The role of vitamin D in osteoporosis

Brincat, Max; Gambin, Jeannine; Brincat, Mark; Calleja‐Agius, Jean

doi:10.1016/j.maturitas.2014.12.018

Cited by 42 publications

(35 citation statements)

References 29 publications

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“…Vitamin D is a regulator of BMD, proliferating calcium and phosphate absorption in the intestine and acting directly on bone cells. 43 Vitamin D has previously been shown to influence BMD, fracture rate and risk 44 ; studies of patients who have sustained a hip fracture typically demonstrated low serum vitamin D (≤30.0 nmol/L 45 ). Supplementation of vitamin D and calcium has been shown to significantly decrease the rate of bone loss in the hip and spine.…”

Section: Discussionmentioning

confidence: 99%

The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

2017

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ObjectivesIn older adults, there is a blunted responsiveness to resistance training and reduced muscle hypertrophy compared with younger adults. There is evidence that both exercise training and vitamin D supplementation may benefit musculoskeletal health in older adults, and it is plausible that in combination their effects may be additive. The aim of this systematic review was to evaluate the effectiveness of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health in older adults.Data sourcesA comprehensive search of electronic databases, including Science Direct, Medline, PubMed, Google Scholar and Cochrane Central Register of Controlled Trials (Cochrane CENTRAL accessed by Wiley Science) was conducted. Eligible studies were randomised controlled trials including men and women (aged ≥65 years or mean age ≥65 years); enlisting resistance exercise training and vitamin D3 supplementation; including outcomes of muscle strength, function, muscle power, body composition, serum vitamin D/calcium status or quality of life comparing results with a control group. The review was informed by a preregistered protocol (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015020157).ResultsSeven studies including a total of 792 participants were identified. Studies were categorised into two groups; group 1 compared vitamin D3 supplementation and exercise training versus exercise alone (describing the additive effect of vitamin D3 supplementation when combined with resistance exercise training) and group 2 compared vitamin D3 supplementation and exercise training versus vitamin D3 supplementation alone (describing the additive effect of resistance exercise training when combined with vitamin D3 supplementation).Meta-analyses for group 1 found muscle strength of the lower limb to be significantly improved within the intervention group (0.98, 95% CI 0.73 to 1.24, p<0.001); all other outcomes showed small but non-significant positive effects for the intervention group. The short physical performance battery (SPPB), timed up and go (TUG), muscle strength of the lower limb and femoral neck bone mineral density showed significantly greater improvements in the intervention group for group 2 comparisons.ConclusionsThis review provides tentative support for the additive effect of resistance exercise and vitamin D3 supplementation for the improvement of muscle strength in older adults. For other functional variables, such as SPPB and TUG, no additional benefit beyond exercise was shown. Further evidence is required to draw firm conclusions or make explicit recommendations regarding combined exercise and vitamin D3 supplementation.

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Section: Discussionmentioning

confidence: 99%

The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

2017

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“…Representing a known risk factor of bone loss, smoking may interact with 25 hydroxylase in the liver, resulting in lower levels of 25(OH) vitamin D [ 28 ]. Menopausal age has been independently associated with reduced levels of vitamin D, further deteriorating the effect of weight loss on the mobilization of the HPP axis [ 29 , 30 ]. However, serum levels of calcium should not be regarded as an accurate indicator of calcium absorption, since mobilization of the HPP axis results in further release of calcium from bone, which is subsequently utilized to maintain plasma levels of calcium [ 6 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study

Alexandrou

Tsoka

Armeni

et al. 2015

International Journal of Endocrinology

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Objective. Nutritional deficiencies are common after bariatric surgery. We aimed to assess the prevalence and possible predictors of secondary hyperparathyroidism (SHPT) in bariatric patients. Methods. A total of 95 patients who had undergone Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were assessed after a median of 3 years after surgery. Anthropometric/demographic and weight-loss parameters were compared according to the presence of SHPT, independently for men/premenopausal women and postmenopausal women. Results. SHPT was highly prevalent (men/premenopausal women, 52.1%; postmenopausal women, 31.9%). Among men/premenopausal women, multivariate analysis indicated that SHPT was predicted by (a) 25-hydroxyvitamin D levels (Exp(B) = 0.869, P-value = 0.037), independently of age, sex, smoking; (b) calcium (Exp(B) = 0.159, P-value = 0.033) and smoking, independently of age and sex; (c) magnesium (Exp(B) = 0.026, P-value = 0.046) and smoking, independently of age and sex. Among postmenopausal women, SHPT was predicted by menopausal age independently of age, smoking, and levels of 25-hydroxyvitamin D or calcium. The development of SHPT was not associated with the type of surgery. Conclusions. RYGB and SG exhibited similar effects regarding the regulation of the hypothalamus-pituitary-parathyroid axis after surgery. Vitamin D status and menopausal age appear to determine SHPT on the long term. SHPT should be sought and vigorously treated with calcium and vitamin D supplementation.

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“…In elderly, vitamin D insufficiency and deficiency appear to be particularly prevalent in nursing home residents. Inadequate levels of vitamin D lead to a reduced intestinal calcium absorption, secondary hyperparathyroidism, impaired mineralization, and increased bone resorption [ 264 ]. The Institute of Medicine consequently recommends a daily dose of vitamin D supplement (800 IU) for elderly over 71 y [ 265 ].…”

Section: Consequences Of Malnutrition On Functional Decline Of Organ mentioning

confidence: 99%

Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition

et al. 2015

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Although the prevalence of malnutrition in the old age is increasing worldwide a synthetic understanding of the impact of aging on the intake, digestion, and absorption of nutrients is still lacking. This review article aims at filling the gap in knowledge between the functional decline of the aging gastrointestinal tract (GIT) and the consequences of malnutrition on the health status of elderly. Changes in the aging GIT include the mechanical disintegration of food, gastrointestinal motor function, food transit, chemical food digestion, and functionality of the intestinal wall. These alterations progressively decrease the ability of the GIT to provide the aging organism with adequate levels of nutrients, what contributes to the development of malnutrition. Malnutrition, in turn, increases the risks for the development of a range of pathologies associated with most organ systems, in particular the nervous-, muscoskeletal-, cardiovascular-, immune-, and skin systems. In addition to psychological, economics, and societal factors, dietary solutions preventing malnutrition should thus propose dietary guidelines and food products that integrate knowledge on the functionality of the aging GIT and the nutritional status of the elderly. Achieving this goal will request the identification, validation, and correlative analysis of biomarkers of food intake, nutrient bioavailability, and malnutrition.

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The role of vitamin D in osteoporosis

Cited by 42 publications

References 29 publications

The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study

Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition

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The role of vitamin D in osteoporosis

Cited by 42 publications

References 29 publications

The effect of combined resistance exercise training and vitamin D3supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

The effect of combined resistance exercise training and vitamin D3supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study

Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition

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Resources

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The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis

The effect of combined resistance exercise training and vitamin D₃supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis