BMDD) in the VitC incompetent Gulo-/- mouse model and wild-type mice. In particular, VitC-supplemented, 20-week-old mice were compared with age-matched counterparts where dietary VitC intake was excluded from week 15. VitC depletion in Gulo-/- mice severely reduced cortical thickness of the diaphyseal shaft and bone volume around the growth plate (eg, bone volume of the primary spongiosa -43%, p < 0.001). Loss of VitC also diminished the amount of newly formed bone tissue as visualized by histology and calcein labeling of the active mineralization front. BMDD analysis revealed a shift to higher calcium concentrations upon VitC supplementation, including higher average (~10% increase in female VitC deficient mice, p < 0.001) and peak calcium concentrations in the epiphyseal and metaphyseal spongiosa. These findings suggest higher bone tissue age. Importantly, loss of VitC had significantly more pronounced effects in female mice, indicating a higher sensitivity of their skeleton to VitC deficiency. Our results reveal that VitC plays a key role in bone formation rate, which directly affects mineralization. We propose that low VitC levels may contribute to the higher prevalence of bone-degenerative diseases in females and suggest leveraging this vitamin against these conditions. © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Farzaneh Khani
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Phaedra Messmer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Paul Roschger
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Markus A Hartmann
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | | | - Roman Thaler
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Barbara M Misof
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
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Ku Md. Saad S, Khalid K, Glackin S. Fatigue, bleeding tendency and osteoporosis in an adolescent: a diagnostic conundrum. Oxf Med Case Reports 2023; 2023:omad015. [PMID: 36860957 PMCID: PMC9969819 DOI: 10.1093/omcr/omad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Accepted: 02/01/2023] [Indexed: 03/02/2023] Open
Abstract
Scurvy is a rare nutritional deficiency, particularly in developed nations. Sporadic cases are still reported, particularly among alcoholics and malnourished. Herein we present an unusual case of a previously healthy 15-year-old Caucasian girl, who was recently hospitalized for low velocity spine fractures, back pain and stiffness over several months and rash for 2 years. She was later diagnosed with scurvy and osteoporosis. Dietary modifications were instituted together with supplementary vitamin C, supportive treatment with regular dietician review and physiotherapy. Gradual clinical recovery was seen over the course of therapy. Our case highlights the importance of recognizing scurvy even among low-risk populations to ensure prompt and effective clinical management.
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Affiliation(s)
| | - Karniza Khalid
- Correspondence address. Endocrine Unit, Specialised Diagnostic Centre, Institute for Medical Research, Jalan Pahang, 50588 Wilayah Persekutuan Kuala Lumpur, Malaysia. E-mail:
| | - Sinead Glackin
- Department of Paediatrics, Sligo University Hospital, Sligo, Ireland
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Zhang R, Huang Q, Su G, Wei M, Cui Y, Zhou H, Song W, Di D, Liu J, Wang Q. Association between multiple vitamins and bone mineral density: a cross-sectional and population-based study in the NHANES from 2005 to 2006. BMC Musculoskelet Disord 2023; 24:113. [PMID: 36765290 PMCID: PMC9912521 DOI: 10.1186/s12891-023-06202-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/27/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Bone mineral density (BMD) alterations in response to multivitamin exposure were rarely studied. Our study assessed the association of coexposure to six types of vitamins (i.e., vitamins B12, B9, C, D, A and E) with BMD measurements in adults in the US. METHODS Data were collected from participants aged ≥ 20 years (n = 2757) in the U.S. National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2006. Multiple linear regression, restricted cubic splines, principal component analysis (PCA) and weighted quantile sum (WQS) regression were performed for statistical analysis. RESULTS The circulating levels of vitamins B12 and C were positively associated with BMDs, and an inverted L-shaped exposure relationship was observed between serum vitamin C and BMDs. PCA identified two principal components: one for 'water-soluble vitamins', including vitamins B12, B9 and C, and one for 'fat-soluble vitamins', including vitamins A, D and E. The former was positively associated with total femur (β = 0.009, 95%CI: 0.004, 0.015) and femoral neck (β = 0.007, 95%CI: 0.002, 0.013) BMDs, and the latter was negatively associated with BMDs with non-statistical significance. The WQS index constructed for the six vitamins was significantly related to total femur (β = 0.010, 95%CI: 0.001, 0.018) and femoral neck (β = 0.008, 95%CI: 0.001, 0.015) BMDs, and vitamins B12 and C weighted the most. The WQS index was inversely related to BMDs with non-statistical significance, and vitamins E and A weighted the most. CONCLUSION Our findings suggested a positive association between water-soluble vitamin coexposure and BMD, and the association was mainly driven by vitamins B12 and C. Negative association between fat-soluble vitamin coexposure and BMD was indicated, mainly driven by vitamins E and A. An inverted L-shaped exposure relationship was found between vitamin C and BMD.
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Affiliation(s)
- Ruyi Zhang
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Qin Huang
- grid.33199.310000 0004 0368 7223Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Guanhua Su
- grid.33199.310000 0004 0368 7223Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Muhong Wei
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Yuan Cui
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Haolong Zhou
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Wenjing Song
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Dongsheng Di
- grid.33199.310000 0004 0368 7223MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Junan Liu
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Qi Wang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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13
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Marcucci G, Domazetovic V, Nediani C, Ruzzolini J, Favre C, Brandi ML. Oxidative Stress and Natural Antioxidants in Osteoporosis: Novel Preventive and Therapeutic Approaches. Antioxidants (Basel) 2023; 12:antiox12020373. [PMID: 36829932 PMCID: PMC9952369 DOI: 10.3390/antiox12020373] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
This review reports in detail the cellular and molecular mechanisms which regulate the bone remodeling process in relation to oxidative stress (OS), inflammatory factors, and estrogen deficiency. OS is considered an important pathogenic factor of osteoporosis, inducing osteocyte apoptosis and varying levels of specific factors, such as receptor activator κB ligand (RANKL), sclerostin, and, according to recent evidence, fibroblast growth factor 23, with consequent impairment of bone remodeling and high bone resorption. Bone loss increases the risk of fragility fractures, and the most commonly used treatments are antiresorptive drugs, followed by anabolic drugs or those with a double effect. In addition, recent data show that natural antioxidants contained in the diet are efficient in preventing and reducing the negative effects of OS on bone remodeling and osteocytes through the involvement of sirtuin type 1 enzyme. Indeed, osteocytes and some of their molecular factors are considered potential biological targets on which antioxidants can act to prevent and reduce bone loss, as well as to promote bone anabolic and regenerative processes by restoring physiological bone remodeling. Several data suggest including antioxidants in novel therapeutic approaches to develop better management strategies for the prevention and treatment of osteoporosis and OS-related bone diseases. In particular, anthocyanins, as well as resveratrol, lycopene, oleuropein, some vitamins, and thiol antioxidants, could have protective and therapeutic anti-osteoporotic effects.
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Affiliation(s)
- Gemma Marcucci
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Vladana Domazetovic
- Department of Paediatric Haematology-Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy
| | - Chiara Nediani
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy
- Correspondence:
| | - Jessica Ruzzolini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Claudio Favre
- Department of Paediatric Haematology-Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy
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14
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Guasti L, Cianferotti L, Pampaloni B, Tonelli F, Martelli F, Iantomasi T, Brandi ML. Evaluation of food and nutrient intake in a population of subjects affected by periodontal disease with different levels of bone mineral density. Front Endocrinol (Lausanne) 2023; 14:1098366. [PMID: 36864837 PMCID: PMC9971598 DOI: 10.3389/fendo.2023.1098366] [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: 12/07/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Both osteoporosis and periodontitis are pathologies characterized by an imbalance in the bone tissue. Vitamin C is an important factor involved in maintaining the health of the periodontium; its deficiency causes characteristic lesions to periodontal tissues such as bleeding and redness of the gums. Among the essential minerals for the health of the periodontium we find instead calcium.Objectives of the study: The objectives of the proposed study are to study the association between the presence of osteoporosis and periodontal disease. We tried to identify the possible connections between particular dietary patterns and therefore the etiopathogenesis of periodontal disease and secondarily of osteoporosis.Materials and methods: 110 subjects were recruited in a single-center observational cross-sectional study carried through the collaboration between the University of Florence and the private institute of dentistry Excellence Dental Network based in Florence, suffering of periodontitis, 71 osteoporotic/osteopenic and 39 non-osteoporotic/osteopenic. Anamnestic data and information on eating habits were collected. RESULTS The population showed eating habits that do not meet the intake levels recommended by the L.A.R.N. Regarding the relationship between nutrient intake and plaque index, it appears that in the population, the higher the intake of vitamin C through food, the lower the plaque index value is. This result could reinforce the scientific evidence that there is a protective factor in the onset of periodontal disease by the consumption of vitamin C which to date is still the subject of investigation. In addition, the same type of trend would also have been observed for calcium intake, but a larger sample size would be required to make this effect significant. CONCLUSIONS The relationship between osteoporosis and periodontitis and the role of nutrition in influencing the evolution of these pathologies still seems to be deeply explored. However, the results obtained seem to consolidate the idea that there is a relationship between these two diseases and that eating habits play an important role in their prevention.
