25-hydroxyvitamin-d-2 and Osteoarthritis

Studies indicate that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with a range of disease processes, many of which are inflammatory. However, other lipid-soluble vitamins decrease during the systemic inflammatory response, and this response may confound the interpretation of plasma 25(OH)D.. The objective was to examine whether plasma 25(OH)D concentrations change during evolution of the systemic inflammatory response.. Patients (n = 33) who underwent primary knee arthroplasty had venous blood samples collected preoperatively and postoperatively (beginning 6-12 h after surgery and on each morning for 5 d) for the measurement of 25(OH) D, vitamin D-binding protein, parathyroid hormone (PTH), calcium, C-reactive protein, and albumin. A final sample was collected at 3 mo.. Preoperatively, most patients were 25(OH)D deficient (<50 nmol/L) and had secondary hyperparathyroidism (PTH > 5 pmol/L). Age, sex, body mass index, season, medical history, and medication use were not associated with significant differences in preoperative plasma 25(OH)D concentrations. By day 2 there was a large increase in C-reactive protein concentrations (P < 0.001) and a significant decrease in 25(OH)D of ≈40% (P < 0.001). C-reactive protein, 25(OH)D, and calculated free 25(OH)D had not returned to preoperative concentrations by 5 d postoperatively (all P < 0.001). At 3 mo, 25(OH)D and free 25(OH)D remained significantly lower (20% and 30%, respectively; P < 0.01).. Plasma concentrations of 25(OH)D decrease after an inflammatory insult and therefore are unlikely to be a reliable measure of 25(OH)D status in subjects with evidence of a significant systemic inflammatory response.

Topics: 25-Hydroxyvitamin D 2; Aged; Aged, 80 and over; Algorithms; Arthroplasty, Replacement, Knee; C-Reactive Protein; Calcifediol; Elective Surgical Procedures; Female; Humans; Hyperparathyroidism, Secondary; Male; Middle Aged; Nutritional Status; Osteoarthritis; Statistics, Nonparametric; Systemic Inflammatory Response Syndrome; Time Factors; Vitamin D Deficiency; Vitamin D-Binding Protein

Age-related bone loss in men is receiving increased attention. In light of this, animal models for male bone loss are desirable. This study examined the effects of age and osteoarthritis (OA) on bone mineral content (BMC), bone mineral density (BMD), and markers of bone turnover and skeletal relevance in 56 male rhesus monkeys 4-34 years of age. BMC and BMD increased at all sites from 4 to 10 years of age. Male rhesus monkeys reach peak bone mass at approximately 10 years of age after which bone mass is lower at the lateral spine and distal radius. Markers of bone turnover (osteocalcin and carboxyterminal telopeptide of type I collagen [ICTP]) decreased with age. There was no relationship between PTH, 25-hydroxyvitamin D, FSH, or testosterone and age. With advancing age, the prevalence of lumbar spine OA increases dramatically, masking decreases in posteroanterior spine bone mass that are clear in the lateral projection. These data suggest that male rhesus monkeys sustain age-related bone loss in the absence of nutritional or gonadal steroid deficiencies. These animals may prove useful in studying the mechanisms of age-related bone loss.

Topics: 25-Hydroxyvitamin D 2; Absorptiometry, Photon; Aging; Alkaline Phosphatase; Animals; Biomarkers; Bone Density; Collagen; Collagen Type I; Disease Models, Animal; Lumbar Vertebrae; Macaca mulatta; Male; Osteoarthritis; Osteocalcin; Osteoporosis; Peptides; Testosterone