Associations between vitamin E status and bone mineral density in children and adolescents aged 8–19 years: Evidence based on NHANES 2005–2006, 2017–2018

Abstract

Introduction Bone mineral density (BMD) in adolescence is a crucial determinant in osteoporosis and fragility fractures in older age. Vitamin E is the most abundant lipid-soluble antioxidant present in the blood. However, the association of vitamin E status with BMD in children and adolescents remains unclear. Methods We first measured the association of vitamin E status (serum α- and γ tocopherol) with BMD in children and adolescents with the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were performed to evaluate their relationship after adjusting for a large range of covariates. Stratified analyses and interaction tests were used to explore their effects on different genders, ages, and races/ethnicities. Results 13,606 children and adolescents from NHANES (2005–2006, 2017–2018) were included in our analysis. Compared with the lowest α-tocopherol quartile, individuals in the highest α-tocopherol quartile are likelier to be Non-Hispanic White and have a higher value of poverty income ratio (PIR). They have a lower value of serum phosphorus and lumbar spine BMD. Every 1umol/L increase in serum α- and γ- tocopherol, the lumbar spine BMD decreased by -0.0016 and -0.0068 g/cm2. Compared with the lowest quartile serum α- and γ- tocopherol concentration, individuals in the highest quartile have a -0.0223 and -0.0329 g/cm2 lower mean BMD, respectively. Interaction effects suggest that the negative effect is more prominent among female youth, individuals aged 8–13 years, non-Hispanic whites, Mexican Americans, and non-Hispanic blacks. Conclusions Our study indicates serum α- and γ-tocopherol are negatively correlated with lumbar BMD. Age, gender, and race may have a modifying effect on this relationship. Our study has an important clinical implication. A higher vitamin E status for children and adolescents could not improve BMD, even decrease BMD. More prospective research with stronger evidence is needed to verify our findings and their underlying mechanisms.

Association between composite dietary antioxidant and bone mineral density in children and adolescents aged 8–19 years: findings from NHANES

“…However, there are few studies on the effects of antioxidant intake on bone health in children and adolescents. Furthermore, these studies always focus on a single antioxidant and ignore the overall total dietary antioxidant capacity 7 , 36 – 38 . For example, in a cross-sectional study of 426 children, Zhang et al 36 found that vitamin A intake is positively related to BMD after adjusting confounders.…”

“…Previous studies showed that a 10% increase in PBM during adolescence may decrease 50% fracture risk in senior citizens 4 . The formulation of PBM can be affected by nutrition, genetics, physical activities, certain diseases, and other factors 5 – 7 .…”

“…Therefore, antioxidants have become a potential therapy to attenuate bone loss and prevent osteoporosis induced by excess ROS 11 . Several studies have explored the effects of ingesting individual antioxidants on bone mineral density (BMD), but the results are controversial 7 , 14 – 16 . A study by Kim et al 17 analyzed 1196 postmenopausal females from the Korean National Health and Nutrition Examination Survey (KNHANES) over 50 years.…”

Bioenergetic profile and redox tone modulate in vitro osteogenesis of human dental pulp stem cells: new perspectives for bone regeneration and repair

“…Counteracting the ROS-mediated signaling by administration of an exogenous antioxidant, such as Trolox, in the earlier-middle phase post-induction delays the action of the osteogenic inducers. Accordingly controversial evidence has been documented about the safety of antioxidant therapies including vitamin E [ 67 , 68 ] and the recently reported negative correlation between serum tocopherols and bone mineralization [ 69 ]. Our findings might have practical consequences/applications in regenerative medicine and stem cell-based therapies and confirm the need of caution in the nowadays extensive utilization of antioxidants as pharmacologic adjuvant in the clinical practice as well as food-supplementation in the everyday life.…”

The First Physiologically Based Pharmacokinetic (PBPK) Model for an Oral Vaccine Using Alpha-Tocopherol as an Adjuvant

“…This is important because age, gender, ethnicity, and disease state of patients may determine the dose adjustment of alpha-tocopherol for it to be effective. These will be essential for the effective dose and frequency of administration determination of the vaccine adjuvant [ 51 , 52 ].…”