scholarly journals HYPOVITAMINOSIS D AND MENOPAUSE: STILL AN ISSUE IN 2016?

2016 ◽  
Vol 63 (3) ◽  
pp. 209-210
Author(s):  
Adina Ghemigian ◽  
◽  
Otilia Radu ◽  
Ana Valea ◽  
Nicoleta Dumitru ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Loss ◽  
Meta Analysis ◽  
Osteoporotic Fractures ◽  
Hypovitaminosis D ◽  
Mineral Density ◽  
Level Of Evidence ◽  
Knowing That ◽  
Risk Increase ◽  
Risk Of Falls

Vitamin D in menopause is essential for skeleton and metabolic involvement. Our purpose is to introduce the level of evidence regarding menopause – related hypovitaminosis D through a brief review of papers published on PubMed in 2016. The correlation between low vitamin D and risk of falls is a traditional observation. Lack of vitamin D remains one of the major contributors to osteoporotic fractures which have an annual incidence of 8.9 million worldwide. Yale FIT trial referring to menopausal cancer survivors after 12 months of aerobic physical exercise confirmed the bone loss under aromatase inhibitors opposite to tamoxifen is significant, a bone loss that is lower if vitamin D ranges are low. Arzoxifene Generations Trial followed for 5 years menopausal women treated only with vitamin D and calcium and found a fracture risk increase by 46% for each unit of lumbar T-score that decreases. A meta-analysis of 34 studies on 11,090 patients treated with ibandronate showed that hypovitaminosis D at baseline is a predictor of bone mineral density improvement only at lumbar spine. Another study revealed that 77% of menopausal females have 25-hydoxyvitamin D (25-OH D) less than 30 ng/mL while a negative correlation between 25-OH D and waist circumference was found knowing that android fat disposition in women with hipovitaminosis D is a hallmark of metabolic syndrome. Overall, in 2016, PubMed published papers regarding vitamin D in menopause still reflect its deficiency and associated metabolic risk.

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

2008 ◽  
Vol 67 (2) ◽  
pp. 163-176 ◽  
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.

Prevalence of Vitamin D Deficiency in Patients With Talar Osteochondral Lesions

2018 ◽  
Vol 39 (4) ◽  
pp. 471-478 ◽  
Author(s):  
Jessica J. M. Telleria ◽  
Lauren V. Ready ◽  
Eric M. Bluman ◽  
Christopher P. Chiodo ◽  
Jeremy T. Smith
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Health Care Providers ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Osteochondral Lesions ◽  
Care Providers ◽  
Mineral Density ◽  
Level Of Evidence

Background: Vitamin D deficiency affects over 1 billion people worldwide and is common in foot and ankle patients. The prevalence in those with osteochondral lesions of the talus (OLTs) is unknown. This study identified the prevalence and risk factors for hypovitaminosis D in patients with an OLT. Methods: Serum 25(OH)D levels were obtained from patients presenting with an OLT from May to November during 2007 to 2016. Hypovitaminosis D was defined as 25(OH)D less than 30 ng/mL (75 nmol/L). Patients presenting with an acute ankle sprain (AS) during the same months served as a control group. Specific medical risk factors for hypovitaminosis D were recorded. The final OLT population included 46 patients (31 women [67.4%]; mean [SD] age 43.6 [14.8] years). The comparison AS group had 40 patients (32 women [80.0%]; mean [SD] age 56.2 [13.0] years). Results: The mean (SD) 25(OH)D in the OLT and AS cohorts were 31.2 (12.6) ng/mL and 37.1 (13.5) ng/mL, respectively ( P = .039). Hypovitaminosis D was identified in 54% of the OLT population and 28% of the AS population ( P = .012). Conclusion: Hypovitaminosis D is intimately related to decreased bone mineral density. This study identified a significantly higher rate of hypovitaminosis D in patients with an OLT compared to a cohort of AS patients. These findings suggest that when patients present with an OLT, health care providers should consider evaluating for and treating hypovitaminosis D. Level of Evidence: Level III, comparative study.

Baseline Osteopenia and Osteoporosis in Untreated Non-Hodgkin’s Lymphoma Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4607-4607
Author(s):  
Michael A. Thompson ◽  
Auris Huen ◽  
Gregory D. Ayers ◽  
Bela B. Toth ◽  
Rena V. Sellin ◽  
...  
Keyword(s):  
Vitamin D ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Hodgkin’S Lymphoma ◽  
Hypovitaminosis D ◽  
Hodgkin's Lymphoma ◽  
Mineral Density ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Low Testosterone

