scholarly journals Effect of Vitamin E Supplement on Bone Turnover Markers in Postmenopausal Osteopenic Women: A Double-Blind, Randomized, Placebo-Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4226
Author(s):  
Sakda Arj-Ong Vallibhakara ◽  
Katanyuta Nakpalat ◽  
Areepan Sophonsritsuk ◽  
Chananya Tantitham ◽  
Orawin Vallibhakara

Vitamin E is a strong anti-oxidative stress agent that affects the bone remodeling process. This study evaluates the effect of mixed-tocopherol supplements on bone remodeling in postmenopausal osteopenic women. A double-blinded, randomized, placebo-controlled trial study was designed to measure the effect of mixed-tocopherol on the bone turnover marker after 12 weeks of supplementation. All 52 osteopenic postmenopausal women were enrolled and allocated into two groups. The intervention group received mixed-tocopherol 400 IU/day, while the control group received placebo tablets. Fifty-two participants completed 12 weeks of follow-up. Under an intention-to-treat analysis, vitamin E produced a significant difference in the mean bone resorption marker (serum C-terminal telopeptide of type I collagen (CTX)) compared with the placebo group (−0.003 ± 0.09 and 0.121 ± 0.15, respectively (p < 0.001)). In the placebo group, the CTX had increased by 35.3% at 12 weeks of supplementation versus baseline (p < 0.001), while, in the vitamin E group, there was no significant change of bone resorption marker (p < 0.898). In conclusion, vitamin E (mixed-tocopherol) supplementation in postmenopausal osteopenic women may have a preventive effect on bone loss through anti-resorptive activity.

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannes Zwickl ◽  
Elisabeth Zwickl-Traxler ◽  
Alexander Haushofer ◽  
Josef Seier ◽  
Klaus Podar ◽  
...  

Abstract Background Increased bone turnover is frequently observed in advanced cancer and predominantly related to bone metastases or therapy. Cachexia represents an important cause of morbidity and mortality in cancer patients. Key features are weight loss, muscle wasting and chronic inflammation, which induce profound metabolic changes in several organs, including the bone. However, whether cachexia contributes to abnormal bone metabolism in cancer patients is unknown. Aim of the present study was to determine the potential correlation of bone turnover markers with body composition and laboratory parameters in treatment-naïve cancer patients. Methods In this cross-sectional study we measured the levels of carboxy terminal telopeptide of collagen (CTX), an indicator of bone resorption, as well as osteocalcin (Ocn) and procollagen type I N-terminal propeptide (PINP), indicators of bone formation, in 52 cancer patients and correlated with body composition and laboratory parameters. Univariate and multivariate logistic analysis were performed to identify determinants of negative bone remodeling balance, estimated by CTX/Ocn and CTX/PINP ratio. Results Based on weight loss, body mass index and muscle mass, patients were divided into a cachectic (59.6%) and a control (40.4%) group. After correcting for the presence of bone metastases, our results showed a significant upregulation of CTX in cachectic patients compared to non-cachectic cancer patients (median 0.38 vs 0.27 ng/mL, p < 0.05), with no difference in Ocn and PINP levels (mean 14 vs. 16 ng/ml, p = 0.2 and median 32 vs. 26 μg/L, p = 0.5, respectively). In addition, the CTX/Ocn and the CTX/PINP ratio were indicative of bone resorption in 68% and 60% of cachexia patients, respectively (vs. 20% and 31% in the control group, p = 0.002 and p = 0.06). The main determinants of the unbalanced bone turnover were hypoalbuminemia for the CTX/Ocn ratio (OR 19.8, p < 0.01) and high CRP for the CTX/PINP ratio (OR 5.3, p < 0.01) in the multivariate regression analysis. Conclusions CTX is substantially higher in cachectic patients compared to non-cachectic oncological patients and hypoalbuminemia as well as elevated CRP concentrations are independent predictors of a negative bone remodeling balance in cancer patients. These results strongly indicate that cachexia correlates with exacerbated bone turnover in cancer.


Lupus ◽  
2021 ◽  
Vol 30 (6) ◽  
pp. 965-971
Author(s):  
Wang Tianle ◽  
Zhang Yingying ◽  
Hong Baojian ◽  
Gu Juanfang ◽  
Wang Hongzhi ◽  
...  

