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Giustina A, Bilezikian JP, Adler RA, Banfi G, Bikle DD, Binkley NC, Bollerslev J, Bouillon R, Brandi ML, Casanueva FF, di Filippo L, Donini LM, Ebeling PR, Fuleihan GEH, Fassio A, Frara S, Jones G, Marcocci C, Martineau AR, Minisola S, Napoli N, Procopio M, Rizzoli R, Schafer AL, Sempos CT, Ulivieri FM, Virtanen JK. Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows. Endocr Rev 2024:bnae009. [PMID: 38676447 DOI: 10.1210/endrev/bnae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Indexed: 04/28/2024]
Abstract
The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - John P Bilezikian
- Department of Medicine, Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Giuseppe Banfi
- IRCCS Galeazzi Sant'Ambrogio Hospital, Milano 20161, Italy
- San Raffaele Vita-Salute University, Milan 20132, Italy
| | - Daniel D Bikle
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
- Department of Endocrinology, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | - Neil C Binkley
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium
| | - Maria Luisa Brandi
- Italian Foundation for the Research on Bone Diseases (F.I.R.M.O.), Florence 50129, Italy
| | - Felipe F Casanueva
- Department of Medicine, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario and CIBER de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Santiago de Compostela University, Santiago de Compostela 15706, Spain
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome 00161, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton 3168, Australia
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO CC for Metabolic Bone Disorders, Division of Endocrinology, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona 37129, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, ON K7L 3N6, Canada
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56126, Italy
| | - Adrian R Martineau
- Faculty of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Salvatore Minisola
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes Campus Bio-Medico, University of Rome, Rome 00128, Italy
| | - Massimo Procopio
- Division of Endocrinology, Diabetology and Metabolic Diseases, "Molinette" Hospital, University of Turin, Turin 10126, Italy
| | - René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva 1205, Switzerland
| | - Anne L Schafer
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio FI-70211, Finland
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Hosseini H, Abdouss M, Golshekan M. Hydroxyapatite Incorporated with Fe 3O 4@MCM-41 Core-Shell: A Promising Nanocomposite for Teriparatide Delivery in Bone Tissue Regeneration. ACS OMEGA 2023; 8:41363-41373. [PMID: 37970037 PMCID: PMC10633862 DOI: 10.1021/acsomega.3c04931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/15/2023] [Accepted: 10/06/2023] [Indexed: 11/17/2023]
Abstract
This article presents a comprehensive study of the development of a novel nanocomposite comprising core-shell Fe3O4@MCM-41 with superparamagnetic properties and hydroxyapatite (HAp). The nanocomposite serves as a pH-responsive nanocarrier, offering an efficient injectable dosage for teriparatide (PTH (1-34)) delivery. The aim is to address the limitations associated with drug-induced side effects, precautionary measures, and frequent injections. The nanocomposites, as prepared, were characterized using techniques including X-ray diffraction, Fourier transform infrared, zeta potential, dynamic light scattering, VSM, scanning electron microscopy, and transmission electron microscopy. The nanocomposites' average crystallite diameter was determined to be 27 ± 5 nm. The hydrodynamic size of the PTH (1-34)-loaded nanocarrier ranged from 357 to 495 nm, with a surface charge of -33 mV. The entrapment and loading efficiencies were determined to be 73% and 31%, respectively. All of these findings collectively affirm successful fabrication. Additionally, in vivo medication delivery was investigated using the HPLC method, mirroring the in vitro tests. Utilizing the dialysis approach, we demonstrated sustained-release behavior. PTH (1-34) diffusion increased as the pH decreased from 7.4 to 5.6. After 24 h, drug release was higher at acidic pH (88%) compared to normal pH (43%). The biocompatibility of the PTH (1-34)-loaded nanocarrier was assessed using the MTT assay employing the NIH3T3 and HEK-293 cell lines. The results demonstrated that the nanocarrier not only exhibited nontoxicity but also promoted cell proliferation and differentiation. In the in vivo test, the drug concentration reached 505 μg within 30 min of exposure to the magnetic field. Based on these findings, the Fe3O4@MCM-41/HAp/PTH (1-34) nanocomposite, in combination with a magnetic field, offers an efficient and biocompatible approach to enhance the therapeutic effect of osteogenesis and overcome drug limitations.
