Vitamin D and Bone Disease

Vitamin D is important for normal development and maintenance of the skeleton. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling and bone density. It is well known that Vit. D deficiency in the developing skeleton is related to rickets, while in adults is related to osteomalacia. The causes of rickets include conditions that lead to hypocalcemia and/or hypophosphatemia, either isolated or secondary to vitamin D deficiency. In osteomalacia, Vit. D deficiency leads to impairment of the mineralisation phase of bone remodeling and thus an increasing amount of the skeleton being replaced by unmineralized osteoid. The relationship between Vit. D and bone mineral density and osteoporosis are still controversial while new evidence suggests that Vit. D may play a role in other bone conditions such as osteoarthritis and stress fractures. In order to maintain a “good bone health” guidelines concerning the recommended dietary intakes should be followed and screening for Vit. D deficiency in individuals at risk for deficiency is required, followed by the appropriate action.

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MINERAL DENSITY OF BONE TISSUE AND INDICATORS OF BONE REMODELING IN HIGHLY SKILLED ATHLETES IN THE ANNUAL TRAINING CYCLE

Human Sport Medicine ◽

10.14529/hsm190406 ◽

2020 ◽

Vol 19 (4) ◽

pp. 43-49

Author(s):

K Nikitina ◽

T Abramova ◽

T Nikitina

Keyword(s):

Bone Tissue ◽

Bone Remodeling ◽

Calcium Metabolism ◽

Mineral Density ◽

Osteoblastic Activity ◽

Training Cycle ◽

Highly Skilled ◽

The Status ◽

Heel Bone ◽

The Relationship

Aim. The article aims at studying the relationship between the mineral density of heel bone and bone remodeling in cyclistduring the annual training cycle. Materials and methods. The study involved 14 highly skilled male cyclists (cycle track, MS, MSIC) aged 20–25 years with a sports experience of 5 to 16 years. The measurements were performed in the preparatory, pre-competitive and competitive periods of the annual training cycle. Bone mineral density (BMD) was measured by the method of quantitative ultrasound densitometry (QUS) using the Achilles Express ultrasonometer (Lunar, USA). BMD was estimated as a percentage of the peak norm for a given section of the skeleton (reference norms for 20–29 years). Results. The dynamics of BMD in the annual cycle correlates with a change in bone remodeling and phosphorus-calcium metabolism. A decrease in BMD during the competitive period is associated with an increase in β-Cross Laps and a decrease in osteocalcin, alkaline phosphatase, ionized calcium and serum phosphorus. Conclusion. A decrease in BMD is associated with an increase in the activity of osteoclasts and a decrease in osteoblastic activity. Indicators of bone remodeling and phosphorus-calcium metabolism reflect the status of bone tissue and the processes of general adaptation to training loads, and can be used as markers of risk of decreased BMD. The heel bone QUS method can be used to identify athletes at risk for hypotrophic conditions.

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Relationship Between Nutrient Intake and Vitamin D Status in Osteoporotic Women

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.77.6.376 ◽

2007 ◽

Vol 77 (6) ◽

pp. 376-381 ◽

Cited By ~ 12

Author(s):

de Souza Genaro ◽

de Paiva Pereira ◽

de Medeiros Pinheiro ◽

Szejnfeld ◽

Araújo Martini

Keyword(s):

Vitamin D ◽

Mineral Metabolism ◽

Sodium Intake ◽

Serum Vitamin ◽

Cross Sectional Study ◽

Dietary Intakes ◽

Mineral Density ◽

Cross Sectional ◽

Serum Vitamin D ◽

Dietary Records

Vitamin D is essential for maintaining calcium homeostasis and optimizing bone health. Its inadequacy is related to many factors including dietary intake. The aim of the present study was to evaluate serum 25(OH)D and its relationship with nutrient intakes in postmenopausal Brazilian women with osteoporosis. This cross-sectional study comprised 45 free-living and assisted elderly at São Paulo Hospital. Three-day dietary records were used to assess dietary intakes. Bone mineral density was measured with a dual-energy X-ray absorptiometer (DXA). Blood and urine sample were collected for analysis of biochemical markers of bone and mineral metabolism. Insufficiency of vitamin D was observed in 24.4% of the women and optimal levels (≥ 50 nmol/L) were observed in 75.6%. Parathyroid hormone was above the reference range in 51% of the participants. The mean calcium (724 mg/day) and vitamin D (4.2 μ g/day) intakes were lower than the value proposed by The Food and Nutrition Board and sodium intake was more than two-fold above the recommendation. Higher levels of serum 25(OH)D were inversely associated with sodium intake. Dietary strategies to improve serum vitamin D must focus on increasing vitamin D intake and should take a reduction of sodium intake into consideration.

