Calcium and Vitamin D Supplementation. Myths and Realities with Regard to Cardiovascular Risk

2019 ◽  
Vol 17 (6) ◽  
pp. 610-617 ◽  
Author(s):  
Giovanna Muscogiuri ◽  
Luigi Barrea ◽  
Barbara Altieri ◽  
Carolina Di Somma ◽  
Harjit pal Bhattoa ◽  
...  
Keyword(s):  
Vitamin D ◽  
Side Effects ◽  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
Physiological Role ◽  
Bone Diseases ◽  
Current Evidence ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Muscle Health

Vitamin D and calcium are considered crucial for the treatment of bone diseases. Both vitamin D and calcium contribute to bone homeostasis but also preserve muscle health by reducing the risk of falls and fractures. Low vitamin D concentrations result in secondary hyperparathyroidism and contribute to bone loss, although the development of secondary hyperparathyroidism varies, even in patients with severe vitamin D deficiency. Findings from observational studies have shown controversial results regarding the association between bone mineral density and vitamin D/calcium status, thus sparking a debate regarding optimum concentrations of 25-hydroxyvitamin D and calcium for the best possible skeletal health. Although most of the intervention studies reported a positive effect of supplementation with calcium and vitamin D on bone in patients with osteoporosis, this therapeutic approach has been a matter of debate regarding potential side effects on the cardiovascular (CV) system. Thus, the aim of this review is to consider the current evidence on the physiological role of vitamin D and calcium on bone and muscle health. Moreover, we provide an overview on observational and interventional studies that investigate the effect of vitamin D and calcium supplementation on bone health, also taking into account the possible CV side-effects. We also provide molecular insights on the effect of calcium plus vitamin D on the CV system.

The Effect of Calcium or Calcium and Vitamin D Supplementation on Bone Mineral Density in Healthy Males: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 25 (5) ◽  
pp. 510-524 ◽  
Author(s):  
Leslie N. Silk ◽  
David A. Greene ◽  
Michael K. Baker
Keyword(s):  
Bone Mineral Density ◽  
Systematic Review ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Calcium Supplementation ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Total Body ◽  
Healthy Males

Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardized mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES = 0.644; 95% CI = 0.406–0.883; p < .001), followed by total hip (ES = 0.483, 95% CI= 0.255–0.711, p < .001), femoral neck (ES = 0.402, 95% CI = 0.233–0.570, p = .000) and lumbar spine (ES = 0.306, 95% CI = 0.173–0.440, p < .001). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomized controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.

scholarly journals Osteomalacia in practice of endocrinologist: etiology, pathogenesis, differential diagnosis with osteoporosis

2020 ◽  
Vol 22 (2) ◽  
pp. 23-31
Author(s):  
Olga O. Golounina ◽  
Gyuzel E. Runova ◽  
Valentin V. Fadeyev
Keyword(s):  
Vitamin D ◽  
Differential Diagnosis ◽  
Vitamin D Deficiency ◽  
Clinical Symptoms ◽  
Fibroblast Growth Factor 23 ◽  
Bone Matrix ◽  
Bone Diseases ◽  
Mineral Density ◽  
Bone Formation Rate ◽  
Metabolic Bone Diseases

Osteoporosis is the most common cause of low bone mineral density (BMD) and low-traumatic fractures in adults. However, differential diagnosis should also consider other causes of decreased BMD, including osteomalacia, as treatment for these conditions vary significantly. Osteomalacia is a systemic disorder characterized by decrease in bone strength due to of excessive accumulation of non-mineralized osteoid and uncoupling between bone matrix formation and mineralization. Osteomalacia in adults mostly develops due to severe vitamin D deficiency of any etiology, less often along with kidney pathology, mesenchymal tumors secreting fibroblast growth factor 23 or hereditary metabolic bone diseases. Clinical symptoms of osteomalacia are nonspecific and mostly manifest by generalized diffuse bone pain, muscle weakness, skeletal deformities and often go unnoticed at initial stage of the disease. Histomorphometric examination is the most accurate method of the diagnosis, which allows assessment of bone formation rate and calcification. The utmost priority of the treatment of osteomalacia of any etiology is the elimination of vitamin D deficiency, hypocalcemia, hypophosphatemia and prevention of bone deformities progression and muscle hypotension.

