scholarly journals Association of vitamin D and osteocalcin levels in post-menopausal women with osteoporosis

2017 ◽  
Vol 6 (4) ◽  
pp. 1244
Author(s):  
Yogiraj Vaijanathrao Chidre ◽  
Amir Babansab Shaikh
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Fragility Fractures ◽  
Bone Fragility ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Age Related ◽  
Calcium Phosphorus ◽  
Post Menopausal

Background: Osteoporosis is a common age related problem especially in women, with a consequent increase in bone fragility and susceptibility to fracture. Apart from Calcium, another nutrient that plays an important role in the mineralization of skeleton in Vitamin D. Osteocalcin, which is produced primarily by osteoblasts during bone formation, is considered to be one of the markers for osteoporosis.Methods: 314 women above the age of 40 were included into the study. A thorough physical and clinical examination, assessment of vital parameters, anthropometry evaluation was done for all patients. Bone mineral density was calculated using central DXA osteodensitometer at lumbar spine L1-L4, hip and ultradistal radius (in some cases.). Blood samples were taken for the detection of ionized calcium, phosphorus, alkaline phosphatase, 25hydroxivitamin D (25 ODH) and serum parathyroid hormone (PTH) by chemiluminiscent assay. Bone markers such as osteocalcin were measured as required.Results: Out of the 314 women attending our OPD, 96 of them were diagnosed as having osteoporosis. 24 out of them had fragility fractures, mainly of the hip, and 82 had ostepenia. Elevated levels of calcium (8.96 mg/dl), parathyroid hormone (58.76 pg/ml) and osteocalcin (24.46 ng/ml) were observed. Vitamin D deficiency of ≤ 20 was seen in 59 (63%) of the cases, insufficient in 23 (24%) and only 12 (13%) of these women had normal Vitamin D levels.Conclusions: Osteocalcin is a promising marker for the detection of osteoporosis. There is a considerable Vitamin D deficiency among the women with osteoporosis, and it is under-treated. It is essential to provide Vitamin D supplementation to these women especially those who are at high risk for fragility fractures.

scholarly journals The effectiveness of nutritional vitamin D supplementation and selective vitamin D receptor agonists treatment on secondary hyperparathyroidism in chronic kidney diseases patients

2018 ◽  
Vol 21 (2) ◽  
pp. 12-22 ◽  
Author(s):  
Lilit V. Egshatyan ◽  
Natalya G. Mokrisheva
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Receptor ◽  
Vitamin D Supplementation ◽  
Target Range ◽  
Receptor Agonists ◽  
Stage 4 ◽  
Calcium Phosphorus ◽  
Phosphorus Levels

Background: secondary hyperparathyroidism (SHPT) is an early complication of chronic kidney disease (CKD). Maintaining the level of 25(OH)D and parathyroid hormone concentrations in the target range reduce its associated complications (fractures and cardiovascular calcification). Aims: to examine the effectiveness of vitamin D supplementation and selective vitamin D receptor agonists treatment on SHPT in CKD. Material and methods: prospective observational study to evaluate the efficacy and safety of vitamin D therapy SHPT in 54 in patients with CKD. The first phase (24 weeks) – treatment of suboptimal 25-hydroxycalciferol (25(OH)D) levels. The second (16 weeks) – treatment colecalciferol-resistant SHPT by combination of cholecalciferol with paricalcitol. Blood samples were taken to assess parathyroid hormone (PTH), 25(OH)D, creatinine, calcium, phosphorus levels and calcium excretion. Results: After 8 weeks of cholecalciferol treatment all patients achieved 25(OH)D levels above 20 ng/ml, however 78% of patients still had SHPT. After 16 weeks, the decrease of PTH was achieved in all patients, but significantly only in patients with CKD 2 (19.2%, p< 0.01) and 3 (31%, p <0.05), compared with CKD 4 (17%, p >0.05). After 24 weeks of therapy, PTH normalized in all patients with CKD 2, in 15 (79%) with CKD 3 and in 9 (50%) patients with CKD 4. Cholecalciferol treatment resulted in a substantial increase in 25(OH)D levels with minimal or no impact on calcium, phosphorus levels and kidney function. After 24 weeks we initiated combination therapy (cholecalciferol and paricalcitol) for patients with colecalciferol-resistant SHPT (n=13). PTH levels decreased from 149.1±13.4 to 118.2±14.1 pg/ml at 8 weeks, and to 93.1±9.7 pg/ml (p <0.05) at 16 weeks of treatment. No significant differences in serum calcium, phosphorus or urinary calcium levels. Normalization of PTH was achieved in all patients with CKD 3 and in 8 patients with stage 4. One patient with CKD 4 needed an increase in paricalcitol dose. Conclusion: Cholecalciferol can be used in correcting vitamin D deficiency in patients with all stages of CKD, however, its effectiveness in reducing PTH in stage 4 is limited. Selective analogs, such as paricalcitol, were well-tolerated and effectively decreased PTH levels.