Objectives SLE is a chronic autoimmune disease, which can affect the level of bone metabolism and increase the risk of osteoporosis and fracture. The purpose of this research is to study the effect of SLE on bone turnover markers without the influence of glucocorticoids. Methods A total of 865 female subjects were recruited from Zhejiang Provincial People’s Hospital and the First Hospital of Jiaxing, including 391 SLE patients without the influence of glucocorticoids and 474 non-SLE people. We detected Bone turnover markers including amino-terminal propeptide of type 1 procollagen (P1NP), C-terminal turnover of β - I collagen (β-CTX), N-terminal midfragment of osteocalcin (NMID) and 25(OH)D, and analyzed the difference in Bone turnover markers between the SLE group and the control group, as well as the influence of age and season on bone metabolism in female SLE patients. Results In the SLE group, the average age was 43.93±13.95 years old. In the control group, the average age was 44.84±11.42 years old. There was no difference between the two groups (t = 1.03, P = 0.30). P1NP, NMID and 25(OH)D in the SLE group were significantly lower than those in the control group (Z = 8.44, p < 0.001; Z = 14.41, p < 0.001; Z = 2.19, p = 0.029), and β-CTX in the SLE group was significantly higher than that in the control group (Z = 2.61, p = 0.009). In addition, the levers of β-CTX, NMID, P1NP and 25(OH)D in older SLE female patients were statistically significantly higher than those in younger (ρ = 0.104, p = 0.041; ρ = 0.223, p < 0.001; ρ = 0.105, p = 0.038; ρ = 0.289, p < 0.001). Moreover, β-CTX reached a high value in summer and PINP reached a low value in winter. Conclusion The bone formation markers of female SLE patients without glucocorticoid were lower than those of normal people and the bone resorption marker was higher than that of normal people. The 25 (OH) D of female SLE patients without glucocorticoid was lower than that of normal people. The risk of osteoporosis and fracture may be higher in elderly women with SLE. The bone resorption level of female SLE patients is high in summer and the bone formation level is low in winter.


2014 ◽  
Vol 99 (2) ◽  
pp. 491-497 ◽  
Author(s):  
Juan P. Valderas ◽  
Oslando Padilla ◽  
Sandra Solari ◽  
Manuel Escalona ◽  
Gilberto González

Context: Roux-en-Y gastric bypass (RYGB) is associated with high bone turnover. In healthy subjects, feeding causes acute reduction of bone resorption, which is regulated by several intestinal and pancreatic peptides. Objective: Our objective was to assess bone turnover after feeding in patients with RYGB. Design and Setting: This was a cross-sectional case-control study at a university hospital. Participants: Fifteen postmenopausal women who underwent RYGB 7.4 ± 4.1 years previously were matched by age and body mass index with 15 nonoperated women (controls). Main Outcomes: Serum PTH, calcium, phosphorus, insulin, carboxy telopeptide (CTX), procollagen type I N-terminal propeptide (P1NP), and glucagon-like peptide 2 (GLP-2) were measured while fasting and after a standard meal (SM). Results: The fasting calcium, phosphorus, and PTH were similar in both groups and exhibited similar decreases after an SM. The fasting CTX level was higher in the RYGB than in the control group (0.589 ± 0.18 vs 0.382 ± 0.11 ng/mL; P &lt; .05) and fell to a nadir of 42.2% of the basal value in the RYGB and 53.9% in controls (P &lt; .05). The fasting and postprandial P1NP levels were similar in both groups and fell to a nadir of 85.8% in the RYGB and 89.3% in controls. Insulin and GLP-2 levels were similar during fasting in both groups. RYGB patients had exaggerated postprandial insulin and GLP-2 response compared with the controls with the insulin and GLP-2 area under the curve being significantly higher in the RYGB group. There was a significant negative correlation between the peak of insulin levels and the CTX changes. Conclusion: The acute reduction in bone resorption after feeding is preserved in RYGB and is even higher than in nonoperated subjects. This phenomenon is related to the increase of postprandial levels of insulin. These findings suggest a bone-protecting mechanism in RYGB that may counteract the elevated bone resorption that occurs during fasting.