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Hypovitaminosis D in Patients with Ankylosing Spondylitis: Frequency and Consequences

Current Rheumatology Reviews ◽

10.2174/1573397117666210308122515 ◽

2021 ◽

Vol 17 ◽

Author(s):

Gehan Elolemy ◽

Waleed Hassan ◽

Mohamed Nasr ◽

Eman Baraka

Keyword(s):

Vitamin D ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Bone Mineral ◽

Hypovitaminosis D ◽

Healthy Controls ◽

Mineral Density ◽

Z Scores ◽

The Impact ◽

Active Disease

Objectives: was to assess the frequency of hypovitaminosis D in patients with ankylosing spondylitis (AS) compared to healthy controls and to evaluate its association with disease activity, structural damage and bone mineral density (BMD). Methods: Serum 25(OH) D in 30 AS male patients was compared to 30 matched healthy controls. AS disease activity was assessed using AS Disease Activity Score and C - reactive protein (ASDAS-CRP). Bath AS Functional Index (BASFI) and Bath AS Metrology Index (BASMI) were used to assess the functional impairment and the spinal mobility respectively. Radiological damage was scored according to modified Stoke AS Spine Score (mSASSS) and BMD was measured in the lumbar spine and femoral neck. Results: The mean serum 25(OH)D levels in AS patients were significantly lower compared to healthy controls (27.73 ± 14.27 vs. 38.46 ± 8.11ng/ml, P <0.001). Among the patients, 60% exhibited hypovitaminosis D. AS patients with hypovitaminosis D had significantly higher ASDAS-CRP (p<0.001), BASFAI (p=0.0003) and mSASSS (p=0.04) scores. Additionally, BMD and Z scores at lumbar and femoral sites were significantly reduced in the patients with hypovitaminosis D (P < 0.05). Serum 25(OH)D was positively correlated with BMD (lumbar and femoral; p=0.002 and p=0.01 respectively) and Z scores (lumbar and femoral; p<0.001and p=0.01 respectively), whereas, negatively correlated with ASDAS-CRP (p<0.001), BASFI (p<0.001), mSASSS (p=0.003). ASDAS -CRP was the only significant predictor of hypovitaminosis D in AS patients. Conclusions: hypovitaminosis D is prevalent among AS patients and is associated with increased risk of active disease, impaired function, radiographic severity and bone mineral loss. Future studies with larger sample size are recommended to assess the impact of vitamin D deficiency on radiological progression in AS and to address whether or not vitamin D supplementation will help control active disease.

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Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment

Proceedings of The Nutrition Society ◽

10.1017/s0029665108007003 ◽

2008 ◽

Vol 67 (2) ◽

pp. 163-176 ◽

Cited By ~ 66

Author(s):

Susan A. Lanham-New

Keyword(s):

Vitamin D ◽

Bone Loss ◽

Vitamin K ◽

Hypovitaminosis D ◽

Osteoporosis Prevention ◽

Mineral Density ◽

Increased Risk ◽

Post Menopause ◽

Exogenous Factors ◽

The Uk

Throughout the life cycle the skeleton requires optimum development and maintenance of its integrity to prevent fracture. Bones break because the loads placed on them exceed the ability of the bone to absorb the energy involved. It is now estimated that one in three women and one in twelve men aged >55 years will suffer from osteoporosis in their lifetime and at a cost in the UK of >£1·7×109 per year. The pathogenesis of osteoporosis is multifactorial. Both the development of peak bone mass and the rate of bone loss are determined by key endogenous and exogenous factors. Ca supplements appear to be effective in reducing bone loss in women late post menopause (>5 years post menopause), particularly in those with low habitual Ca intake (<400 mg/d). In women early post menopause (<5 years post menopause) who are not vitamin D deficient, Ca supplementation has little effect on bone mineral density. However, supplementation with vitamin D and Ca has been shown to reduce fracture rates in the institutionalised elderly, but there remains controversy as to whether supplementation is effective in reducing fracture in free-living populations. Re-defining vitamin D requirements in the UK is needed since there is evidence of extensive hypovitaminosis D in the UK. Low vitamin D status is associated with an increased risk of falling and a variety of other health outcomes and is an area that requires urgent attention. The role of other micronutrients on bone remains to be fully defined, although there are promising data in the literature for a clear link between vitamin K nutrition and skeletal integrity, including fracture reduction.

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The relationship between serum vitamin D levels and bone mineral density in community-dwelling elderly

European Geriatric Medicine ◽

10.1016/j.eurger.2012.07.200 ◽

2012 ◽

Vol 3 ◽

pp. S92

Author(s):

H. Yildiz ◽

T. Atli ◽

M. Varli ◽

S. Aras ◽

A. Yalcin ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Serum Vitamin ◽

Community Dwelling ◽

Mineral Density ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

The Relationship

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Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong

British Journal Of Nutrition ◽

10.1017/s0007114507844382 ◽

2008 ◽

Vol 99 (6) ◽

pp. 1330-1334 ◽

Cited By ~ 43

Author(s):

Jean Woo ◽

Christopher W. K. Lam ◽

Jason Leung ◽

Winny Y. Lau ◽

Edith Lau ◽

...

