Search Results
Search for other papers by Natércia Neves Marques de Queiroz in
Google Scholar
PubMed
Search for other papers by Franciane Trindade Cunha de Melo in
Google Scholar
PubMed
Search for other papers by Fabrício de Souza Resende in
Google Scholar
PubMed
Search for other papers by Luísa Corrêa Janaú in
Google Scholar
PubMed
Search for other papers by Norberto Jorge Kzan de Souza Neto in
Google Scholar
PubMed
Search for other papers by Manuela Nascimento de Lemos in
Google Scholar
PubMed
Search for other papers by Ana Carolina Lobato Virgolino in
Google Scholar
PubMed
Search for other papers by Maria Clara Neres Iunes de Oliveira in
Google Scholar
PubMed
Search for other papers by Angélica Leite de Alcântara in
Google Scholar
PubMed
Search for other papers by Lorena Vilhena de Moraes in
Google Scholar
PubMed
Search for other papers by Tiago Franco David in
Google Scholar
PubMed
Search for other papers by Wanderson Maia da Silva in
Google Scholar
PubMed
Search for other papers by Scarlatt Souza Reis in
Google Scholar
PubMed
Search for other papers by Márcia Costa dos Santos in
Google Scholar
PubMed
Search for other papers by Ana Carolina Contente Braga de Souza in
Google Scholar
PubMed
Search for other papers by Pedro Paulo Freire Piani in
Google Scholar
PubMed
Search for other papers by Neyla Arroyo Lara Mourão in
Google Scholar
PubMed
Search for other papers by Karem Mileo Felício in
Google Scholar
PubMed
Search for other papers by João Felício Abrahão Neto in
Google Scholar
PubMed
Search for other papers by João Soares Felício in
Google Scholar
PubMed
Objective:
Investigate the prevalence of vitamin D deficiency in an equatorial population through a large-sample study.
Methods:
Cross-sectional study with 30,224 healthy individuals from the North Region, in Brazil (Amazônia – state of Pará), who had 25-hydroxy-vitamin D (25(OH)D) and intact parathyroid hormone (PTH) serum levels measured by immunoassay method. Those with history of acute or chronic diseases were excluded. Abnormal levels of calcium, creatinine, glycemia and albumin were also exclusion criteria.
Results:
25(OH)D levels were 29.1 ± 8.2 ng/mL and values <12.7 ng/mL were equal to < −2 s.d. below average. Hypovitaminosis D was present in 10% of subjects according to the Institute of Medicine (values <20 ng/mL) and in 59%, in consonance with Endocrine Society (values 20–30 ng/mL as insufficiency and <20 ng/mL as deficiency) criteria. Individuals were divided according to four age brackets: children, adolescents, adults and elderly, and their 25(OH)D levels were: 33 ± 9; 28.5 ± 7.4; 28.3 ± 7.7; 29.3 ± 8.5 ng/mL, respectively. All groups differed in 25(OH)D, except adolescents vs adults. Regression model showed BMI, sex, living zone (urban or rural) and age as independent variables to 25(OH)D levels. Comparing subjects with vitamin D deficiency (<20 ng/mL) to those with vitamin D insufficiency (20–30 ng/mL), a difference between PTH levels in these two groups was observed (95.9 ± 24.7 pg/mL vs 44.2 ± 64.5 pg/mL; P < 0.01). Additionally, the most accurate predictive vitamin D level for subclinical hyperparathyroidism in ROC curve was 26 ng/mL.
Conclusion:
Our equatorial population showed low prevalence of vitamin D hypovitaminosis ranging with age bracket. The insufficient category by Endocrine Society was corroborated by our PTH data.