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Affiliation(s)
- Hamid
Reza Hosseini
- Department
of Biomedical Engineering, Central Tehran Branch, Islamic Azad University, Tehran 13185/768, Iran
| | - Majid Abdouss
- Department
of Chemistry, Amirkabir University of Technology, P.O. Box: 15875-4413, Tehran 1591634311, Iran
| | - Mostafa Golshekan
- Guilan
Road Trauma Research Center, Guilan University
of Medical Sciences, Rasht 13111-41937, Iran
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Ab Hamid MR, Abd Razak MA, Ridhwan MU. Assessment of Knowledge, Physical Activity and Calcium Intake among Female University Students. ENVIRONMENT-BEHAVIOUR PROCEEDINGS JOURNAL 2023; 8:175-181. [DOI: 10.21834/ebpj.v8i24.4632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/30/2023] [Indexed: 09/02/2023]
Abstract
Insufficient calcium intake and being physically inactive lead to osteoporosis. This study aimed to assess the level of knowledge about osteoporosis, physical activity levels and their correlation with calcium intake. 276 female undergraduate students participated in this study. A set of questionnaires was distributed. Majority students had low knowledge (76.1%), moderate physical activity level (47.1%) and did not meet the recommended calcium intake (79.0%). There was a moderate to strong positive correlation but not significant between knowledge (r= 0.051, p=0.121) and physical activity (r = 0.081, p=0.181) to dietary calcium intake. In conclusion, students had poor knowledge about osteoporosis.
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Zhang C, Li H, Li J, Hu J, Yang K, Tao L. Oxidative stress: A common pathological state in a high-risk population for osteoporosis. Biomed Pharmacother 2023; 163:114834. [PMID: 37163779 DOI: 10.1016/j.biopha.2023.114834] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023] Open
Abstract
Osteoporosis is becoming a major concern in the field of public health. The process of bone loss is insidious and does not directly induce obvious symptoms. Complications indicate an irreversible decrease in bone mass. The high-risk populations of osteoporosis, including postmenopausal women, elderly men, diabetic patients and obese individuals need regular bone mineral density testing and appropriate preventive treatment. However, the primary changes in these populations are different, increasing the difficulty of effective treatment of osteoporosis. Determining the core pathogenesis of osteoporosis helps improve the efficiency and efficacy of treatment among these populations. Oxidative stress is a common pathological state secondary to estrogen deficiency, aging, hyperglycemia and hyperlipemia. In this review, we divided oxidative stress into the direct effect of reactive oxygen species (ROS) and the reduction of antioxidant enzyme activity to discuss their roles in the development of osteoporosis. ROS initiated mitochondrial apoptotic signaling and suppressed osteogenic marker expression to weaken osteogenesis. MAPK and NF-κB signaling pathways mediated the positive effect of ROS on osteoclast differentiation. Antioxidant enzymes not only eliminate the negative effects of ROS, but also directly participate in the regulation of bone metabolism. Additionally, we also described the roles of proinflammatory factors and HIF-1α under the pathophysiological changes of inflammation and hypoxia, which provided a supplement of oxidative stress-induced osteoporosis. In conclusion, our review showed that oxidative stress was a common pathological state in a high-risk population for osteoporosis. Targeted oxidative stress treatment would greatly optimize the therapeutic schedule of various osteoporosis treatments.
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Affiliation(s)
- Chi Zhang
- Department of Orthopedics, First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, China
| | - Hao Li
- Department of Orthopedics, First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, China
| | - Jie Li
- Department of Orthopedics, First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, China
| | - Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang 110122, China
| | - Keda Yang
- Department of Orthopedics, First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, China.
| | - Lin Tao
- Department of Orthopedics, First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, China.
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