scholarly journals Effects of vitamin D and calcium supplementation on bone mineral density among Thai youth using daily HIV pre‐exposure prophylaxis

2020 ◽  
Vol 23 (10) ◽  
Author(s):  
Krittaporn Pornpaisalsakul ◽  
Wipaporn Natalie Songtaweesin ◽  
Supatporn Tepmongkol ◽  
Prissana Wongharn ◽  
Surinda Kawichai ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Calcium Supplementation ◽  
Mineral Density ◽  
Exposure Prophylaxis

scholarly journals Prevalence of vitamin D deficiency and secondary hyperparathyroidism during winter in pre-menopausal Bangladeshi and Somali immigrant and ethnic Finnish women: associations with forearm bone mineral density

2011 ◽  
Vol 107 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Md Zahirul Islam ◽  
Heli T. Viljakainen ◽  
Merja U. M. Kärkkäinen ◽  
Elisa Saarnio ◽  
Kalevi Laitinen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Forearm Fracture ◽  
Quantitative Computed Tomography ◽  
Fracture Load ◽  
Mineral Density ◽  
Cross Sectional ◽  
High Prevalence ◽  
Somali Women

Secondary hyperparathyroidism (SHPT) is one of the outcomes of vitamin D deficiency that negatively affects bone metabolism. We studied the ethnic differences in vitamin D status in Finland and its effect on serum intact parathyroid hormone (S-iPTH) concentration and bone traits. The study was done in the Helsinki area (60°N) during January–February 2008. A total of 143 healthy women (20–48 years of age) from two groups of immigrant women (Bangladeshi, n 34 and Somali, n 48), and a group of ethnic Finnish women (n 61) were studied in a cross-sectional setting. Serum concentrations of 25-hydroxyvitamin D (S-25OHD) and S-iPTH were measured. Peripheral quantitative computed tomography measurements were taken at 4 and 66 % of the forearm length. In all groups, the distribution of S-25OHD was shifted towards the lower limit of the normal range. A high prevalence of vitamin D insufficiency (S-25OHD < 50 nmol/l) was observed (89·6 %) in the Somali group. The prevalence of SHPT (S-iPTH>65 ng/l) was higher (79·1 %) in Somali women than in Finnish women (16 %). There was a significant association between S-25OHD and S-iPTH (r − 0·49, P < 0·001). Ethnicity and S-25OHD together explained 30 % of the variation in S-iPTH. The total bone mass at all sites of the forearm, fracture load and stress–strain index was higher (P < 0·001) in Bangladeshi and Finnish women than in Somali women. The high prevalence of hypovitaminosis D, SHPT and low bone status in Somali women indicates a higher risk of osteoporosis.

scholarly journals No evidence for a bone phenotype in GPRC6A knockout mice under normal physiological conditions

2008 ◽  
Vol 42 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Petrine Wellendorph ◽  
Lars Dan Johansen ◽  
Anders A Jensen ◽  
Emilio Casanova ◽  
Martin Gassmann ◽  
...  
Keyword(s):  
Amino Acids ◽  
Knockout Mice ◽  
Divalent Cations ◽  
Physiological Role ◽  
Bone Homeostasis ◽  
Wild Type ◽  
Mineral Density ◽  
Calcium Sensing ◽  
Wide Range ◽  
Mammalian Tissues