Search for other papers by Raja Padidela in
Google Scholar
PubMed
Search for other papers by Moira S Cheung in
Google Scholar
PubMed
Search for other papers by Vrinda Saraff in
Google Scholar
PubMed
Search for other papers by Poonam Dharmaraj in
Google Scholar
PubMed
X-linked hypophosphataemia (XLH) is caused by a pathogenic variant in the PHEX gene, which leads to elevated circulating FGF23. High FGF23 causes hypophosphataemia, reduced active vitamin D concentration and clinically manifests as rickets in children and osteomalacia in children and adults. Conventional therapy for XLH includes oral phosphate and active vitamin D analogues but does not specifically treat the underlying pathophysiology of elevated FGF23-induced hypophosphataemia. In addition, adherence to conventional therapy is limited by frequent daily dosing and side effects such as gastrointestinal symptoms, secondary hyperparathyroidism and nephrocalcinosis. Burosumab, a recombinant human IgG1 MAB that binds to and inhibits the activity of FGF23, is administered subcutaneously every 2 weeks. In clinical trials (phase 2 and 3) burosumab was shown to improve phosphate homeostasis that consequently resolves the skeletal/non-skeletal manifestations of XLH. Burosumab was licensed in Europe (February 2018) with the National Institute for Health and Care Excellence, UK approving use within its marketing authorisation in October 2018. In this publication, the British Paediatric and Adolescent Bone Group (BPABG) reviewed current evidence and provide expert recommendations for care pathway and management of XLH with burosumab.
Search for other papers by Ghazala Zaidi in
Google Scholar
PubMed
Search for other papers by Vijayalakshmi Bhatia in
Google Scholar
PubMed
Search for other papers by Saroj K Sahoo in
Google Scholar
PubMed
Search for other papers by Aditya Narayan Sarangi in
Google Scholar
PubMed
Search for other papers by Niharika Bharti in
Google Scholar
PubMed
Search for other papers by Li Zhang in
Google Scholar
PubMed
Search for other papers by Liping Yu in
Google Scholar
PubMed
Search for other papers by Daniel Eriksson in
Google Scholar
PubMed
Search for other papers by Sophie Bensing in
Google Scholar
PubMed
Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Sweden
Search for other papers by Olle Kämpe in
Google Scholar
PubMed
Search for other papers by Nisha Bharani in
Google Scholar
PubMed
Search for other papers by Surendra Kumar Yachha in
Google Scholar
PubMed
Search for other papers by Anil Bhansali in
Google Scholar
PubMed
Search for other papers by Alok Sachan in
Google Scholar
PubMed
Search for other papers by Vandana Jain in
Google Scholar
PubMed
Search for other papers by Nalini Shah in
Google Scholar
PubMed
Search for other papers by Rakesh Aggarwal in
Google Scholar
PubMed
Search for other papers by Amita Aggarwal in
Google Scholar
PubMed
Search for other papers by Muthuswamy Srinivasan in
Google Scholar
PubMed
Search for other papers by Sarita Agarwal in
Google Scholar
PubMed
Search for other papers by Eesh Bhatia in
Google Scholar
PubMed
Objective
Autoimmune polyendocrine syndrome type 1 (APS1) is a rare autosomal recessive disorder characterized by progressive organ-specific autoimmunity. There is scant information on APS1 in ethnic groups other than European Caucasians. We studied clinical aspects and autoimmune regulator (AIRE) gene mutations in a cohort of Indian APS1 patients.
Design
Twenty-three patients (19 families) from six referral centres in India, diagnosed between 1996 and 2016, were followed for [median (range)] 4 (0.2–19) years.
Methods
Clinical features, mortality, organ-specific autoantibodies and AIRE gene mutations were studied.
Results
Patients varied widely in their age of presentation [3.5 (0.1–17) years] and number of clinical manifestations [5 (2–11)]. Despite genetic heterogeneity, the frequencies of the major APS1 components (mucocutaneous candidiasis: 96%; hypoparathyroidism: 91%; primary adrenal insufficiency: 55%) were similar to reports in European series. In contrast, primary hypothyroidism (23%) occurred more frequently and at an early age, while kerato-conjunctivitis, urticarial rash and autoimmune hepatitis were uncommon (9% each). Six (26%) patients died at a young age [5.8 (3–23) years] due to septicaemia, hepatic failure and adrenal/hypocalcaemic crisis from non-compliance/unexplained cause. Interferon-α and/or interleukin-22 antibodies were elevated in all 19 patients tested, including an asymptomatic infant. Eleven AIRE mutations were detected, the most common being p.C322fsX372 (haplotype frequency 37%). Four mutations were novel, while six others were previously described in European Caucasians.
