Diet Modulates the Effects of Genetic Variants on the Vitamin D Metabolic Pathway and Bone Mineral Density in Mexican Postmenopausal Women

2021 ◽  
Author(s):  
Berenice Rivera-Paredez ◽  
Amado D Quezada-Sánchez ◽  
Edgar Denova-Gutiérrez ◽  
Leticia Torres-Ibarra ◽  
Yvonne N Flores ◽  
...  

ABSTRACT Background Macro- and micronutrients, such as proteins, vitamin D, and calcium (Ca), are important dietary factors that can modify bone mineral density (BMD). Genetic factors can interact with diet, affecting an individual's predisposition to osteoporosis. Objectives This study aimed to evaluate the associations between macro- and micronutrient intakes and BMD in Mexican postmenopausal women, and their interactions with genetic polymorphisms involved in the vitamin D metabolic pathway. Methods We analyzed data from 317 postmenopausal women from the Health Workers Cohort Study, a longitudinal cohort studied in Cuernavaca, Mexico. Postmenopausal women participated in 2 data collection waves (2004–2006 and 2010–2011), with a mean time of 6.4 years. Dietary intake was assessed with a semi-quantitative FFQ. BMD (femoral neck, hip, and lumbar spine) was measured by DXA. Hybrid mixed-effects regression models were used to assess the associations of dietary macro- and micronutrients on BMD, after adjusting for confounding factors and for diet and single nucleotide polymorphism interactions. Results At baseline, the median age was 57 years (IQR, 50–64). Mean femoral neck, hip, and lumbar spine BMDs decreased over time. We observed statistically significant longitudinal associations for diet (Ca, vitamin D, magnesium, phosphorus, and protein intake) and BMD. Increases of vitamin D, Ca, and protein intakes by 1 SD were associated with mean increases in the femoral neck BMD (0.083 SD, 0.064 SD, and 0.130 SD, respectively). Multiple significant interactions were identified between several loci (CYP2R1, CYP24A1, CYP27B1, VDR, and DHCR7/NADSYN1) and diet for BMDs (femoral neck, hip, and lumbar spine), mainly for protein intake. Conclusions Our data support associations of vitamin D, Ca, protein, phosphorous, and magnesium consumption with BMD in Mexican postmenopausal women and suggest possible gene-diet interactions. These results could facilitate future personalized nutrition recommendations to help prevent low BMD.

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Aneeta J Joseph ◽  
Jesus L Penabad ◽  
Antonio Pinero-Pilona

Abstract Introduction: Teriparatide, a parathyroid hormone analog, is an important anabolic agent approved by the U.S. Food and Drug Administration to increase bone mineral density in osteoporotic patients. Parathyroid hormone (PTH) regulates calcium, phosphate, and active vitamin-D metabolites.The amino terminal peptide fragments of PTH has been known to increase bone mass and are being used in clinical practice for osteoporosis management (1). Current literature shows the efficacy of teriparatide in increasing bone density of lumbar spine and femoral neck, and decreasing the risk of vertebral and non-vertebral fractures both in postmenopausal women and men. It is also known to prevent fractures in patients with osteoporosis and promote healing of fractures (2). Case Description: A 79-year-old Hispanic female with history of osteopenia and major lumbar spine wedge compression fractures presented to our clinic for consultation. She was on ibandronate for the past four months and was having symptoms of pill esophagitis. Her last bone mineral density done on August 2017 revealed T-score of -2.5 at the lumbar spine, -1.5 at the left femoral neck, and 3.3% bone loss on the left femoral head. Rather than being started on teriparatide, zoledronic acid, or denosumab, she continued ibandronate along with calcium and vitamin D. Two months after the initial consultation, she sustained a traumatic fracture of the posterior arch and body of C2 bilaterally following a motor vehicle accident. There were discussions about starting anabolic treatment, as serial imaging did not show any significant improvement in the healing process despite the use of a collar. Two months after sustaining C2 fracture, she was started on teriparatide. Repeat cervical spine x-ray three months later showed complete healing of the C2 fracture. Discussion: There are a limited number of cases reported in regards to teriparatide induced healing of non-osteoporotic fractures (3). Our case is one of the very few reported to have shown complete radiographic and clinical healing of a traumatic, non-osteoporotic fracture after use of teriparatide for 12 weeks.


2015 ◽  
Vol 26 (3) ◽  
pp. 58-64
Author(s):  
C Zonunsanga ◽  
Hmingthanmawii LNU ◽  
Minggam Pertin ◽  
Chongreilen Chiru ◽  
Romi Singh Nongmaithem ◽  
...  

Abstract Aim To evaluate the quality of life in postmenopausal women and its correlation with bone mineral density. Study design Cross-sectional study. Duration of the study October 2012 to September 2014. Settings Physical Medicine and Rehabilitation Department, Regional Institute of Medical Sciences, Imphal. Study population Postmenopausal women who attended the department during the study period. Materials and Methods Quality of life was assessed using WHOQOL-BREF questionnaire, a validated brief version of the WHOQOL-100. Bone mineral density (BMD) in the lumbar spine, femoral neck and trochanter were measured using dual energy x-ray absorptiometry (DEXA) scan – GE Lunar model. Results A total of 125 patients were studied. The mean t-scores in lumbar spine, femoral neck and trochanter were -2.550 ± 1.209, -1.831 ± 0.921 and -1.621 ± 1.064 respectively. The mean BMD (g/cm2) in lumbar spine, femoral neck and trochanter were 0.867 ± 0.144, 0.789 ± 0.131 and 0.682 ± 0.139 respectively. The mean overall WHOQOL score was 57.68±10.07. There were statistically significant positive association of WHOQOL score with the BMDs in lumbar spine, femoral neck and trochanter (p < 0.05). Multivariate regression showed significant relation of overall WHOQOL score with BMD lumbar spine (b=0.229; R2=0.119), BMD femoral neck (b=0.285; R2=0.129), and BMD trochanter (b=0.245; R2=0.119). Conclusion BMDs in the lumbar spine, femoral neck and trochanter had a positive correlation with quality of life scores. BMD also had a good predictive value in determining the quality of life in postmenopausal women.


2020 ◽  
Vol 14 (4) ◽  
pp. 282-289
Author(s):  
Susana Cararo Confortin ◽  
Lariane Mortean Ono ◽  
Larissa Pruner Marques ◽  
Thamara Hubler Figueiró ◽  
Gilciane Ceolin ◽  
...  

OBJECTIVE: To verify associations between osteopenia/osteoporosis and vitamin D and sarcopenia in the older adult population of Florianopolis, Brazil. METHODS: A cross-sectional population-based study, with 604 older adults (60 years and over). The appendicular muscle mass index (AMMI) was used to identify sarcopenia, with cutoffs of AMMI (Kg/m2) < 7.26 kg/m2 for men and < 5.50 kg/m2 for women indicating inadequate values (sarcopenia). The independent variable osteopenia/osteoporosis was measured using bone mineral density (BMD, g/cm2): T-Scores for whole body BMD, lumbar spine BMD, and femoral neck BMD, categorized as normal (BMD ≥ -1 SD) or osteopenia/osteoporosis (BMD < -1 SD from the mean of the young adult reference population). Fasting serum samples were collected and assayed using the microparticle chemiluminescence (CMIA)/Liaison method. Vitamin D concentrations of < 30 ng/mL were defined as hypovitaminosis. Crude and adjusted logistic regression analyses were performed. RESULTS: Osteopenia/osteoporosis in the lumbar spine and femoral neck were associated with higher odds of sarcopenia in women and men. Osteopenia/osteoporosis in the whole body was associated with sarcopenia in women only. Vitamin D was not associated with sarcopenia in either sex. CONCLUSIONS: Having osteopenia/osteoporosis is associated with sarcopenia in the older adult population.


2008 ◽  
Vol 99 (6) ◽  
pp. 1322-1329 ◽  
Author(s):  
Md Zahirul Islam ◽  
Abu Ahmed Shamim ◽  
Virpi Kemi ◽  
Antti Nevanlinna ◽  
Mohammad Akhtaruzzaman ◽  
...  