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

2009 ◽  
Vol 27 (13) ◽  
pp. 2151-2156 ◽  
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.

Effects on bone mineral density of calcium and vitamin D supplementation in elderly women with vitamin D deficiency

2003 ◽  
Vol 70 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Franck Grados ◽  
Michel Brazier ◽  
Saïd Kamel ◽  
Sigolène Duver ◽  
Nathalie Heurtebize ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Elderly Women ◽  
Vitamin D Supplementation ◽  
Mineral Density

scholarly journals The role of vitamin D in maintaining bone health in older people

2017 ◽  
Vol 9 (4) ◽  
pp. 89-95 ◽  
Author(s):  
Thomas R. Hill ◽  
Terry J. Aspray
Keyword(s):  
Vitamin D ◽  
Fracture Risk ◽  
Vitamin D Deficiency ◽  
Calcium Absorption ◽  
Vitamin D Supplementation ◽  
Optimum Dose ◽  
Main Concern ◽  
Mineral Density ◽  
Vitamin D Metabolism ◽  
The Impact

This review summarises aspects of vitamin D metabolism, the consequences of vitamin D deficiency, and the impact of vitamin D supplementation on musculoskeletal health in older age. With age, changes in vitamin D exposure, cutaneous vitamin D synthesis and behavioural factors (including physical activity, diet and sun exposure) are compounded by changes in calcium and vitamin D pathophysiology with altered calcium absorption, decreased 25-OH vitamin D [25(OH)D] hydroxylation, lower renal fractional calcium reabsorption and a rise in parathyroid hormone. Hypovitaminosis D is common and associated with a risk of osteomalacia, particularly in older adults, where rates of vitamin D deficiency range from 10–66%, depending on the threshold of circulating 25(OH)D used, population studied and season. The relationship between vitamin D status and osteoporosis is less clear. While circulating 25(OH)D has a linear relationship with bone mineral density (BMD) in some epidemiological studies, this is not consistent across all racial groups. The results of randomized controlled trials of vitamin D supplementation on BMD are also inconsistent, and some studies may be less relevant to the older population, as, for example, half of participants in the most robust meta-analysis were aged under 60 years. The impact on BMD of treating vitamin D deficiency (and osteomalacia) is also rarely considered in such intervention studies. When considering osteoporosis, fracture risk is our main concern, but vitamin D therapy has no consistent fracture-prevention effect, except in studies where calcium is coprescribed (particularly in frail populations living in care homes). As a J-shaped effect on falls and fracture risk is becoming evident with vitamin D interventions, we should target those at greatest risk who may benefit from vitamin D supplementation to decrease falls and fractures, although the optimum dose is still unclear.