Conclusions
Indian APS1 patients exhibited considerable genetic heterogeneity and had highly variable clinical features. While the frequency of major manifestations was similar to that of European Caucasians, other features showed significant differences. A high mortality at a young age was observed.
Search for other papers by Ann-Kristin Picke in
Google Scholar
PubMed
Search for other papers by Graeme Campbell in
Google Scholar
PubMed
Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, Missouri, USA
Search for other papers by Nicola Napoli in
Google Scholar
PubMed
Search for other papers by Lorenz C Hofbauer in
Google Scholar
PubMed
Search for other papers by Martina Rauner in
Google Scholar
PubMed
The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, especially as a result of our aging society, high caloric intake and sedentary lifestyle. Besides the well-known complications of T2DM on the cardiovascular system, the eyes, kidneys and nerves, bone strength is also impaired in diabetic patients. Patients with T2DM have a 40–70% increased risk for fractures, despite having a normal to increased bone mineral density, suggesting that other factors besides bone quantity must account for increased bone fragility. This review summarizes the current knowledge on the complex effects of T2DM on bone including effects on bone cells, bone material properties and other endocrine systems that subsequently affect bone, discusses the effects of T2DM medications on bone and concludes with a model identifying factors that may contribute to poor bone quality and increased bone fragility in T2DM.
The University of Warwick, Coventry, UK
Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
Search for other papers by Sharon A Huish in
Google Scholar
PubMed
Search for other papers by Carl Jenkinson in
Google Scholar
PubMed
Search for other papers by Janet A Dunn in
Google Scholar
PubMed
Search for other papers by David J Meredith in
Google Scholar
PubMed
Search for other papers by Rosemary Bland in
Google Scholar
PubMed
Search for other papers by Martin Hewison in
Google Scholar
PubMed
Low serum 1,25-dihydroxyvitamin D (1,25(OH)2D) in end-stage renal disease (ESRD) is considered a consequence of elevated fibroblast growth factor 23 (FGF23) and concomitant reduced activity of renal 1α-hydroxylase (CYP27B1). Current ESRD treatment strategies to increase serum calcium and suppress secondary hyperparathyroidism involve supplementation with vitamin D analogues that circumvent 1α-hydroxylase. This overlooks the potential importance of 25-hydroxyvitamin D (25(OH)D) deficiency as a contributor to low serum 1,25(OH)2D. We investigated the effects of vitamin D (cholecalciferol) supplementation (40,000 IU for 12 weeks and maintenance dose of 20,000 IU fortnightly), on multiple serum vitamin D metabolites (25(OH)D, 1,25(OH)2D3 and 24,25(OH)2D3) in 55 haemodialysis patients. Baseline and 12 month data were compared using related-samples Wilcoxon signed rank test. All patients remained on active vitamin D analogues as part of routine ESRD care. 1,25(OH)2D3 levels were low at baseline (normal range: 60–120 pmol/L). Cholecalciferol supplementation normalised both serum 25(OH)D and 1,25(OH)2D3. Median serum 25(OH)D increased from 35.1 nmol/L (IQR: 23.0–47.5 nmol/L) to 119.9 nmol/L (IQR: 99.5–143.3 nmol/L) (P < 0.001). Median serum 1,25(OH)2D3 and 24,25(OH)2D3 increased from 48.3 pmol/L (IQR: 35.9–57.9 pmol/L) and 3.8 nmol/L (IQR: 2.3–6.0 nmol/L) to 96.2 pmol/L (IQR: 77.1–130.6 pmol/L) and 12.3 nmol/L (IQR: 9–16.4 nmol/L), respectively (P < 0.001). A non-significant reduction in daily active vitamin D analogue dose occurred, 0.94 µmcg at baseline to 0.77 µmcg at 12 months (P = 0.73). The ability to synthesise 1,25(OH)2D3 in ESRD is maintained but is substrate dependent, and serum 25(OH)D was a limiting factor at baseline. Therefore, 1,25(OH)2D3 deficiency in ESRD is partly a consequence of 25(OH)D deficiency, rather than solely due to reduced 1α-hydroxylase activity as suggested by current treatment strategies.
