Bilateral Looser zones or pseudofractures in the anteromedial tibia as a component of medial tibial stress syndrome in athletes

Abstract Purpose Medial tibial stress syndrome (MTSS) represents a common diagnosis in individuals exposed to repetitive high-stress loads affecting the lower limb, e.g., high-performance athletes. However, the diagnostic approach and therapeutic regimens are not well established. Methods Nine patients, diagnosed as MTSS, were analyzed by a comprehensive skeletal analysis including laboratory bone turnover parameters, dual-energy X-Ray absorptiometry (DXA), and high-resolution peripheral quantitative computed tomography (HR-pQCT). Results In 4/9 patients, bilateral pseudofractures were detected in the mid-shaft tibia. These patients had significantly lower levels of 25-hydroxycholecalciferol compared to patients with MTSS but similar levels of bone turnover parameters. Interestingly, the skeletal assessment revealed significantly higher bone mineral density (BMD) Z-scores at the hip (1.3 ± 0.6 vs. − 0.7 ± 0.5, p = 0.013) in patients with pseudofractures and a trend towards higher bone microarchitecture parameters measured by HR-pQCT at the distal tibia. Vitamin D supplementation restored the calcium-homeostasis in all patients. Combined with weight-bearing as tolerated, pseudofractures healed in all patients and return to competition was achieved. Conclusion In conclusion, deficient vitamin D levels may lead to pseudofractures due to localized deterioration of mineralization, representing a pivotal component of MTSS in athletes with increased repetitive mechanical loading of the lower limbs. Moreover, the manifestation of pseudofractures is not a consequence of an altered BMD nor microarchitecture but appears in patients with exercise-induced BMD increase in combination with reduced 25-OH-D levels. The screening of MTSS patients for pseudofractures is crucial for the initiation of an appropriate treatment such as vitamin D supplementation to prevent a prolonged course of healing or recurrence. Level of evidence III.

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Effect of calcium and vitamin D supplementation with and without collagen peptides on volumetric and areal bone mineral density, bone geometry and bone turnover in postmenopausal women with osteopenia

Journal of Clinical Densitometry ◽

10.1016/j.jocd.2021.11.011 ◽

2021 ◽

Author(s):

Kalliopi Lampropoulou-Adamidou ◽

Efthymia Karlafti ◽

Chrysoula Argyrou ◽

Konstantinos Makris ◽

George Trovas ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Mineral ◽

Bone Geometry ◽

Vitamin D Supplementation ◽

Areal Bone Mineral Density ◽

Mineral Density ◽

Collagen Peptides

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High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2008.19.6162 ◽

2009 ◽

Vol 27 (13) ◽

pp. 2151-2156 ◽

Cited By ~ 96

Author(s):

Katherine D. Crew ◽

Elizabeth Shane ◽

Serge Cremers ◽

Donald J. McMahon ◽

Dinaz Irani ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Black Women ◽

Adjuvant Chemotherapy ◽

Vitamin D Deficiency ◽

White Women ◽

Premenopausal Women ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Vitamin D Levels

Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation. Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater. Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use. Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined.

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25-hydroxy vitamin D levels in healthy premenopausal women: Association with bone turnover markers and bone mineral density

Bone ◽

10.1016/j.bone.2009.05.012 ◽

2009 ◽

Vol 45 (3) ◽

pp. 423-426 ◽

Cited By ~ 48

Author(s):

Silvano Adami ◽

Francesco Bertoldo ◽

Vania Braga ◽

Elena Fracassi ◽

Davide Gatti ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Premenopausal Women ◽

Mineral Density ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D ◽

Turnover Markers

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Calcium and vitamin D supplementation in children with frequently relapsing and steroid-dependent nephrotic syndrome

Paediatrica Indonesiana ◽

10.14238/pi52.1.2012.16-21 ◽

2012 ◽

Vol 52 (1) ◽

pp. 16

Author(s):