Abstract BACKGROUND: Lymphoma treatment with alkylating agents and steroids can cause premature osteoporosis, increasing the risk of vertebral and hip fracture. Mechanisms of bone loss may include local microenvironment lymphoma-related cytokine activity, steroid-mediated bone loss, and hypogonadism from chemotherapy. The bisphosphonate pamidronate every three months has been found to reduce bone loss and the risk of new vertebral fractures in lymphoma patients receiving chemotherapy; however, the more potent bisphosphonate, zoledronic acid, has not been evaluated in this patient population. We are conducting a randomized study of zoledronic acid in untreated non-Hodgkin’s lymphoma (NHL) patients to study chemotherapy induced bone loss and improve NHL survivorship. While this trial is still accruing patients, we report the abnormal baseline bone mineral density (BMD) and endocrine characteristics found in patients screened for this study. METHODS: We report the preliminary baseline endocrine characteristics for this ongoing bone health research study. Untreated NHL patients were screened for BMD and endocrine studies including vitamin D levels, testosterone, and bone turnover markers. Patients on the study were stratified as male, female (pre-menopausal), and female (post-menopausal). Exclusion criteria included bone fractures, BMD T-scores worse than −2.0, creatinine clearance less than 60 mL/min, dental problems, and prior steroid or bisphosphonate use. Patients accrued to the study are randomized to receive either: 1) oral calcium and vitamin D (Ca+D) or 2) Ca+D and 4 mg zoledronic acid IV at baseline and at 6 months. RESULTS: Patient characteristics included: 49 male, 35 female (10 pre-menopausal), median age 61 (range: 18–87). Of 84 patients screened for BMD to date, patients had the following abnormalities: 12/84 (14%) had osteoporosis and 47/84 (56%) had osteopenia or osteoporosis. Of 20 patients who consented to the trial and who were evaluated with additional studies, 10 were excluded due to the following: 3/20 hypovitaminosis D, 1/20 with prior steroid use, 1/20 low testosterone, 1/20 prior HRT, 1/20 with bone disease, 2/20 required dental extractions, and 1/20 treatment changed to chemotherapy without steroids. Patients with osteoporosis or T score worse than −2.0 were evaluated by their primary oncologist for treatment with bisphosphonates. Patients with other abnormal studies were further evaluated and treated by specialists in endocrinology and dentistry. CONCLUSIONS: Baseline testing of BMD and endocrine studies revealed osteopenia or osteoporosis in 56% of untreated NHL patients. Hypovitaminosis D or low testosterone was found in a smaller number of tested patients. While these patients were excluded from the remainder of the study and referred for further evaluation, patients should benefit from having these underlying problems addressed. Our ongoing clinical trial will address the potential role of zoledronic acid in preserving bone density for survivors of NHL. This trial was funded by Novartis. ClinicalTrials.gov Identifier: NCT00352846.

scholarly journals Vitamin D: A Review on Its Effects on Muscle Strength, the Risk of Fall, and Frailty

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Matthieu Halfon ◽  
Olivier Phan ◽  
Daniel Teta
Keyword(s):  
Vitamin D ◽  
Muscle Strength ◽  
Meta Analysis ◽  
Active Form ◽  
Hypovitaminosis D ◽  
Muscle Cells ◽  
Vitamin D Supplementation ◽  
Risk Of Falls ◽  
Differentiation And Proliferation

Vitamin D is the main hormone of bone metabolism. However, the ubiquitary nature of vitamin D receptor (VDR) suggests potential for widespread effects, which has led to new research exploring the effects of vitamin D on a variety of tissues, especially in the skeletal muscle.In vitrostudies have shown that the active form of vitamin D, calcitriol, acts in myocytes through genomic effects involving VDR activation in the cell nucleus to drive cellular differentiation and proliferation. A putative transmembrane receptor may be responsible for nongenomic effects leading to rapid influx of calcium within muscle cells. Hypovitaminosis D is consistently associated with decrease in muscle function and performance and increase in disability. On the contrary, vitamin D supplementation has been shown to improve muscle strength and gait in different settings, especially in elderly patients. Despite some controversies in the interpretation of meta-analysis, a reduced risk of falls has been attributed to vitamin D supplementation due to direct effects on muscle cells. Finally, a low vitamin D status is consistently associated with the frail phenotype. This is why many authorities recommend vitamin D supplementation in the frail patient.

scholarly journals Screening for hypovitaminosis D: cost-effective or not?

2019 ◽  
Vol 180 (3) ◽  
pp. D1-D7 ◽  
Author(s):  
Salvatore Minisola ◽  
Luciano Colangelo ◽  
Cristiana Cipriani ◽  
Jessica Pepe ◽  
Dana Paulina Cook ◽  
...  
Keyword(s):  
Vitamin D ◽  
Controlled Trial ◽  
Cost Effective ◽  
Hypovitaminosis D ◽  
Vitamin D Metabolites ◽  
Vitamin D Status ◽  
Mineral Density ◽  
Randomized Controlled ◽  
Risk Of Falls ◽  
Research Plan

Few topics have elicited more emotion than the issue of screening for vitamin D status and the discussion on the need for global supplementation with vitamin D metabolites. The importance of the problem is highlighted by the USPSTF posted draft research plan with the aim of making an update recommendations statement, possibly next year. Here, we discuss two different viewpoints on screening for vitamin D status: for and against. In the literature there are scientifically sound opinions supporting pro and cons positions. However, we believe that the best way to definitively elucidate this issue is the implementation of a randomized controlled trial evaluating clinical outcomes or harms in persons screened versus those not screened for vitamin D deficiency. The feasibility of such a trial is probably questionable owing to uncertainties still present concerning threshold for vitamin D sufficiency and end points (that is, for example, improved bone mineral density, reduced risk of falls and so on) to be reached.