GPRC6A is a seven-transmembrane receptor mediating signaling by a wide range of l-α-amino acids, a signaling augmented by the divalent cations Ca2+ and Mg2+. GPRC6A transcripts are detected in numerous mammalian tissues, but the physiological role of the receptor is thus far elusive. Analogously to the closely related calcium-sensing receptor, GPRC6A has been proposed to function as a metabolic sensor of Ca2+ and amino acids in bone and other tissues. In the present study, we have generated the first GPRC6A knockout mice and studied their phenotype with particular focus on bone homeostasis. The generated GPRC6A knockout mice are viable and fertile, develop normally, and exhibit no significant differences in body weight compared with wild-type littermates. Assessment of bone mineral density, histomorphometry, and bone metabolism demonstrated no significant differences between 13-week-old knockout and wild-type mice. In conclusion, our data do not support a role for GPRC6A in normal bone physiology.

scholarly journals Bone Regeneration, Reconstruction and Use of Osteogenic Cells; from Basic Knowledge, Animal Models to Clinical Trials

2020 ◽  
Vol 9 (1) ◽  
pp. 139 ◽  
Author(s):  
Greg Hutchings ◽  
Lisa Moncrieff ◽  
Claudia Dompe ◽  
Krzysztof Janowicz ◽  
Rafał Sibiak ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Bone Diseases ◽  
Basic Knowledge ◽  
Growth Factor Delivery ◽  
Bone Homeostasis ◽  
Skeletal Health ◽  
Paracrine Factors ◽  
Regeneration Rate ◽  
Biomimetic Scaffolds

The deterioration of the human skeleton’s capacity for self-renewal occurs naturally with age. Osteoporosis affects millions worldwide, with current treatments including pharmaceutical agents that target bone formation and/or resorption. Nevertheless, these clinical approaches often result in long-term side effects, with better alternatives being constantly researched. Mesenchymal stem cells (MSCs) derived from bone marrow and adipose tissue are known to hold therapeutic value for the treatment of a variety of bone diseases. The following review summarizes the latest studies and clinical trials related to the use of MSCs, both individually and combined with other methods, in the treatment of a variety of conditions related to skeletal health. For example, some of the most recent works noted the advantage of bone grafts based on biomimetic scaffolds combined with MSC and growth factor delivery, with a greatly increased regeneration rate and minimized side effects for patients. This review also highlights the continuing research into the mechanisms underlying bone homeostasis, including the key transcription factors and signalling pathways responsible for regulating the differentiation of osteoblast lineage. Paracrine factors and specific miRNAs are also believed to play a part in MSC differentiation. Furthering the understanding of the specific mechanisms of cellular signalling in skeletal remodelling is key to incorporating new and effective treatment methods for bone disease.

scholarly journals Impact of HIV-1 Infection and Antiretroviral Therapy on Bone Homeostasis and Mineral Density in Vertically Infected Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
D. Donà ◽  
E. Mozzo ◽  
D. Luise ◽  
R. Lundin ◽  
A. Padoan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Hiv Infection ◽  
Antiretroviral Drugs ◽  
University Hospital ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Anthropometric Data ◽  
Hiv 1

Daily assumption of antiretroviral drugs and HIV-related immune activation lead to important side effects, which are particularly evident in vertically infected patients. Bone homeostasis impairment and reduction of bone mineral density (BMD) is one of the most important side effects. Primary aim of this study is to assess the prevalence of bone homeostasis alterations in a group of vertically infected patients; secondary aim is to analyze the relationship between bone homeostasis alterations and anthropometric data, severity of HIV infection, and antiretroviral therapy. We studied 67 patients with vertically transmitted HIV-1 (aged 6-31 years), followed by the Pediatric Infectious Disease Unit of the University Hospital of Padua, Italy. We analyzed bone turnover markers (P1NP and CTx) and we performed lumbar spine and femoral dual energy X-ray absorption densitometry (DXA). Personal and anthropometric data and information on HIV-infection severity and antiretroviral therapy were collected for all patients. We found that BMD values recorded by DXA showed a significant correlation with age, race, BMI, physical activity, and antiretroviral therapy duration. P1NP was increased in 43% of patients, while CTX in 61% of them. P1NP alteration was related to age, race, BMI, physical activity, therapy duration, and ever use of protease inhibitors and nucleotide reverse transcriptase inhibitors. CTX alteration was found to be correlated only with age. In conclusion, our study confirms that a wide percentage of HIV vertically infected patients show reduced BMD and impaired bone homeostasis. Strict monitoring is needed in order to early identify and treat these conditions.