Vitamin D, Parathyroid Hormone, and Acroosteolysis in Systemic Sclerosis

2008 ◽  
Vol 35 (11) ◽  
pp. 2201-2205 ◽  
Author(s):  
YOLANDA BRAUN-MOSCOVICI ◽  
DANIEL E. FURST ◽  
DORON MARKOVITS ◽  
ALEXANDER ROZIN ◽  
PHILIP J. CLEMENTS ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Systemic Sclerosis ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Medical Records ◽  
Disease Duration ◽  
Laboratory Evaluation ◽  
Vitamin D Levels ◽  
Calcium Phosphorus

ObjectiveSclerodactyly with acroosteolysis (AO) and calcinosis are prominent features of systemic sclerosis (SSc), but the pathogenesis of these findings is poorly understood. Vitamin D and parathyroid hormone (PTH) have a crucial role in bone metabolism and resorption and may affect AO and calcinosis. We assessed vitamin D and PTH in patients with SSc.MethodsMedical records of 134 consecutive patients with SSc (American College of Rheumatology criteria) followed at the rheumatology department during the years 2003–2006 were reviewed for clinical assessment, laboratory evaluation [including 25(OH) vitamin D, calcium, phosphorus, alkaline phosphatase, PTH, creatinine, and albumin]; imaging data confirming AO and/or calcinosis. Patients followed routinely at least once a year were included (81 patients). Of these, 60 patients’ medical records were found to have complete, relevant clinical, laboratory, and radiographic imaging.ResultsThirteen patients had diffuse disease and 47 limited disease — 51 women and 9 men, 44 Jews and 16 Arabs; mean age 55 ± 14 years; disease duration 8 ± 6 years. AO with or without calcinosis was observed in 42 patients (70%). Vitamin D deficiency was found in 46% of patients (16 out of 44 Jewish patients, 10 out of 16 Arab patients). PTH was elevated in 21.7% of patients. Significant correlations were observed between acroosteolysis and PTH (p = 0.015), calcinosis (p = 0.009), and disease duration (p = 0.008), and between PTH and vitamin D levels (p = 0.01). All patients had normal serum concentrations of calcium, phosphorus, magnesium, and albumin, and liver and kidney functions.ConclusionIn this group of Mediterranean patients with SSc, the incidence of vitamin D deficiency and secondary hyperparathyroidism was surprisingly high. This finding correlated with the occurrence of AO and calcinosis. Low levels of vitamin D may reflect silent malabsorption and might be a risk factor for secondary hyperparathyroidism and bone resorption. Traditional dress habits and low exposure to sun may contribute to vitamin D deficiency in an Arab population but do not explain all the findings. The pathogenesis of these findings needs to be corroborated in other SSc populations.

scholarly journals Bone condition in children with juvenile idiopathic arthritis

2021 ◽  
pp. 45-52
Author(s):  
N.S. Shevchenko ◽  
◽  
L.F. Bogmat ◽  
Yu.V. Khadzhinova ◽  
◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Juvenile Idiopathic Arthritis ◽  
Parathyroid Hormone ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Bone Tissue ◽  
Control Group ◽  
Mineral Density ◽  
Calcium And Phosphorus