Vitamin D in Basketball Players: Current Evidence and Future Directions

2021 ◽  
pp. 194173812110193
Author(s):  
Emilija Stojanović ◽  
Dragan Radovanović ◽  
Tamara Hew-Butler ◽  
Dušan Hamar ◽  
Vladimir Jakovljević
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Body Composition ◽  
Physical Performance ◽  
Bone Health ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Basketball Players ◽  
Level Of Evidence

Context: Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. Objective: To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. Data Sources: PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. Study Selection: After screening, 15 studies were included in the systematic review and meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. Results: The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% ( P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat ( r = −0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. Conclusion: The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.

Hypovitaminosis D in Patients with Ankylosing Spondylitis: Frequency and Consequences

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.

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 Treatment of Glucocorticoid-Induced Osteoporosis with Bisphosphonates Alone, Vitamin D Alone or a Combination Treatment in Eastern Asians: A Meta-Analysis

2019 ◽  
Vol 25 (14) ◽  
pp. 1653-1662
Author(s):  
Junjie Wang ◽  
Hongzhuo Li
Keyword(s):  
Vitamin D ◽  
Femoral Neck ◽  
Combination Treatment ◽  
Type I Collagen ◽  
Meta Analysis ◽  
Type I ◽  
Mineral Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Asian Populations ◽  
Significant Difference

Background: Glucocorticoid (GC)-induced osteoporosis and fractures have become a serious problem for Eastern Asians. Bisphosphonates (BPs), vitamin D and a combination treatment are effective methods to prevent and treat GC-induced osteoporosis. Objective: The study aimed to compare the efficacy of BPs, vitamin D and a combination treatment for preventing and managing GC-induced osteoporosis in Eastern Asians. Methods: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane CENTRAL databases was undertaken for randomized controlled trials (RCTs) on the effect of BPs, vitamin D and the combination treatment on GCs-induced osteoporosis in Eastern Asian populations. Primary outcome measures were the change in bone mineral density (BMD) and bone turnover markers. The final search was performed in March 2019. Results: Nine RCTs were included. A total of 545 patients met the inclusion criteria. Compared with vitamin D, BPs and the combination treatment significantly alleviated osteoporosis of the spine and femoral neck in Eastern Asians with GC-induced osteoporosis. At the same time, the change in serum bone-specific alkaline phosphatase (BAP) and serum C-telopeptide of type I collagen (CTX) levels was observed to be significantly less with BPs and the combination treatment with vitamin D alone. No significant difference was found between BPs and the combination treatment in the markers mentioned above. Conclusion: Compared with vitamin D alone, BPs alone and the combination treatment were significantly effective on Eastern Asians with GC-induced osteoporosis. Compared with the combination treatment, BPs alone were observed to be effective enough to increase the BMDs of the spine and femoral neck on both sides and thus prevent GC-induced osteoporosis in Eastern Asians.

Longitudinal Study of Bone Density and Periodontal Disease in Men

2007 ◽  
Vol 86 (11) ◽  
pp. 1110-1114 ◽  
Author(s):  
K.R. Phipps ◽  
B.K.S. Chan ◽  
T.E. Madden ◽  
N.C. Geurs ◽  
M.S. Reddy ◽  
...  
Keyword(s):  
Bone Loss ◽  
Periodontal Disease ◽  
Osteoporotic Fractures ◽  
Older Men ◽  
Whole Body ◽  
Mineral Density ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
X Ray ◽  
Periodontal Destruction

Bone loss is a feature of both periodontitis and osteoporosis, and periodontal destruction may be influenced by systemic bone loss. This study evaluated the association between periodontal disease and bone mineral density (BMD) in a cohort of 1347 (137 edentulous) older men followed for an average of 2.7 years. Participants were recruited from the Osteoporotic Fractures in Men Study. Random half-mouth dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque, and bleeding. BMD was measured at the hip, spine, and whole-body, by dual-energy x-ray absorptiometry, and at the heel by ultrasound. After adjustment for age, smoking, race, education, body mass index, and calculus, there was no association between number of teeth, periodontitis, periodontal disease progression, and either BMD or annualized rate of BMD change. We found little evidence of an association between periodontitis and skeletal BMD among older men.

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