2017 ◽  
Vol 39 (1) ◽  
pp. 53-56 ◽  
Author(s):  
D Auzina ◽  
S Lejniece

Background: Multiple myeloma (MM) is characterized by osteolytic bone disease resulting from increased osteoclast activity and reduced osteoblast function. Aim: The aim of our research was to determine connection between bone turnover markers and presence of bone lesions, their degree of severity, to monitor MM bone disease and to assess effectiveness of anti-myeloma treatment. Materials and Methods: Serum samples and clinical data from 123 patients with newly diagnosed MM were collected at Riga East Clinical University Hospital (Riga, Latvia) from June 2014 to June 2016. Bone lesions detected by radiography, CT scans, MRI, and PET/CT were divided into degrees from 0 to 3 (0 — no bone involvement, 1 — ≤ 3 bone lesions, 2 — ≥ 3 bone lesions, 3 — fracture). Staging was performed applying Durie/Salmon (DS) and International Staging System classifications. Progressive disease was defined as development of one or more new bone lesions. The levels of bone metabolic markers β-isomerized C-terminal telopeptide of collagen type I (β-CTX) and bone-specific alkaline phosphatase (bALP) were monitored regularly in the year. Results: Bone lesions were found in 86 (69%) patients. From these 6 (4%) patients had 1st degree, 11 (9%) had 2nd degree and 69 (56%) had 3rd degree bone lesions. Level of the bone resorption marker β-CTX in the control group was 0.41 ng/ml, which is lower than in MM patients (p < 0.001). Spearman correlation coefficient analysis found a positive and statistically significant correlation (rs = 0.51, p < 0.001) between bone lesions degree and β-CTX levels. Mean β-CTX for patients without bone lesions was 0.72 ng/ml (SD = 0.64), but for patients with 3rd degree bone lesions it was 1.34 ng/ml (SD = 0.65) difference being 38% (p < 0.001). In patients who responded to therapy after 6 months of treatment reduction of β-CTX was found compared to baseline values (M = –0.65). In contrast, in patients who did not respond to therapy, there was a statistically significant (p < 0.001) increase in β-CTX values after six months of treatment compared to baseline values (M = 0.42). Exact cutoff value of β-CTX is 0.79. When analyzing mean bALP, no significant difference between MM patients and control group was found. ANOVA statistical analysis showed no statistically significant differences in bALP levels at different degrees of bone lesions (p = 0.95) in MM patients. Analysis of bALP suitability as MM diagnostic marker using receiver operating characteristics curve showed that bALP is not applicable for clinical diagnosis of MM (AUC 0.5, p > 0.05). However, β-CTX was found to be an excellent diagnostic marker for MM (AUC 0.91; 95% confidence interval, 0.88–0.94; p < 0.001). Conclusions: Patients with MM and bone lesions have increased value of bone resorption marker β-CTX. There is a correlation between bone resorption marker and degree of bone lesions. Changes in β-CTX levels may be used to monitor the effectiveness of myeloma treatment.


2021 ◽  
Vol 9 (B) ◽  
pp. 116-121
Author(s):  
Marwa Mostafa Ahmed ◽  
Eman Ahmed Rushdy ◽  
Dalia Ahmed Aboul Azm ◽  
Rehab Mohamed Sabry ◽  
Heba Galal El Nahas

BACKGROUND: Fibrocystic changes (FCCs) of the breast are a common breast condition. Mastalgia is the most common symptom of FCC; it usually causes fear of breast cancer and has negative effects on the quality of life. AIM: The objective of the research was to establish the effect of cosupplementation of omega-3 plus Vitamin E on mastalgia in FCC patients, to evaluate its effect with that of Vitamin E only, and to determine the effect of omega-3 plus Vitamin E versus Vitamin E only on the radiological findings in FCC patients. METHODS: This randomized controlled trial was conducted on 120 FCC patients with mastalgia. The participants were randomly assigned into three groups: Omega-3 plus Vitamin E group, Vitamin E only group, and control group. The new breast pain chart was used to assess the severity of mastalgia in the three groups before, through, and after intervention. Radiological assessment was done before and after the intervention. RESULTS: After 3 months of the intervention, there was a statistically significant difference between the three groups regarding radiological results with p > 0.05 and, after the 3rd month of interventions, there was a statistically significant difference between the groups regarding the new pain score with p > 0.001. The median of the new pain score premenstrual was 4.8, 2, and 2.5 in control, omega-3 plus Vitamin E, and Vitamin E only, respectively, but this difference was insignificant between the last two groups (p < 0.996). CONCLUSION: This study showed that Vitamin E and Vitamin E plus omega-3 were effective in relieving mastalgia in FCC patients. However, the addition of omega-3 was ineffective.