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Affiliation(s)
- Leonardo Guasti
- Fondazione Italiana Ricerca sulle Malattie dell’Osso (F.I.R.M.O.) Foundation, San Gallo Florence, Italy
- *Correspondence: Leonardo Guasti, ; Maria Luisa Brandi,
| | | | - Barbara Pampaloni
- Fondazione Italiana Ricerca sulle Malattie dell’Osso (F.I.R.M.O.) Foundation, San Gallo Florence, Italy
| | - Francesco Tonelli
- Fondazione Italiana Ricerca sulle Malattie dell’Osso (F.I.R.M.O.) Foundation, San Gallo Florence, Italy
| | | | | | - Maria Luisa Brandi
- Fondazione Italiana Ricerca sulle Malattie dell’Osso (F.I.R.M.O.) Foundation, San Gallo Florence, Italy
- *Correspondence: Leonardo Guasti, ; Maria Luisa Brandi,
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15
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Chen Y, Tang W, Li H, Lv J, Chang L, Chen S. Composite dietary antioxidant index negatively correlates with osteoporosis among middle-aged and older US populations. Am J Transl Res 2023; 15:1300-1308. [PMID: 36915799 PMCID: PMC10006777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/28/2022] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To assess whether the composite dietary antioxidant index (CDAI) is associated with osteoporosis (OP) in middle-aged and older US populations. METHODS We conducted a cross-sectional survey and identified individuals aged 40-85 years (n=11,664) from secondary datasets from the 2007-2010, 2013-2014, and 2017-2018 National Health and Nutrition Examination Survey (NHANES). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), and OP was defined as a BMD T-score ≤-2.5 at the femoral neck or lumbar spine. The CDAI score was calculated based on dietary data from the first NHANES 24-hour dietary recall. Multivariate logistic regression models were used to evaluate the association between CDAI and OP. RESULTS Among the 11,664 participants, the average age was 60.3 (11.8), 5,898 (50.6%) were female, and 925 (7.9%) had OP. The median CDAI was -2.0 (interquartile range, -6.9 to 4.2). After adjusting for age, sex, race, family income, body mass index, physical activity, calorie intake, estimated glomerular filtration rate, smoking and drinking status, hypertension, and diabetes, the CDAI was associated with OP (odds ratio (OR), 0.98; 95% CI: 0.96-0.99). Participants in the highest CDAI quantile were at low risk of osteoporosis (OR, 0.61; 95% CI: 0.44-0.85) versus those in the lowest quantile. Moreover, this association was stable in the subgroup and sensitivity analyses. CONCLUSION Dietary antioxidant ability assessed by using the CDAI was inversely associated with OP among US adults aged 40-85 years.