Ayi Dilla Septarini ◽

Taralan Tambunan ◽

Pustika Amalia

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Vitamin D Supplementation ◽

Ionized Calcium ◽

Mineral Density ◽

Vitamin D Levels ◽

Before And After ◽

25 Hydroxy Vitamin D ◽

Serum Ionized Calcium

Background Children with frequently relapsing and steroiddependentnephrotic syndrome (FRNS/SDNS) are at riskfor osteoporosis due to impaired metabolism of calcium andvitamin D.Objective To determine the effect of calcium and vitamin Dsupplementation on bone mineral density, serum ionized calciumlevels and serum 25-hydroxy-vitamin D levels in children withFRNS and SDNS.Methods A clinical trial with a before and after design wasperformed. Subjects were SDNS or FRNS pediatric patients 2: 5years of age. Subjects received 800 mg elemental calcium and 400IU vitamin D supplementation for 8 weeks. Serum ionized calcium,serum 25-hydroxy-vitamin D [25(0H)D], and bone mineral density(BMD) were determined before and after the supplementation.Results Of the 30 subjects, 28 completed the study. However,only 20 subjects underwent BMD determination before and aftersupplementation. Of the 28 subjects, 22 had hypocalcemia and 26had low vitamin D levels. Osteopenia was found in 14/20 subjects andosteoporosis was in 2/20 subjects. After 8 weeks of supplementation,mean serum ionized calcium increased from low [1.15 mmol/L (SDO.oJ)] to normal [1.18 mmol/L (SD 0.04)] (P< 0.001) levels, butmean serum 25(0H)D only increased from vitamin D deficiencycategory [20 ng/mL (SD 7 .7)] to vitamin D insufficiency category[25.5 ng/mL (7.7)] (P=0.010). Mean z-score BMD increased from-1.1 (SD 0.9) to -0.7 (SD 0.2) after supplementation (P<0.001).Conclusion Calcium vitamin D supplementation effectively increasedserum ionized calcium, serum 25 (OH)D, and BMD in subjectswith FRNS and SDNS. [Paediatr lndones. 2012;52:16-21].

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Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa

International Journal of Eating Disorders ◽

10.1002/eat.22731 ◽

2017 ◽

Vol 50 (9) ◽

pp. 1041-1049 ◽

Cited By ~ 11

Author(s):

Alessandro Giollo ◽

Luca Idolazzi ◽

Cristian Caimmi ◽

Angelo Fassio ◽

Francesco Bertoldo ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Anorexia Nervosa ◽

Weight Gain ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Mineral Density ◽

Vitamin D Levels ◽

Turnover Markers

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No Vitamin D Deficiency in Patients With Parkinson’s Disease

10.21203/rs.3.rs-1128183/v1 ◽

2021 ◽

Author(s):

Wilfried Kuhn ◽

Georg Karp ◽

Thomas Müller

Keyword(s):

Parkinson’S Disease ◽

Vitamin D ◽

Parkinson's Disease ◽

Disease Severity ◽

Case Control Study ◽

Case Control ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Vitamin D Levels ◽

Control Study

Abstract Previous trials describe a decrease of vitamin D levels in patients with Parkinson’s disease and relationships to clinical disease severity. This case control study found not significant but higher 25-OH-vitamin D plasma levels in patients with Parkinson’s disease patients compared with age and sex matched controls and no associations to clinical parameters, such as rating scores of disease severity or assessments of cognitive function. A certain variability of vitamin D concentration was observed in both cohorts. These outcomes put into perspective the emerging discussion on the importance of vitamin D in patients with Parkinson’s disease. Our results warrant further confirmatory research with a strict matching design of patients and controls, which has not been done in previous investigations. We stress that this case control study does not allow any comment on the putative beneficial effects of vitamin D supplementation, i.e. on bone mass or bone mineral density in patients with Parkinson’s disease.