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Search for other papers by Mojca Zerjav Tansek in
Google Scholar
PubMed
Search for other papers by Ana Bertoncel in
Google Scholar
PubMed
Search for other papers by Brina Sebez in
Google Scholar
PubMed
Search for other papers by Janez Zibert in
Google Scholar
PubMed
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Search for other papers by Urh Groselj in
Google Scholar
PubMed
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Search for other papers by Tadej Battelino in
Google Scholar
PubMed
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Search for other papers by Magdalena Avbelj Stefanija in
Google Scholar
PubMed
Despite recent improvements in the composition of the diet, lower mineral bone density and overweight tendencies are incoherently described in patients with phenylketonuria (PKU). The impact of dietary factors and plasma phenylalanine levels on growth, BMI, body composition, and bone mineral density was investigated in our cohort of patients with hyperphenylalaninemia (HPA) with or without dietary treatment. The anthropometric, metabolic, BMI and other nutritional indicators and bone mineral density were compared between the group of 96 treated patients with PKU (58 classic PKU (cPKU) and 38 patients with moderate-mild PKU defined as non-classic PKU (non-cPKU)) and the untreated group of 62 patients with benign HPA. Having compared the treated and untreated groups, there were normal outcomes and no statistically significant differences in BMI, body composition, and bone mineral density. Lower body height standard deviation scores were observed in the treated as compared to the untreated group (P < 0.001), but the difference was not significant when analyzing patients older than 18 years; however, cPKU adults were shorter compared to non-cPKU treated adults (P = 0.012). Interestingly, the whole-body fat was statistically higher in non-cPKU as compared to cPKU patients. In conclusion, the dietary treatment ensured adequate nutrition without significant consequences in BMI, body composition, and bone mineral density. A low protein diet may have delayed the growth in childhood, but the treated patients gained a normal final height. Mild untreated hyperphenylalaninemia characteristic for benign HPA had no negative physiological effect on bone mineral density.
Department of Endocrinology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Search for other papers by Lizhi Zhang in
Google Scholar
PubMed
Search for other papers by Jinwei He in
Google Scholar
PubMed
Search for other papers by Xiang Sun in
Google Scholar
PubMed
Search for other papers by Dongyue Pang in
Google Scholar
PubMed
Search for other papers by Jingjing Hu in
Google Scholar
PubMed
Search for other papers by Bo Feng in
Google Scholar
PubMed
We demonstrated previously that there is a correlation between glucagon-like peptide-1 (GLP-1) single-nucleotide polymorphism (SNP) and bone mineral density in postmenopausal women. Both GLP-1 and glucose-dependent insulinotropic peptide are incretins. The glucose-dependent insulinotropic peptide receptor (GIPR) SNP rs10423928 has been extensively studied. However, it is not clear whether GIPR gene mutations affect bone metabolism. The aim of this study was to investigate the association between rs10423928 and bone mineral density in postmenopausal women in Shanghai. rs10423928 was detected in 884 postmenopausal women in Shanghai, and the correlation between the GIPR SNP and bone mineral density was assessed. The dominant T/T genotype of rs10423928 was found to be related to the bone mineral density of the femoral neck (P = 0.035). Overall, our findings indicate that the dominant T/T genotype of rs10423928 in postmenopausal women is significantly associated with a higher bone mineral density and that the T/T genotype exerts a bone-protective effect.