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Affiliation(s)
- Yuanhong Chen
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
| | - Weishang Tang
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
| | - Haijing Li
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
| | - Jiesen Lv
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
| | - Li Chang
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
| | - Shaohui Chen
- Department of Gynecology, Dongguan Eastern Central Hospital Dongguan 523560, Guangdong, China
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16
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Moretti A, Liguori S, Paoletta M, Migliaccio S, Toro G, Gimigliano F, Iolascon G. Bone fragility during the COVID-19 pandemic: the role of macro- and micronutrients. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158200. [PMID: 36937822 PMCID: PMC10015293 DOI: 10.1177/1759720x231158200] [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: 08/05/2022] [Accepted: 02/01/2023] [Indexed: 03/18/2023] Open
Abstract
Bone fragility is the susceptibility to fracture due to poor bone strength. This condition is usually associated with aging, comorbidities, disability, poor quality of life, and increased mortality. International guidelines for the management of patients with bone fragility include a nutritional approach, mainly aiming at optimal protein, calcium, and vitamin D intakes. Several biomechanical features of the skeleton, such as bone mineral density (BMD), trabecular and cortical microarchitecture, seem to be positively influenced by micro- and macronutrient intake. Patients with major fragility fractures are usually poor consumers of dairy products, fruit, and vegetables as well as of nutrients modulating gut microbiota. The COVID-19 pandemic has further aggravated the health status of patients with skeletal fragility, also in terms of unhealthy dietary patterns that might adversely affect bone health. In this narrative review, we discuss the role of macro- and micronutrients in patients with bone fragility during the COVID-19 pandemic.
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Affiliation(s)
| | - Sara Liguori
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health
Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health and
Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
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17
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Mendonça F, Soares R, Carvalho D, Freitas P. The Impact of Bariatric Surgery on Bone Health: State of the Art and New Recognized Links. Horm Metab Res 2022; 54:131-144. [PMID: 35276738 DOI: 10.1055/a-1767-5581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Bariatric surgery (BS) is the most effective therapy for severe obesity, which improves several comorbidities (such as diabetes, hypertension, dyslipidemia, among others) and results in marked weight loss. Despite these consensual beneficial effects, sleeve gastrectomy and Roux-en-Y gastric bypass (the two main bariatric techniques) have also been associated with changes in bone metabolism and progressive bone loss. The objective of this literature review is to examine the impact of bariatric surgery on bone and its main metabolic links, and to analyze the latest findings regarding the risk of fracture among patients submitted to bariatric surgery.
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Affiliation(s)
- Fernando Mendonça
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar e Universitário de S. João, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Raquel Soares
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar e Universitário de S. João, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Paula Freitas
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar e Universitário de S. João, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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18
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The Role of Macronutrients, Micronutrients and Flavonoid Polyphenols in the Prevention and Treatment of Osteoporosis. Nutrients 2022; 14:nu14030523. [PMID: 35276879 PMCID: PMC8839902 DOI: 10.3390/nu14030523] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoporosis is considered an age-related disorder of the skeletal system, characterized primarily by decreased bone mineral density (BMD), microstructural quality and an elevated risk of fragility fractures. This silent disease is increasingly becoming a global epidemic due to an aging population and longer life expectancy. It is known that nutrition and physical activity play an important role in skeletal health, both in achieving the highest BMD and in maintaining bone health. In this review, the role of macronutrients (proteins, lipids, carbohydrates), micronutrients (minerals—calcium, phosphorus, magnesium, as well as vitamins—D, C, K) and flavonoid polyphenols (quercetin, rutin, luteolin, kaempferol, naringin) which appear to be essential for the prevention and treatment of osteoporosis, are characterized. Moreover, the importance of various naturally available nutrients, whether in the diet or in food supplements, is emphasized. In addition to pharmacotherapy, the basis of osteoporosis prevention is a healthy diet rich mainly in fruits, vegetables, seafood and fish oil supplements, specific dairy products, containing a sufficient amount of all aforementioned nutritional substances along with regular physical activity. The effect of diet alone in this context may depend on an individual’s genotype, gene-diet interactions or the composition and function of the gut microbiota.