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Prevalence of vitamin D inadequacy and bone turnover markers concerning bone mineral density in older persons

Journal of Medicine and Life ◽

10.25122/jml-2020-0113 ◽

2021 ◽

Vol 14 (3) ◽

pp. 397-401

Author(s):

Abhinav Jha ◽

◽

Aditi Singh Tanwar ◽

Manish Bhargava ◽

Anil Raj ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Bone Turnover Marker ◽

Mineral Density ◽

Vitamin D Levels ◽

Removable Prosthesis ◽

Turnover Markers

Owing to the early tooth loss in a large population, the need for removable prosthodontic therapy has widely increased. Loss of teeth can occur due to trauma, periodontal disease, dental caries, and/or oral health negligence. The removable prosthesis is preferred over other teeth replacement methods owing to its cost-effectiveness. However, due to continuous alveolar bone resorption, relining of the removable prosthesis is needed regularly. We aimed to assess the prevalence of vitamin D deficiency and bone turnover marker concerning bone mineral density. Eighty complete denture wearers either in the maxilla or in the mandible or both constituted the study sample. Before the study, all subjects were explained the procedures of the study, and informed consent was obtained before proceeding with the study. Subjects were instructed to provide an early morning sample in a fasting state as serum osteocalcin (OCN) and C-terminal telopeptide (C-Tx) have diurnal variations. Blood samples were collected, and samples were ruled out for 25-OH vitamin D, serum OCN, and C-TX. To determine the association between frequency of relining and bone turnover marker, the collected data were subjected to statistical evaluation. Significant correlations were seen between bone C-Tx, turnover markers (p<0.001), and frequency of denture relining and osteocalcin (p<0.001). No statistically significant effect of gender, vitamin D levels, age, calcium levels, vitamin D supplements, and diabetes was seen on denture relining frequency. The present study concludes that an elevated level of the bone turnover markers such as OCN and C-Tx increases the frequency of relining.

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Role of vitamin D levels and vitamin D supplementation on bone mineral density in Klinefelter syndrome

Endocrine Abstracts ◽

10.1530/endoabs.37.gp.10.08 ◽

2015 ◽

Author(s):

Alberto Ferlin ◽

Riccardo Selice ◽

Mambro Antonella Di ◽

Marco Ghezzi ◽

Nicola Caretta ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Klinefelter Syndrome ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Vitamin D Levels

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The Effects of Season-Long Vitamin D Supplementation on Collegiate Swimmers and Divers

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.23.5.431 ◽

2013 ◽

Vol 23 (5) ◽

pp. 431-440 ◽

Cited By ~ 30

Author(s):

Regina M. Lewis ◽

Maja Redzic ◽

D. Travis Thomas

Keyword(s):

Vitamin D ◽

Body Composition ◽

Bone Turnover ◽

Inflammatory Cytokines ◽

Bone Turnover Markers ◽

Female Athletes ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Turnover Markers ◽

Total Body

The purpose of this 6-month randomized, placebo-controlled trial was to determine the effect of season-long (September–March) vitamin D supplementation on changes in vitamin D status, which is measured as 25(OH) D, body composition, inflammation, and frequency of illness and injury. Forty-five male and female athletes were randomized to 4,000 IU vitamin D (n = 23) or placebo (n = 22). Bone turnover markers (NTx and BSAP), 25(OH)D, and inflammatory cytokines (TNF-alpha, IL-6, and IL1-β) were measured at baseline, midpoint, and endpoint. Body composition was assessed by DXA and injury and illness data were collected. All athletes had sufficient 25(OH)D (> 32 ng/ml) at baseline (mean: 57 ng/ml). At midpoint and endpoint, 13% and 16% of the total sample had 25(OH)D < 32 ng/ml, respectively. 25(OH)D was not positively correlated with bone mineral density (BMD) in the total body, proximal dual femur, or lumbar spine. In men, total body (p = .04) and trunk (p = .04) mineral-free lean mass (MFL) were positively correlated with 25(OH)D. In women, right femoral neck BMD (p = .02) was positively correlated with 25(OH)D. 25(OH)D did not correlate with changes in bone turnover markers or inflammatory cytokines. Illness (n = 1) and injury (n = 13) were not related to 25(OH)D; however, 77% of injuries coincided with decreases in 25(OH)D. Our data suggests that 4,000 IU vitamin D supplementation is an inexpensive intervention that effectively increased 25(OH)D, which was positively correlated to bone measures in the proximal dual femur and MFL. Future studies with larger sample sizes and improved supplement compliance are needed to expand our understanding of the effects of vitamin D supplementation in athletes.

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