1999 ◽  
Vol 84 (1) ◽  
pp. 179-183
Author(s):  
K. M. Prestwood ◽  
D. L. Thompson ◽  
A. M. Kenny ◽  
M. J. Seibel ◽  
C. C. Pilbeam ◽  
...  

Previous studies have shown that treatment with estrogen or calcium decreases bone turnover in older women. The mechanisms by which estrogen and calcium exert their effects are probably different. We therefore examined the possibility of an additive or synergistic effect of combined treatment with calcium and low dose estrogen on bone turnover in older women, using biochemical markers. Thirty-one healthy women over 70 yr of age were randomized to 12 weeks of treatment with either micronized 17β-estradiol [0.5 mg/day Estrace (E2)] or 1500 mg/day elemental calcium, given as carbonate plus vitamin D (800 IU/day; Ca+D). At the end of the initial 12-week treatment period, both groups received both Ca+D and E2 for an additional 12 weeks. Eleven older women were followed for 36 weeks without any treatment and served as a control group. Serum and urine were collected at baseline, at 12 and 24 weeks on treatment, and at 12 weeks after treatment was terminated for measurement of biochemical markers of bone turnover. Markers of bone formation were bone alkaline phosphatase, osteocalcin, and type I procollagen peptide; markers of bone resorption were urinary cross-linked C-telopeptides and N-telopeptides of type I collagen, serum cross-linked N-telopeptides of type I collagen, urinary free deoxypyridinoline cross-links, and serum bone sialoprotein. Repeated measures ANOVA was used to determine changes in bone turnover measures over time by group. All markers of bone resorption decreased with initial treatment and decreased further with combination therapy (P &lt; 0.001). Markers of bone formation decreased with Ca+D treatment, but not with E2 alone; there was no additional effect of combination therapy on formation markers compared to Ca+D alone. Neither markers of formation nor resorption changed in the control group. These results suggest that there is an additive effect of low dose estrogen and calcium on bone resorption, but not on bone formation, in older women. Thus, the combination of low dose estrogen plus calcium is likely to be more effective in older women than either treatment alone.


2016 ◽  
Vol 23 (01) ◽  
pp. 114-118
Author(s):  
Rana Ata ur Rehman ◽  
Muhammad Muzammil Tahir ◽  
Muhammad Seerwan

Introduction: Cystoscopic intraluminal placement of ureteral stents has become a routine practice in urology. Ureteral stents preserve urine flow from the kidney to the bladder in cases of ureteral obstruction (intrinsic or extrincis). In patients with obvious ureteral obstruction, the placement of a ureteral stent will restart urine transport and protect the kidney from possible risks. Ureteral stents are troublesome in some patients and causes LUTS. Study Design: Prospective randomized controlled trial. Setting: Urology Department, Sheikh Zayed Hospital Lahore. Period: Six month started from August 2015 to December 2015. Material and Methods: 100 patients who were randomly divided into two equal groups. The patients were between 18 to 50 years of age of both gender undergo retrograde double-J ureteral stent placement. Before the double-J stent will be applied, all patients completed an International Prostate Symptom Score (IPSS) questionnaire for evaluation of lower urinary tract symptoms.Patients were divided in two groups on the basis of lottery method tamsolusin group (1) and placebo group (2). Tamsulosin group patients was given tamsulosin post operatively and placebo group was given a placebo postoperatively. Results: There were total 100 patients who were enrolled in this study with a mean age of 42.63±6.24. There were 75(75%) were male while 25(25%) were female. The mean IPSS sore at presentation was 2.47±1.43 and post treatment was 5.20±1.65. There was significant difference in IPSS score in control group with mean 5.28±1.69 versus study as mean 2.22±1.05 group, p-value= 0.010. Conclusion: There is difference in lowering of IPSS score in the patients who are given tamsolusin versus those who were retained on placebo.