P1405ETELCALCETIDE USE IN HEMODIALYTIC PATIENTS: A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bianca Covella ◽  
Luigi Rossi ◽  
Pasquale Libutti ◽  
Simone Corciulo ◽  
Elisabetta Manno ◽  
...  
Keyword(s):  
Vitamin D ◽  
Side Effects ◽  
Therapeutic Target ◽  
Calcium Supplementation ◽  
Drug Efficacy ◽  
P Value ◽  
Receptor Binding Site ◽  
Mean Values ◽  
Single Center Experience

Abstract Background and Aims Etelcalcetide is an injectable calcimimetic, utilized to treat secondary hyperparathyroidism. Recently introduced as alternative to cinacalcet, it acts on a different CaSR (Calcium Sensor Receptor) binding site. Outlined advantages are the intravenous formulation, which solves non adherence, the lower gastrointestinal side effects incidence. The main limitation is iatrogenic hypocalcemia. We show our experience to evaluate findings of our initial fieldwork in order to optimize drug efficacy, safety and tolerability Method We included 27 patients during 2018 (15 M and 12 F, Caucasian, mean age 60,7±13,7 years), followed for at least 6 months. Initial etelcalcetide dose was 15 mg in all patients. PTH, Calcium, Phosphorus monitoring was done every month. Concomitant drugs as phosphorus binders, Vitamin D or analogues, Calcium and the switch from cinacalcet were considered. Therapeutic variations and side effects were recorded. Data are registered at the beginning and the end of follow up. Results Starting values are: PTH 1298±545 pg/ml, Calcium 9,1±0,9, Phosphorus 5,1±1,4. 14 patients already took phosphorus binders, 10 paricalcitol. 12 patients were switched from Cinacalcet because of non-adherence or inefficacy, the other 15 patients never took calcimimetics. Mean values after 6 months are: PTH 661±469 pg/ml, Calcium 8,2±0,5 mg/ml, Phosphorus 4,1±1,6 mg/ml. These data point out a mean decrease in PTH value of 49%, reaching the therapeutic target in 18 patients, that is the 75% of the total population studied. It have been necessary dose modifications in 15 patients (62.5%): 9 etelcalcetide dose variations (37,5%), 6 vitamin D and Calcium supplementation, both the changes in 5 of them. Side effects were hypocalcemia (14), pruritus (1), diarrhea (1), low platelet count (1), registered in 17 patients (63%), 3 of them withdrew therapy and then refused to start it again. It has to be said that thrombocytopenia, occurred after the follow up time (at 7th month), solve after etelcacetide withdrawal. Subgroup analysis pointed out a statistically significant correlation between drug efficacy and switch from cinacalcet, both in terms of extent of iPTH reduction (65% vs 42% - p value &lt; 0,05 ) and of achievement of the therapeutic target (89% vs 66% - p value &lt; 0,05), and between concomitant paricalcitol therapy at zero-time and lower hypocalcemia incidence (10% vs 76% - p value &lt; 0,05). Conclusion Results confirm etelcalcetide efficacy and suggest a correlation between concomitant paricalcitol therapy at baseline and lower hypocalcemia incidence and between greater efficacy and switch from cinacalcet. These data, if confirmed in larger sample, could be useful to guide the starting approach and the maintaining treatment with etelecalcetide.

Sign in / Sign up

Export Citation Format

Share Document