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19
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Rizzoli R, Biver E, Brennan-Speranza TC. Nutritional intake and bone health. Lancet Diabetes Endocrinol 2021; 9:606-621. [PMID: 34242583 DOI: 10.1016/s2213-8587(21)00119-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/12/2022]
Abstract
Osteoporotic or fragility fractures affect one in two women and one in five men who are older than 50. These events are associated with substantial morbidity, increased mortality, and an impaired quality of life. Recommended general measures for fragility fracture prevention include a balanced diet with an optimal protein and calcium intake and vitamin D sufficiency, together with regular weight-bearing physical exercise. In this narrative Review, we discuss the role of nutrients, foods, and dietary patterns in maintaining bone health. Much of this information comes from observational studies. Bone mineral density, microstructure-estimated bone strength, and trabecular and cortical microstructure are positively associated with total protein intake. Several studies indicate that fracture risk might be lower with a higher dietary protein intake, provided that the calcium supply is sufficient. Dairy products are a valuable source of these two nutrients. Hip fracture risk appears to be lower in consumers of dairy products, particularly fermented dairy products. Consuming less than five servings per day of fruit and vegetables is associated with a higher hip fracture risk. Adherence to a Mediterranean diet or to a prudent diet is associated with a lower fracture risk. These various nutrients and dietary patterns influence gut microbiota composition or function, or both. The conclusions of this Review emphasise the importance of a balanced diet including minerals, protein, and fruit and vegetables for bone health and in the prevention of fragility fractures.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Emmanuel Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tara C Brennan-Speranza
- School of Medical Sciences and School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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20
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Izumiya M, Haniu M, Ueda K, Ishida H, Ma C, Ideta H, Sobajima A, Ueshiba K, Uemura T, Saito N, Haniu H. Evaluation of MC3T3-E1 Cell Osteogenesis in Different Cell Culture Media. Int J Mol Sci 2021; 22:ijms22147752. [PMID: 34299372 PMCID: PMC8304275 DOI: 10.3390/ijms22147752] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Many biomaterials have been evaluated using cultured cells. In particular, osteoblast-like cells are often used to evaluate the osteocompatibility, hard-tissue-regeneration, osteoconductive, and osteoinductive characteristics of biomaterials. However, the evaluation of biomaterial osteogenesis-inducing capacity using osteoblast-like cells is not standardized; instead, it is performed under laboratory-specific culture conditions with different culture media. However, the effect of different media conditions on bone formation has not been investigated. Here, we aimed to evaluate the osteogenesis of MC3T3-E1 cells, one of the most commonly used osteoblast-like cell lines for osteogenesis evaluation, and assayed cell proliferation, alkaline phosphatase activity, expression of osteoblast markers, and calcification under varying culture media conditions. Furthermore, the various media conditions were tested in uncoated plates and plates coated with collagen type I and poly-L-lysine, highly biocompatible molecules commonly used as pseudobiomaterials. We found that the type of base medium, the presence or absence of vitamin C, and the freshness of the medium may affect biomaterial regeneration. We posit that an in vitro model that recapitulates in vivo bone formation should be established before evaluating biomaterials.
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Affiliation(s)
- Makoto Izumiya
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Miyu Haniu
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
| | - Katsuya Ueda
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Haruka Ishida
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Chuang Ma
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Hirokazu Ideta
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
- Department of Orthopaedic Surgery, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Atsushi Sobajima
- Department of Orthopaedic Surgery, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
- Department of Orthopedics (Lower Limbs), Social Medical Care Corporation Hosei-kai Marunouchi Hospital, 1-7-45 Nagisa, Matsumoto, Nagano 390-8601, Japan
| | - Koki Ueshiba
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
| | - Takeshi Uemura
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Naoto Saito
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
| | - Hisao Haniu
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (M.I.); (M.H.); (K.U.); (H.I.); (C.M.); (K.U.); (T.U.); (N.S.)
- Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;
- Correspondence: ; Tel.: +81-263-37-3555
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Vitamin C in Human Health and Disease. Nutrients 2021; 13:nu13051595. [PMID: 34064549 PMCID: PMC8150809 DOI: 10.3390/nu13051595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
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22
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Hung KC, Chiang MH, Wu SC, Chang YJ, Ho CN, Wang LK, Chen JY, Chen KH, Sun CK. A meta-analysis of randomized clinical trials on the impact of oral vitamin C supplementation on first-year outcomes in orthopedic patients. Sci Rep 2021; 11:9225. [PMID: 33927326 PMCID: PMC8085077 DOI: 10.1038/s41598-021-88864-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022] Open
Abstract
This meta-analysis aimed at investigating the impact of oral vitamin C supplementation on the post-procedural recovery of orthopedic patients, including functional outcomes and complex regional pain syndrome type I (CRPS I). Literature search using the Medline, Cochrane Library, and Embase databases from inception till March 2021 identified seven eligible randomized controlled trials with 1,361 participants. Forest plot revealed no significant difference in the functional outcomes at 6-12 months [standardized mean difference (SMD) = -0.00, 95% CI - 0.19 to 0.18, 467 patients], risk of overall complications (RR = 0.98, 95% CI 0.68 to 1.39, 426 patients), and pain severity at 3-6 months (SMD = - 0.18, 95% CI - 0.49 to 0.12, 486 patients) between patients with and without oral vitamin C supplementation. Pooled analysis showed that vitamin C treatment reduced the risk of CRPS I regardless of dosage (RR = 0.46, 95% CI 0.25 to 0.85, 1143 patients). In conclusion, the current meta-analysis demonstrated that oral vitamin C supplementation may reduce the risk of complex regional pain syndrome type I but did not improve the functional outcomes in orthopedic patients. Nevertheless, because of the small number of trials included in the present study, further large-scale clinical studies are warranted to support our findings.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Min-Hsien Chiang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Shao-Chun Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
- College of Health Sciences, Chang Jung Christian University, Tainan City, Taiwan
| | - Chun-Ning Ho
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Li-Kai Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Jen-Yin Chen
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Kee-Hsin Chen
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Evidence-Based Knowledge Translation Center, Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.
- College of Medicine, I-Shou University, Kaohsiung City, Taiwan.
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23
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Arnold M, Rajagukguk YV, Gramza-Michałowska A. Functional Food for Elderly High in Antioxidant and Chicken Eggshell Calcium to Reduce the Risk of Osteoporosis-A Narrative Review. Foods 2021; 10:656. [PMID: 33808726 PMCID: PMC8003428 DOI: 10.3390/foods10030656] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
The elderly population is increasing globally and is predicted to reach 1.5 billion in 2050. The quality of life of the elderly must be concerned, for example, with developing functional food for the elderly. In this article, the development of functional food to reduce the risk of osteoporosis in the elderly is reviewed. Oxidative stress is one of the factors which accelerates osteoporosis. Various antioxidants, including vitamin C, vitamin E, polyphenols, or lycopene, have been proven by former studies to have antioxidant activity, therefore, could reduce the risk of osteoporosis. Additionally, the application of eggshell powder in various food products has been reported to improve calcium intake, and its usage is environmentally sustainable as this could contribute to reducing food waste. The application of both antioxidants and calcium could be a good combination, but the amount of some antioxidants must be concerned so it would not interfere with the bioavailability of calcium. Therefore, this review aims to explore the functional food for the elderly to reduce the risk of osteoporosis, particularly with antioxidants and calcium from chicken eggshells. The eating preference and dietary pattern of the elderly are also considered to determine the suitable form of functional food for the elderly. The results presented in the study may be the basis for the development of new calcium-enriched food products for the elderly.
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Affiliation(s)
| | | | - Anna Gramza-Michałowska
- Department of Gastronomy Science and Functional Foods, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60624 Poznań, Poland; (M.A.); (Y.V.R.)
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24
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The Mediterranean Diet in Osteoporosis Prevention: An Insight in a Peri- and Post-Menopausal Population. Nutrients 2021; 13:nu13020531. [PMID: 33561997 PMCID: PMC7915719 DOI: 10.3390/nu13020531] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022] Open
Abstract
Osteoporosis represent a widespread public health problem. The management and prevention of osteoporosis and related low energy fractures start with a correct lifestyle and proper nutrition. Several different nutrients are essential for bone and mineral metabolism, especially calcium. Nevertheless, a well-balanced nutrition, such as Mediterranean diet (MD), proved to be beneficial for several chronic diseases and also fragility fractures resulted lower in the Mediterranean area. A prospective observational study in a population of two hundred peri- and post-menopausal women (aged 30-80 years) was developed at Careggi hospital, Florence. Both MD adherence and dietary calcium intake were evaluated in occasion of a "first visit" and a "follow-up" visit, through validated questionnaires. From a descriptive point of view, although not statistically significant, in both visits a slight increase in calcium intake was observed for high adherence to MD diet. Moreover, a short nutritional interview (20 min) was applied in our population and demonstrated to be sufficient to significantly improve MD adherence level (mean score at T0 = 6.98 ± 1.74 and T1 = 7.53 ± 1.68), opening promising paths in osteoporosis prevention.
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