Keyword(s):

Vitamin D ◽

Hong Kong ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Vitamin D Insufficiency ◽

Dietary Intakes ◽

Hydroxyvitamin D ◽

The North ◽

25 Hydroxyvitamin D ◽

The Relationship

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring – Beijing in the north (latitude 39° north) and Hong Kong (latitude 22° north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18–40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0·001). Vitamin D deficiency ( ≤ 25 nmol/l) was indicated in 40 % of Beijing and 18 % of Hong Kong women, and over 90 % of women in both cities were insufficient ( ≤ 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2·0 μg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of − 0·36 (different from 0; P < 0·001; R 0·26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.

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BONE REMODELING MARKERS AS PREDICTORS OF BONE METABOLIC CHANGES IN MALES WITH DIABETIC OSTEOPATHY

Rheumatology Science and Practice ◽

10.14412/1995-4484-2020-290-293 ◽

2020 ◽

Vol 58 (3) ◽

pp. 290-293

Author(s):

S. S. Safarova ◽

S. S. Safarova

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Remodeling ◽

Control Group ◽

Mineral Density ◽

Amino Terminal ◽

Bone Remodeling Markers ◽

History Of ◽

Male Patients

Diabetic osteopathy is one of the little studied complications of diabetes mellitus (DM), which leads to common lowtrauma fractures and, as a consequence, disability and death. The level of insulin is connected with bone functional and morphological changes followed by decreased bone mineral density (BMD) in the early stages of diabetic osteopathy. Objective: to study bone morphofunctional properties in males with type 1 and 2 DM (T1DM and T2DM). Subjects and methods. Examinations were made in 41 male patients with T1DM and 52 male patients with T2DM without a history of fractures. Their age varied from 40 to 70 years (mean age, 55.8±0.7 years and 58.4±0.9 years, respectively). A control group consisted of 34 patients (mean age, 55.9±0.9 years) without a history of DM. Patients with other endocrine disorders, end-stage complications, or chronic liver and kidney diseases were excluded from the investigation. BMD was determined by dual-energy X-ray absorptiometry (DXA). Serum bone remodeling markers (procollagen type 1 amino-terminal propeptide and C-terminal telopeptide), as well as 25(OH)D, parathyrin, insulin, glycated hemoglobin (HbA1c), and electrolytes (Ca2+, P+) were evaluated. Results and discussion. An association of BMD with renal function, HbA1c, and body mass index was observed in patients with T2DM. In the T1MD group, BMD was closely related to insulin deficiency and was significantly lower than that in the control group. In patients with vitamin D deficiency, BMD was significantly lower than in those with normal vitamin D levels (p<0.05). The patients with T1DM displayed both a decrease in BMD (p<0.05) and a pronounced change in the levels of bone markers (p<0.05). Those with T2DM had impaired bone remodeling processes, which was determined by the level of these markers (p<0.05) and observed in the presence of normal BMD due to the complex pathophysiology of the underlying disease. Conclusion. Vitamin D deficiency, insufficient and decreased insulin sensitivity, hyperglycemia, and overweight are important causes of osteopathy in patients with DM. The markers of bone remodeling may become promising indicators for diagnosing osteopathy, but additional studies are needed to elaborate recommendations for their use in routine practice in order to predict and prevent this complication of DM.

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Determinants of Vitamin D Levels in Children and Adolescents with Down Syndrome

International Journal of Endocrinology ◽

10.1155/2015/896758 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 17

Author(s):

Stefano Stagi ◽

Elisabetta Lapi ◽

Silvia Romano ◽

Sara Bargiacchi ◽

Alice Brambilla ◽

...

Keyword(s):

Vitamin D ◽

Down Syndrome ◽

Autoimmune Diseases ◽

Hypovitaminosis D ◽

Outdoor Exposure ◽

Dietary Intakes ◽

Vitamin D Levels ◽

Cholecalciferol Supplementation ◽

Age And Sex ◽

D Value

Background. Poor studies have evaluated 25-hydroxycholecalciferol (25(OH)D) levels in Down syndrome (DS).Objective. To assess in DS subjects serum 25(OH)D value, to identify risk factors for vitamin D deficiency, and to evaluate whether a normal 25(OH)D value can be restored with a 400 I.U. daily supplement of cholecalciferol in respect to controls.Methods. We have longitudinally evaluated 31 DS patients (aged 4.5–18.9 years old) and 99 age- and sex-matched healthy controls. In these subjects, we analysed calcium, phosphate, parathyroid hormone (PTH), 25(OH)D concentrations, and calcium and 25(OH)D dietary intakes, and we quantified outdoor exposure. After 12.3 months (range 8.1–14.7 months) of 25(OH)D supplementation, we reevaluated these subjects.Results. DS subjects showed reduced 25(OH)D levels compared to controls (P<0.0001), in particular DS subjects with obesity (P<0.05) and autoimmune diseases history (P<0.005). PTH levels were significantly higher in DS subjects than controls (P<0.0001). After cholecalciferol supplementation, 25(OH)D levels were significantly ameliorated (P<0.05), even if reduced compared to controls (P<0.0001), in particular in DS subjects with obesity (P<0.05) and autoimmune diseases (P<0.001).Conclusions. Hypovitaminosis D is very frequent in DS subjects, in particular in presence of obesity and autoimmune diseases. In these subjects, there could be a need for higher cholecalciferol supplementation.

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