Search for other papers by Martine Cohen-Solal in
Google Scholar
PubMed
Search for other papers by Thomas Funck-Brentano in
Google Scholar
PubMed
Department of Renal Physiology, Necker Hospital, Université de Paris, Paris, France
Search for other papers by Pablo Ureña Torres in
Google Scholar
PubMed
Mineral and bone diseases (MBD) are predominant in patients with chronic kidney disease (CKD) and lead to several bone manifestations, from pain to skeletal fractures. Cumulative traditional clinical risk factors, such as age and gender, in addition to those related to CKD, enhance the risk of comorbidity and mortality related to fractures. Despite great advances in understanding MBD in CKD, clinical and biological targets are lacking, which leads to under-management of fractures. Optimal PTH control results in a net improvement in defining the levels of bone remodeling. In addition, circulating biomarkers such as bone-specific alkaline phosphatase and cross-linked collagen type I peptide will also provide additional information about remodeling rate, bone mineralization and the evaluation of fracture risk. Imaging techniques identify patients at risk by measurement of bone mineral density by DEXA or by high peripheral QCT, which allow the discrimination of trabecular and cortical bone. Here, we have reviewed the literature related to epidemiology and the pathophysiological role of mineral and biochemical factors involved in CKD-MBD with a special focus on fracture risk. We also provide an algorithm that could be used for the management of bone diseases and to guide treatment decisions. Finally, the combined expertise of clinicians from various disciplines is crucial for the best prevention of fractures.
Search for other papers by E M Winter in
Google Scholar
PubMed
Search for other papers by A Ireland in
Google Scholar
PubMed
Search for other papers by N C Butterfield in
Google Scholar
PubMed
Search for other papers by M Haffner-Luntzer in
Google Scholar
PubMed
Search for other papers by M-N Horcajada in
Google Scholar
PubMed
Jan van Goyen Medical Center, Department of Internal Medicine, Amsterdam, the Netherlands
Search for other papers by A G Veldhuis-Vlug in
Google Scholar
PubMed
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
Search for other papers by L Oei in
Google Scholar
PubMed
Search for other papers by G Colaianni in
Google Scholar
PubMed
Search for other papers by N Bonnet in
Google Scholar
PubMed
In this review we discuss skeletal adaptations to the demanding situation of pregnancy and lactation. Calcium demands are increased during pregnancy and lactation, and this is effectuated by a complex series of hormonal changes. The changes in bone structure at the tissue and whole bone level observed during pregnancy and lactation appear to largely recover over time. The magnitude of the changes observed during lactation may relate to the volume and duration of breastfeeding and return to regular menses. Studies examining long-term consequences of pregnancy and lactation suggest that there are small, site-specific benefits to bone density and that bone geometry may also be affected. Pregnancy- and lactation-induced osteoporosis (PLO) is a rare disease for which the pathophysiological mechanism is as yet incompletely known; here, we discuss and speculate on the possible roles of genetics, oxytocin, sympathetic tone and bone marrow fat. Finally, we discuss fracture healing during pregnancy and lactation and the effects of estrogen on this process.
Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Search for other papers by Petar Milovanovic in
Google Scholar
PubMed
Search for other papers by Björn Busse in
Google Scholar
PubMed
An increasing number of patients worldwide suffer from bone fractures that occur after low intensity trauma. Such fragility fractures are usually associated with advanced age and osteoporosis but also with long-term immobilization, corticosteroid therapy, diabetes mellitus, and other endocrine disorders. It is important to understand the skeletal origins of increased bone fragility in these conditions for preventive and therapeutic strategies to combat one of the most common health problems of the aged population. This review summarizes current knowledge pertaining to the phenomenon of micropetrosis (osteocyte lacunar mineralization). As an indicator of former osteocyte death, micropetrosis is more common in aged bone and osteoporotic bone. Considering that the number of mineralized osteocyte lacunae per bone area can distinguish healthy, untreated osteoporotic and bisphosphonate-treated osteoporotic patients, it could be regarded as a novel structural marker of impaired bone quality. Further research is needed to clarify the mechanism of lacunar mineralization and to explore whether it could be an additional target for preventing or treating bone fragility related to aging and various endocrine diseases.