Osteopenia (osteopenic syndrome) and osteoporosis (OP) are among the frequent and highly disabling conditions that accompany the development of rheumatic diseases (RD), including juvenile idiopathic arthritis (JIA). Changes in the requirements for the diagnosis and treatment of children with JIA according to the treatment strategy to achieve the goal (treat to target) have led to a decrease in the frequency of development and manifestations of OP in patients with RD. The condition of bone tissue in children with JIA, against the background of modern therapy and in conditions of widespread vitamin D deficiency requires further study. Purpose — to study bone mineral density (BMD) in children with JIA in modern disease management and to identify adverse factors for the development of OP among clinical signs. Materials and methods. We examined 35 children with JIA aged 7 to 17 years, mostly female (77.1%), with oligo (25.7)%, poly (60.0%) and undifferentiated (14.3%) option, 53.4% of whom have not yet received basic therapy. All patients underwent BMD by dual-energy X-ray absorptiometry on a bone densitometer Explorer QD W (Hologic), parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], total and ionized calcium and phosphorus in syvo. The control group consisted of 12 healthy children of the same age with a normal level of 25(OH)D. Results. The mean level of vitamin D in the serum of children in the main group was 20.41±1.35 ng/ml, which was significantly lower than in the control group (30.03±2.53 ng/ml, p<0.05); the frequency of low levels of vitamin D reached 88.57%. The content of calcium and phosphorus in the blood did not deviate from the normative values, despite the widespread deficiency of vitamin D. 98.37% of patients had normal PTH values, the average level in the blood was 30.43±0.90 pg/ml. The content of PTH was the highest in non-differential arthritis (34.33±1.80 pg/ml), the lowest in the oligoarticular variant (28.36±1.43 pg/ml, p<0.05). PTH concentrations correlated with vitamin D levels (r=-0.41; p<0.05) and were independent of patient gender and disease activity. The frequency of decreased BMD was 28.57% of the surveyed children. The prevalence of osteopenia was the same in different variants of arthritis and did not depend on the sex and age of patients, positivity in the RF. Osteopenic syndrome was significantly more common in ANA-positive JIA than in ANA-negative variant (46.15% vs. 18.18%; pϕ<0.05). The condition of bone tissue (Z-criteria) depended on BMI (r=0.33; p<0.05), disease activity on the JADAS scale (r=0.35; p<0.04), the number of active joints (r=0.34; p<0.05); ANA level (r=-0.34; p<0.05). In the group of children with osteopenic syndrome, BMD correlated with the duration of the disease (r=-0.67; p<0.05), the number of active joints (r=-0.62; p<0.05), the level of blood phosphorus 0.74; p<0.05) and the sum of points on the JADAS scale (r=0.59; p<0.05). In the group of children with preserved BMD, the spectrum of correlations was supplemented by indicators of vitamin D status (r=-0.33; p<0.05) and BMI (r=-0.40; p<0.05). Conclusions. In children with JIA, the incidence of osteopenia is 28.57% with vitamin D deficiency in 88.57% of patients, preserved levels of total calcium, phosphorus and PTH in the blood. Decreased BMD in the early stages of JIA is associated with a younger age of patients and the age of onset of the disease, increased prevalence of joint syndrome, inflammatory and serological activity of the disease, ionized calcium and blood phosphorus, PTH levels and decreased vitamin D (р<0,001). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: bone mineral density; juvenile idiopathic arthritis; osteopenia; 25-OH-vitamin D; parathyroid hormone.

scholarly journals Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It?

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1011 ◽  
Author(s):  
Ian R Reid ◽  
Mark J Bolland
Keyword(s):  
Vitamin D ◽  
Bone Density ◽  
Vitamin D Deficiency ◽  
Nursing Home Residents ◽  
Fragility Fractures ◽  
Vitamin D Supplementation ◽  
Community Dwelling ◽  
Current Evidence ◽  
Calcium Supplements ◽  
Vitamin D Supplements

Vitamin D and calcium have different biological functions, so the need for supplementation, and its safety and efficacy, need to be evaluated for each separately. Vitamin D deficiency is usually the result of low sunlight exposure (e.g., in frail older people, those who are veiled, those with dark-skin living at higher latitudes) and is reversible with calciferol 400–800 IU/day. Calcium supplements produce a 1% increase in bone density in the first year of use, without further increases subsequently. Vitamin D supplements do not improve bone density in clinical trials except in analyses of subgroups with baseline levels of 25-hydroxyvitamin D <30 nmol/L. Supplementation with calcium, vitamin D, or their combination does not prevent fractures in community-dwelling adults, but a large study in vitamin D-deficient nursing home residents did demonstrate fracture prevention. When treating osteoporosis, co-administration of calcium with anti-resorptive drugs has not been shown to impact on treatment efficacy. Correction of severe vitamin D deficiency (<25 nmol/L) is necessary before use of potent anti-resorptive drugs to avoid hypocalcemia. Calcium supplements cause gastrointestinal side effects, particularly constipation, and increase the risk of kidney stones and, probably, heart attacks by about 20%. Low-dose vitamin D is safe, but doses >4000 IU/day have been associated with more falls and fractures. Current evidence does not support use of either calcium or vitamin D supplements in healthy community-dwelling adults.

Sign in / Sign up

Export Citation Format

Share Document