Evaluation of Bone and Mineral Metabolism in Patients Recently Diagnosed With Leprosy

Ribeiro, Fernanda Borges; Pereira, Francisco de Assis; Muller, Érica; Foss, Norma Tiraboschi; Paula, Francisco José Albuquerque de

doi:10.1097/maj.0b013e318142bafb

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…Although, no woman of the control group was receiving calcium and vitamin D supplementation, they exhibited normal serum levels of 25-OHD. In agreement with these results, we did not observe a high frequency of hypovitaminosis D in this region of the state of São Paulo, Brazil, in previous studies [34,35]. As vitamin D deficiency is associated with worse bone outcome, it is likely that our groups were in advantageous conditions compared to other populations with a higher incidence of vitamin D deficiency [36].…”

Section: Discussionsupporting

confidence: 91%

Increased vertebral morphometric fracture in patients with postsurgical hypoparathyroidism despite normal bone mineral density

et al. 2013

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BackgroundThe mechanism behind parathyroid hormone (PTH) activation of bone remodeling is intimately dependent on the time of exposure of bone cells to hormone levels. Sustained high PTH levels trigger catabolism, while transitory elevations induce anabolism. The effects of hypoparathyroidism (PhPT) on bone are unknown. The objective was to study the impact of PhPT on bone mineral density (BMD), on the frequency of subclinical vertebral fracture and on mandible morphometry.MethodsThe study comprised thirty-three postmenopausal women, 17 controls (CG) and 16 with PhPT (PhPTG) matched for age, weight and height. Bone mineral density (BMD) of lumbar spine, total hip and 1/3 radius, radiographic evaluation of vertebral morphometry, panoramic radiography of the mandible, and biochemical evaluation of mineral metabolism and bone remodeling were evaluated in both groups.ResultsThere were no significant differences in lumbar spine or total hip BMD between groups. There was marked heterogeneity of lumbar spine BMD in PhPTG (high = 4, normal = 9, osteopenia = 1, and osteoporosis = 2 patients). BMD was decreased in the 1/3 radius in PhPTG P < 0.005). The PhPTG group exhibited an increased frequency of morphometric vertebral fractures and decreased mandible cortical thickness.ConclusionThe study suggests that vertebral fragility occurs in PhPT despite normal or even high BMD. The current results encourage further studies to evaluate the use of panoramic radiography in the identification of osteometabolic disorders, such as PhPT and the development of a more physiological treatment for PhPT.

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Section: Discussionsupporting

confidence: 91%

Increased vertebral morphometric fracture in patients with postsurgical hypoparathyroidism despite normal bone mineral density

et al. 2013

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“…The results observed in Brazil were slightly higher than those detected in Sweden (37%), but lower than those detected in Mexico (67%) and in the United Kingdom (74%) [51]. While other studies have supported these results by demonstrating a high prevalence of vitamin D deficiency in the city of São Paulo [52,53], in Riberão Preto, a city located 300 km from São Paulo, vitamin D deficiency was not observed even in patients harboring chronic diseases associated with bone loss [54,55]. These apparently paradoxical data actually reflect the complex process involved in vitamin D metabolism.…”

Section: Solar Exposure and Serum Vitamin D: Seasons And Skin Pigmentmentioning

confidence: 98%

Vitamin D safety and requirements

Paula

Rosen

2012

Archives of Biochemistry and Biophysics

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Vitamin D an ancient secosteroid is essential for mineral homeostasis, bone remodeling, immune modulation, and energy metabolism. Recently, debates have emerged about the daily vitamin D requirements for healthy and elderly adults, the safety and efficacy of long term supplementation and the role of vitamin D deficiency in several chronic disease states. Since this molecule acts as both a vitamin and a hormone, it should not be surprising that the effects of supplementation are multi-faceted and complex. Yet despite significant progress in the last decade, our understanding of vitamin D physiology and the clinical relevance of low circulating levels of this vitamin remains incomplete. The present review provides the reader with a comprehensive and up-to-date understanding of vitamin D requirements and safety. It also raises some provocative research questions.

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“…It was also reported that serum 1,25OHD and calcium levels remain elevated in patients with leprosy [15]. However, no differences in serum 1,25OHD levels between leprosy patients and normal individuals have also been reported [16]. Further, vitamin D in massive doses was used along with sulfones in the treatment tuberculoid leprosy which modified the clinical course of the disease [6].…”

Section: Introductionmentioning

confidence: 99%

VDR polymorphism, gene expression and vitamin D levels in leprosy patients from North Indian population

et al. 2018

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BackgroundLeprosy is a chronic infectious disease caused by Mycobacterium leprae and mainly affects skin, peripheral nerves. Vitamin D receptor (VDR) gene polymorphism has been found to be associated with leprosy. Vitamin D has been shown to control several host immunomodulating properties through VDR gene. Vitamin D deficiency was also found to be linked to an increased risk for several infections and metabolic diseases.ObjectiveIn the present study, we investigated the association of VDR gene polymorphism, mRNA gene expression of VDR and the vitamin D levels with leprosy and its reactional states.MethodologyA total of 305 leprosy patients consisting of tuberculoid (TT), borderline tuberculoid (BT), borderline lepromatous (BL), lepromatous leprosy (LL), as well as 200 healthy controls were enrolled in the study. We identified single nucleotide polymorphisms (SNPs) of VDR Taq1, Fok1 and Apa1, as well as the expression of VDR mRNA gene using PCR-based restriction fragment length polymorphism (RFLP) analysis and real-time PCR respectively. We also performed ELISA to measure vitamin D levels.ResultWe observed that SNP of VDR gene (Fok1 and Taq1) are associated with the leprosy disease. The allelic frequency distribution of T and t allele (p = 0.0037), F and f allele (p = 0.0024) was significantly higher in leprosy patients and healthy controls. ff genotype of Fok1 was found to be associated with leprosy patients [p = 0.0004; OR (95% CI) 3.148 (1.662–5.965)]. The recessive model of Fok1 genotype was also found to be significantly associated in leprosy patients in comparison to healthy controls [p = 0.00004; OR (95% CI) 2.85 (1.56–5.22)]. Leprosy patients are significantly associated with t-F-a haplotype. Further, VDR gene expression was found to be lower in non-reaction group compared to that of reaction group of leprosy and healthy controls. Paradoxically, we noted no difference in the levels of vitamin D between leprosy patients and healthy controls.ConclusionBlood levels of vitamin D do not play any role in clinical manifestations of any forms of leprosy. ff genotype of Fok1 and tt genotype of Taq1 was found to be associated with leprosy per se. Association of t-F-a haplotype with leprosy was found to be significant and could be used as a genetic marker to identify individuals at high risk for developing leprosy. VDR gene expression was lower in TT/BT and BL/LL groups of leprosy in comparison to that of healthy controls.

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Evaluation of Bone and Mineral Metabolism in Patients Recently Diagnosed With Leprosy

Cited by 12 publications

References 13 publications

Increased vertebral morphometric fracture in patients with postsurgical hypoparathyroidism despite normal bone mineral density

Increased vertebral morphometric fracture in patients with postsurgical hypoparathyroidism despite normal bone mineral density

Vitamin D safety and requirements

VDR polymorphism, gene expression and vitamin D levels in leprosy patients from North Indian population

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