2018 ◽  
Vol 35 (3) ◽  
pp. 24-31
Author(s):  
S. S. Safarova

Aim. To assess the influence of changes, observed in men and women with type 1and 2 diabetes mellitus (DM1, DM2) on the state of bone metabolism markers; to determine the directions of changes in bone remodeling serum markers among patients of both genders, suffering from this disease. Materials and methods. The cross-sectional study of patients, diagnosed DM1 (n = 98) and DM2 (n = 137) was conducted; the control group included 82 persons. In all patients, calciotropic hormones, the serum markers of bone remodeling, were studied. Results. The obtained results, regarding assessment of bone metabolism markers content in blood of DM1 and DM2 patients compared to the control, indicated the presence of pathological changes in bone remodeling processes in the form of decrease in osteogenesis marker PINP for patients with DM1 by 16 %, DM 2 – by 12 %, compared with the control group, and increase in bone resorption marker b-CTx in 32 % of patients with DM1 and 25 % with DM2; inconsistency of changes in bone remodeling processes in DM1 patients, with preferential alterations of bone resorption indices, was determined in 28 % of cases. Patients with DM2 had lower PINP and b-CTx levels that reflects the lower bone tissue metabolism, compared to DM1 patients, irrespective of age and duration of disease. Conclusions. The bone mass loss in the majority of the examined patients with diabetes is connected with suppression of osteogenesis and to a significantly lesser extent – with bone tissue resorption. Bone remodeling marker values in patients with DM2 are lower than with DM1. Such factors as glycemic profile compensation, duration of diabetes and presence of diabetic nephropathy are able to influence bone metabolism.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jeong-Su Park ◽  
Sunju Park ◽  
Chun-Hoo Cheon ◽  
Seong-Cheon Jo ◽  
Han Baek Cho ◽  
...  

Objective. This study was a multicenter, randomized, double-blind, and controlled trial with two parallel arms: the GJBNH group and the placebo group. This trial recruited 100 women aging 18 to 35 years with primary dysmenorrhea caused by blood stagnation. The investigational drugs, GJBNH or placebo, were administered for two menstrual periods (8 weeks) to the participants three times per day. The participants were followed up for two menstrual cycles after the administration.Results. The results were analyzed by the intention-to-treat (ITT) dataset and the per-protocol (PP) dataset. In the ITT dataset, the change of the average menstrual pain VAS score in the GJBNH group was statistically significantly lower than that in the control group. Significant difference was not observed in the SF-MPQ score change between the GJBNH group and the placebo group. No significant difference was observed in the PP analyses. In the follow-up phase, the VAS scores of the average menstrual pain and the maximum menstrual pain continually decreased in the placebo group, but they increased in the GJBNH group.Conclusion. GJBNH treatment for eight weeks improved the pain of the dysmenorrhea caused by blood stagnation, but it should be successively administered for more than two menstrual cycles.Trial Registration. This trial is registered with Current Controlled Trials no.ISRCTN30426947.


2011 ◽  
Vol 164 (6) ◽  
pp. 1035-1041 ◽  
Author(s):  
Maria P Yavropoulou ◽  
Konstantinos Tomos ◽  
Xanthippi Tsekmekidou ◽  
Olympia Anastasiou ◽  
Pantelis Zebekakis ◽  
...  

ObjectivePostprandial suppression of bone resorption is considered one of the main contributors in the circadian rhythm of bone turnover markers. The aim of this study was to investigate this physiological response of bone tissue in diseases that affect bone metabolism.Patients and methodsIn this study, 118 patients (45 hypothyroid, 40 hyperthyroid, and 33 β-thalassemic patients) and 78 healthy individuals matched for age and body mass index were included. An oral glucose test (75 g glucose) was performed after overnight fasting. Serum levels of procollagen type-I N-terminal propeptide (P1NP), β-C-terminal telopeptide of type I collagen (β-CTX), and osteocalcin were assayed at 0, 60, and 120 min.ResultsBaseline values of bone turnover markers were significantly elevated in hyperthyroid and β-thalassemic patients but not in hypothyroid patients compared with the control group. After oral glucose, the levels of β-CTX but not P1NP or osteocalcin were significantly suppressed in all groups (mean change from baseline is 46.9% for β-CTX, 7.9% for P1NP, and 8% for osteocalcin). The percentage change from baseline for β-CTX was significantly augmented in hypothyroidism (52 vs 42%, P=0.009).ConclusionThe preservation or even augmentation of postprandial suppression of bone resorption in diseases that affect bone metabolism through distinct pathogenetic mechanisms suggests the importance of this physiological response to nutrients for the general homeostasis and functional integrity of the skeleton.


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