The manufacture of garments is the main industry in Bangladesh and employs 1·6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18–36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36·7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16 % of the subjects were found to be vitamin D-deficient (S-25OHD < 25 nmol/l). We observed a high prevalence (88·5 %) of vitamin D insufficiency (S-25OHD < 50 nmol/l) as well as a significant inverse relationship between S-25OHD and S-iPTH (r − 0·25, P ≤ 0·001). A decrease in S-25OHD ( < 38 nmol/l) and an increase in S-iPTH (>21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < − 2·5 had a trend of lower values of BMI, waist–hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Wei He ◽  
Ming Liu ◽  
Xiaonan Huang ◽  
Zuhong Qing ◽  
Wei Gao

Growing evidence indicates that the vitamin D receptor (VDR) gene is an important candidate gene for influencing the development of osteoporosis. The aim of the study was to evaluate the potential association between genetic variants ofVDRgene and bone mineral density (BMD) and osteoporosis in Chinese postmenopausal women. The study included 970 Chinese postmenopausal women at the postmenopausal osteoporosis (482) and healthy controls (488). The BMD of lumbar spine (L2–4anterior-posterior view), femoral neck hip, and total hip was evaluated using the Norland XR-46 dual energy X-ray absorptiometry (DEXA). The genotypes ofVDRgenetic variants were determined by the created restriction site-PCR (CRS-PCR) and confirmed by DNA sequencing methods. Our data indicated that theVDRp.Glicine (Gly)14 alanine (Ala) and p.histidine (His) 305 glutanine (Gln) genetic variants were statistically associated with adjusted femoral neck hip BMD, adjusted lumbar spine BMD, and adjusted total hip BMD (Pvalues < 0.05). Results from this study suggest that theVDRp.Gly14Ala and p.His305Gln genetic variants are significantly associated with BMD decrease in Chinese postmenopausal women and might be used as molecular markers for assessing the risk of BMD and osteoporosis.


2016 ◽  
Vol 6;19 (6;7) ◽  
pp. 389-396
Author(s):  
Jeong Hun Suh

Background: No studies to date have compared bone mineral density (BMD) changes after epidural steroid injection (ESI) between postmenopausal patients taking antiosteoporotic medication and those who are not. Objective: The aim of the present study was to analyze the relationship between ESI and BMD changes in postmenopausal patients according to antiosteoporotic medication use. Study Design: Retrospective analysis. Setting: Department of Anesthesiology and Pain Medicine at Asan Medical Center, Korea. Methods: We retrospectively analyzed postmenopausal women who underwent ESI using dexamethasone. All women had received a diagnosis of lumbar spinal stenosis and their BMD had been measured before and after treatment. BMD was evaluated by dual-energy x-ray absorptiometry at the lumbar spine, femoral neck, femoral trochanter, and total femur, and was recorded as absolute g/cm2 and T-scores. A total of 126 patients were included in the final analysis. ESI patients were grouped as follows: group 1 (n = 74) ESI patients who took antiosteoporotic medication; group 2 (n = 52) ESI patients who did not take antiosteoporotic medication. Results: In group 1, there were no significant differences between baseline and post-treatment BMD absolute values (g/cm2) in the lumbar spine, femoral neck, femoral trochanter, and total femur. In group 2, significant changes in the post-treatment BMD absolute values (g/cm2) from baseline were observed in the femoral neck (–1.48 ± 3.84%), femoral trochanter (–2.80 ± 7.50%), and total femur (–2.23 ± 4.52%), but not in the lumbar spine (–2.23 ± 4.52%). Limitations: This study contained a small sample size, no control group, and no long-term follow-up of the BMD changes after ESI. Conclusions: Our data provide new evidence indicating that ESI causes BMD changes in postmenopausal women who do not take antiosteoporotic medication. Thus, we recommend that prophylactic antiosteoporotic treatment be considered for postmenopausal women who require ESI treatment. Keywords: Glucocorticoid, osteoporosis, bone mineral density, epidural steroid injection, antiosteoporotic medication, postmenopausal women, dexamethasone


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